Surgical Management of Pervious Urachus - A Report of Six Gir calves.
Keywords: Gir calves; pervious urachus
Before birth, urinary bladder communicates with allantois through urachus which becomes atrophied and its lumen gets obliterated after parturition (Laverty and Salisbury, 2002). Complete failure of urachal lumen obliteration throughout its length results in development of pervious urachus (Langan et al., 2001). Treatment of patent urachus usually consists of topical intra-urachal cauterization or surgical correction of umbilical remnants if complicated by spread of infection to intra-abdominal structures (Grover and Godden, 2011).
The disorder is sometimes accompanied by urethral obstruction and consequently uroperitoneum, deteriorated animal condition and could be life threatening. Usually pervious urachus is accompanied by omphalitis, omphalophlebitis, urachitis and uroperitoneum. Calves with this condition show dribbling of urine from umbilicus and area surrounding it remained wet (Anjaneya et al., 2016). The paper records, surgical management of pervious urachus in six Gir calves.
Materials and Methods
Six Gir calves (5 females and 1 male) of age less than two weeks were presented with history of urine dribbling from umbilicus besides from external urethral orificies. Upon presentation, visual examination of cases too revealed free flow of urine through the external urethral orifices and dribbling of urine from umbilicus. No any systemic infections were noticed in all calves. Gynaecological and andrological examinations revealed normal structures of vulvo-vagina like clitoris, external urethral orifices, penis and prepuce.
The condition was diagnosed as pervious urachus and decided to perform surgical correction. In all the calves physiological, haematological and biochemical parameters were well within the normal ranges. On careful clinical examination, the openings of urachus and umbilicus could be identified individually. Caudal to umbilicus, a hard cord like structure could be palpated (Fig. 1).
Treatment and Discussion
In all calves, prophylactic antimicrobial and analgesic therapies were given with Ceftriaxone and Meloxicam, 10 mg/kg and 0.2 mg/kg intramuscularly respectively. Surgical site was antiseptically and local analgesia was achieved by 2% Lignocaine hydrochloride, 1ml/cm area (Fig. 2). In female calves, linear incision of skin (Fig. 3) was given posterior to umbilicus on mid ventral line on lineal alba where as in male calf the skin incision posterior to umbilicus near to prepucal orifice. After separation of skin, fascia, lineal alba, the urachus and blood vessels were identified (Fig. 4). The urachus was traced up to the bladder and was ligated by chromic catgut number 2 absorbable sutures as close to the bladder as possible (Fig.5) and then the same was resected. The abdominal rent was closed by simple interrupted suture on linea alba followed by continuous lock stich of subcutaneous tissue using number 1 polyglactin (Fig. 6) and number 2-0 chromic catgut respectively and skin edges were approximated by a series of horizontal mattress sutures with sterile black braided silk number 2. The urachus and peritoneum were free from infection in all calves. Post-operatively, same antimicrobial and analgesic therapy was continued for 5 days and 3 days respectively. All calves showed normal urination from their external urethral opening after the procedure. Antiseptic dressing was continued till healing of abdominal wound. Skin sutures were removed on tenth post-operative days. All calves recovered uneventfully.
Pervious urachus occurs most frequently in foals and is less prevalent in calves (Potter, 2007). As in foals, omphalitis often accompanies patent urachus and is believed to be involved in its pathogenesis. In calves, the spread of infection to intra-abdominal umbilical remnants is commonly seen (Baird, 2008). Pervious urachus was reported as a common anomaly in domestic foals (Mc Gavin et al., 2001), cow calves (Dilip kumar and Dhage, 2010) and as a rare finding in buffalo calves (Mouli, 1988, Sharma and Singh, 2004). Etiological factors responsible for the condition may be failure of urachal involution, neonatal omphalitis, umbilical abscess and congenital urethral obstruction (Mc Gavin et al., 2001). If the urachus remains open for longer period it may act as source of ascending infections to bladder (Langan et al, 2001) which was not found in this study. No systemic infections were noticed in any of the cases which could be attributed to their early presentation. Contrary to this, Anjaneya et al. (2016) observed uroperitoneum, cystitis, umbilical cord infection and urinary obstruction in cow calf with pervious urachus.
Urethra was considered to be patent in all calves as the animals were voiding urine through urethral opening at vulva and penis besides urachal opening at umbilicus. Prognosis of pervious urachus is grave when the urethra is permanently occluded (O'Connor, 1980). In this study, urachus was ligated close to bladder and excised as suggested by Oehme and Prier, (1974). In all animals, umbilicus was retained during surgery to conserve the normal appearance of animal so that there will not be any depreciation in the cost of animal. Treatment procedures like application of blister around the orifice, needle point firing, ligation of urachus, inserting a needle suture were advised by O'Connor, (1980) to treat pervious urachus condition where as Sharma and Singh (2004) suggested application of 90% phenol dipped cotton swab over the urachus as a conservative method of treatment. As the calf owner who owns these animals wanted a permanent remedy and as there were no complications, conservative therapy could not be even thought off and surgery was performed. After all, early diagnosis and surgical intervention of patent urachus in all calves ensured uneventful recovery.
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J.V. Vadalia (1), N.R. Padaliya (2), Vineet Kumar (2), V.D. Dodia (2) and K.S. Gameti (2)
Department of Veterinary Surgery and Radiology College of Veterinary Science and Animal Husbandry Junagadh Agricultural University (JAU) Junagadh - 362001 (Gujarat)
(1.) Assistant Professor and Corresponding author.
(2.) Assistant Professor
Junagadh Agricultural University and Animal Nutrition Society of India invites all for XVIIth Biennial Conference of Animal Nutrition Society of India (ANSI) on the theme
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|Title Annotation:||Clinical Article|
|Author:||Vadalia, J.V.; Padaliya, N.R.; Kumar, Vineet; Dodia, V.D.; Gameti, K.S.|
|Article Type:||Clinical report|
|Date:||Jul 1, 2017|
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