Uroperitoneum in foals

Abstract

Uroperitoneum in foals is the accumulation of urine in the abdominal cavity, most frequently as a consequence of urinary bladder rupture or a patent urachus. The aetiology is not fully known, but it is considered a result of trauma rather than a congenital condition. Currently, the best known treatment is by surgery under general anaesthesia, in which even healthy foals are at high risk and require individual assessment as well as extra care compared to mature horses. One major concern during anaesthesia is waste material and electrolytes from the urine accumulated in the abdomen, diffusing across the peritoneal lining and reentering the bloodstream, causing life threatening electrolyte and pH disturbances. Direct life preserving and specific treatment related to correcting these disturbances should be employed before inducing anaesthesia. Anaesthetic protocol should be tailored to accommodate the serum biochemistry derangements of each individual case, much relying on the knowledge and experience of the anaesthesiologist. Surgeons need to be aware of foals that relapse and require follow up surgeries are at increased risk of death due to adhesions and their already deteriorated general condition. Every precautionary measure should be taken in order to prevent having to perform multiple surgeries on the same animal, even if it means taking some extra time during the initial surgery. When detected early, and managed appropriately, the prognosis of survival is quite good.