2.1.2 Surgery
At surgery, a one stage umbilical vein marsupialization was performed
due to a severely enlarged and friable umbilical vein that continued
into the liver.8 The colt was placed in dorsal
recumbency. A fusiform-shaped skin incision was made around the
umbilicus and sharp dissection was used to enter the abdomen. The
umbilical vein was transected as far cranial as possible without leading
to contamination. The umbilical vein remnant was exteriorized through a
secondary 6 cm incision to the right of midline. The vein
marsupialization was sutured in place with simple interrupted sutures
using 2-0 poliglecaprone 25 to the abdominal wall, subcutaneous tissue
and skin. An abdominal lavage with sterile physiologic saline was
performed prior to ventral midline incision closure. The incision was
closed in a simple continuous pattern –2 USP polyglactin 910 for linea
alba, 2-0 USP poliglecaprone 25 for subcutaneous layer, 2-0 USP
poliglecaprone 25 for skin. An Ioban bandage was placed over the
marsupialization and omphalectomy incisions for recovery.
Post-operatively the foal was continued on antibiotics and omeprazole
for 6 days. Flunixin meglumine was continued for 3 days.
The umbilical vein was rinsed in dilute chlorhexidine solution twice
daily during hospitalization. The foal was discharged alive after 6 days
of hospitalization on trimethoprim sulfamethoxazole (30 mg/kg, orally, q
12 hours) for 7 days and twice daily spraying of the marsupialization
site with dilute chlorhexidine solution.