When nature calls at the wrong time.

New minimally invasive surgery will repair ruptured bladders in foals

An article by Clare Illingworth, SPARK writer, University of Guelph.


Like all babies, foals are often born with a full bladder. During delivery, a strong contraction by the mare can burst the baby’s bladder, putting newborns in grave danger and requiring immediate surgery. University of Guelph surgeons are exploring the use of a new technique to repair the problem while boosting a foal’s chance of survival.

Prof. Ludovic Bour? of the Department of Clinical Studies is determining if laparoscopy, a minimally invasive technique, will improve recovery success compared with the currently used laparotomy method

“Current surgical treatment may be considered invasive and can cause com-plications,” says Bour?. “We would like to determine if the less invasive laparoscopy avoids many of the complications now experienced.”

Symptoms of a ruptured bladder can go unnoticed for several days. The split most often occurs on the top and down the middle, making it difficult to access with con-ventional surgical techniques. Eventually, the foal begins to stand in the urinating position without success, and the belly begins to fill with urine, causing toxic side effects. When that happens, surgeons have to act fast.

During laparotomy, the belly must be opened. That puts the horse at risk of infec-tion as well as adhesions (caused by outer surfaces of the bowels joining together, limiting normal bowel movement and interrupt-ing digestive flow). These adhesions can lead to chronic abdominal pain and colic, a potentially deadly digestive problem in horses.

Laparoscopy, on the other hand, requires only three one centimetre incisions, through which the veterinarian inserts long instru-ments and a small video camera to guide the surgery. To manoeuvre the camera, which is mounted on a stiff bendable wand, the surgeons add carbon dioxide to the abdomen to give them more room to work. This less-inva-sive technique lowers the risk of adhesions and infections.

It is not, however, without its own dangers, says Bour?. To carry out this procedure, surgeons have to work with the foal on its back on a tilted table. The table incline moves the digestive tract forward away from the bladder, giving surgeons more manoeuvrability. But this position puts strain on blood flow to the heart, potentially compromising the cardiovascular system in the young foal.

“Although both procedures have down-falls, we hope to determine which technique offers the best hope of survival for these critically ill foals,” says Bour?.

Others involved in this project are clinical studies professors Carolyn Kerr and Simon Pearce and graduate student Jennifer Lans-downe. This research was sponsored by the Ontario Ministry of Agriculture and Food.