Horse-Breeding Woes: Ruptured Bladder

This foal health issue is not uncommon.

With foaling time coming soon for many mares, it is important to stay abreast of potential foal health ailments. A ruptured bladder is one such emergency that must not be taken lightly.

The Story

We watched as a 16-year-old mare gave birth unassisted at 1:15 in the morning on the day prior to her due date in mid-April. She had given birth to six healthy foals previously. The navel of the newborn filly was immediately dipped with diluted chlorhexadine solution after the umbilical cord broke and the stump was subsequently dipped three times per day for the next two days. The foal passed meconium within an hour and a half, and first nursed from the mare within two hours after birth.

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Colostrum collected from the mare was estimated to have a high antibody content, and a blood sample from the foal at 16 hours of age revealed adequate antibodies against infectious diseases. Throughout the next four days, the foal was generally alert and active in her stall and nursed regularly from her dam. The filly also urinated and defecated normally. However, there were also occasional reports of the foal being “not quite right.” Barn personnel would occasionally catch her posturing as if to urinate or defecate and nothing would pass. She would then straighten up and meander around her stall as if nothing was wrong.


An emergency call was received at 6 a.m. on Day 6 after foaling, when the foal was discovered to be depressed and reluctant to move. A quick physical examination revealed that her body temperature was increased to 103.9 degrees Fahrenheit, and mild inflammatory reaction was noted around the lining of the eyes (conjunctivitis). The external umbilical stump was not swollen, not damp, and did not have discharge. Her joints were not swollen or painful upon manipulation. A list of potential medical problems was formulated, and a series of diagnostic tests was immediately performed to help rule in or rule out various potential complications. A complete blood count revealed an elevation in white blood cells, suggesting an inflammatory or infectious condition. Blood chemistry tests indicated issues with the urinary system; electrolyte analysis revealed that serum concentrations of sodium and chloride were low and potassium levels were elevated. The combined test results strongly suggested that the young filly had ruptured her urinary bladder. An ultrasound examination of the abdomen was quickly performed. The exam clearly showed a large volume of free fluid in her abdomen, along with a small urinary bladder. An area on her ventral abdomen was shaved and scrubbed clean with disinfectant. A small needle was passed into the abdomen, and a stream of pale yellow fluid rapidly exited the needle. The ultrasound and abdominal fluid analysis confirmed the original diagnosis of a ruptured bladder.

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The mare and filly were transported to the veterinary teaching hospital for surgery. Exploration of the abdomen revealed a 1-inch tear in the dorsal wall of the urinary bladder, which was successfully repaired. The foal recovered uneventfully and was sent home two days later. Rupture of the urinary bladder is a potentially life-threatening condition in newborn foals. An early diagnosis and surgical intervention are required for a successful outcome.

Take-Home Message

•    Ruptured bladder is not uncommon in foals.

•    The incidence rate is equal in colts and fillies.

•    Rupture does not always occur at birth.

•    Abdominal ultrasonography and serum chemistry are the diagnostic tests of choice.

Dr. Patrick M. McCue is the equine reproduction laboratory director at the College of Veterinary Medicine & Biomedical Sciences at Colorado State University and a regular contributor to The American Quarter Horse Journal.