# Short- and Long-Term Outcome of 71 Foals Undergoing Omphalectomy with Peritonealization of Arterial Stumps

## TL;DR

This study shows that a specific surgical technique for umbilical disorders in baby horses is safe and leads to good short- and long-term outcomes.

## Contribution

The study provides evidence that peritonealization of arterial stumps during omphalectomy reduces long-term abdominal complications in neonatal foals.

## Key findings

- 83.1% of foals survived to hospital discharge after the surgery.
- Only 6.4% of foals experienced colic after discharge, with minimal cases linked to adhesions.
- Most foals successfully began their intended athletic activities after recovery.

## Abstract

Umbilical disorders are common in neonatal foals and may involve infection of the umbilical vessels or urachal structures, potentially leading to severe systemic complications. Although medical management is often attempted initially, surgical intervention is frequently required in complicated cases. Abdominal surgery in neonatal foals is traditionally considered high risk, particularly because of concerns regarding postoperative infection and intra-abdominal adhesion formation, which may result in colic later in life. This study evaluated the short- and long-term outcomes of 71 neonatal foals that underwent surgical removal of umbilical structures using a technique that included peritonealization of the umbilical arterial stumps. Most foals survived to hospital discharge, and deaths were mainly related to severe concurrent illnesses rather than the surgery itself. Long-term follow-up showed that only a small number of foals developed colic after surgery, and only one case was diagnosed with abdominal adhesions. Most foals for which sport activity follow-up was available started their expected athletic activity. These results suggest that this surgical technique is safe and may help reduce long-term abdominal complications associated with adhesions, improving both animal welfare and future performance.

Umbilical remnant disorders are common in neonatal foals and may require surgical intervention when complicated by infection or urinary involvement. Abdominal surgery in this population is often considered high risk, particularly due to postoperative complications and adhesion formation. The aim of this retrospective observational study was to evaluate the short- and long-term outcomes of foals undergoing omphalectomy with peritonealization of the umbilical arterial stumps. Medical records of foals younger than 30 days treated surgically between 2005 and 2025 were reviewed. Data regarding signalment, diagnosis, comorbidities, postoperative complications, and short-term survival were collected. Long-term follow-up was obtained by owner interview to assess post-discharge colic episodes and if they started their intended athletic activity. Seventy-one foals met the inclusion criteria. Overall, 83.1% survived to hospital discharge. Mortality was significantly associated with the presence of concurrent comorbidities and postoperative complications, but not with age or sex. Long-term follow-up was available for a subset of foals; post-discharge colic was reported in 6.4% of cases, with only one foal developing colic considered compatible with postoperative adhesions. Most foals with available follow-up successfully started their expected athletic activity. These findings suggest that omphalectomy with peritonealization of the umbilical arterial stumps is associated with favorable short- and long-term outcomes and may represent a safe surgical option in neonatal foals.