ISSN 2398-2977      

Urachus: patent

pequis

Synonym(s): Urachal fistula


Introduction

  • Cause: congenital and acquired forms of failure of the urachus to occlude at the umbilicus.
  • Acquired types may be associated with systemic debilitation and/or umbilical infection.
  • Signs: Presents within first 2 weeks of life with moist umbilicus and leakage of urine from the patent urachus.
  • In acquired forms may be severe systemic signs in compromised neonatal foal.
  • Diagnosis: history, signs.
  • Treatment: is usually medical with antibiotic therapy, local umbilical cleaning/skin protection, possibly cautery, primary problem care and surgical resection of the umbilical remnants with persistent cases.
  • Prognosis: guarded in systemically ill foals.

Pathogenesis

Etiology

  • Congenital or acquired.

Pathophysiology

Congenital urachus syndrome
  • Urachus never closes at birth.
  • Unknown etiology possibly due to distention from cord torsionin uteroor during delivery leading to tension of the umbilicus, dilation of the urachus and preventing occlusion.
    Acquired urachus syndrome
  • Re-opens post-partum as the dried umbilical stump falls off.
  • Associated with umbilical infection/inflammation or excessive use of concentrated iodine dip resulting in premature sloughing of umbilical stump.
  • Excessive wetness or trauma to the umbilical stump in the recumbent foal.
  • Prolonged recumbency in debilitated foal.
  • Poor/inexperienced cord ligation or severance. Ligature, if not removed may result in premature sloughing of stump.
  • Any cause of increased intra-abdominal pressure, eg meconium retention   Rectum: meconium impaction  (tenesmus, dysuria etc).
  • Urine leakage   →   persistent irritation and potential source of infection.
  • Congenital forms are present at birth.

Timecourse

  • Acquired forms develop in the first 2 weeks of life.

Diagnosis

This article is available in full to registered subscribers

Sign up now to obtain ten tokens to view any ten Vetlexicon articles, images, sounds or videos, or Login

Treatment

This article is available in full to registered subscribers

Sign up now to obtain ten tokens to view any ten Vetlexicon articles, images, sounds or videos, or Login

Prevention

This article is available in full to registered subscribers

Sign up now to obtain ten tokens to view any ten Vetlexicon articles, images, sounds or videos, or Login

Outcomes

This article is available in full to registered subscribers

Sign up now to obtain ten tokens to view any ten Vetlexicon articles, images, sounds or videos, or Login

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Smith M (2006) Management of umbilical disorders in the foal. In Pract 28 (5), 280-287 VetMedResource.
  • Reef V B, Collatos C, Spencer P A et al (1989) Clinical, ultrasonographic, and surgical findings in foals with umbilical remnant infections. JAVMA 195 (1), 69-72 PubMed.
  • Reef V B & Collatos C (1988) Ultrasonography of umbilical structures in clinically normal foals. Am J Vet Res 49 (12), 2143-2146 PubMed.
  • Richardson D W (1985) Urogenital problems in the neonatal foal. Vet Clin North Am Equine Pract (1), 179-188 PubMed.
  • Richardson D W & Kohn C W (1983) Uroperitoneum in the foal. JAVMA 182 (3), 267-271 PubMed
  • Ford J & Lokai M D (1982) Ruptured urachus in a foal. Vet Med Small Anim Clin 77 (1) 94-95 PubMed.

Other sources of information

  • Barrelet A (1999) Investigation and management of foal umbilical disorders. In: Proc 38th BEVA Congress. pp 8-10.

Can’t find what you’re looking for?

We have an ever growing content library on Vetlexicon so if you ever find we haven't covered something that you need please fill in the form below and let us know!

 
 
 
 

To show you are not a Bot please can you enter the number showing adjacent to this field

 Security code