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Diagnosis and initial management of uroabdomen in dogs and cats

02 July 2022
11 mins read
Volume 27 · Issue 9
Figure 1. Cysto-colic view in a dog positive for free fluid. Free fluid is seen as an ill-defined anechoic area (arrow) cranial to the bladder apex
Figure 1. Cysto-colic view in a dog positive for free fluid. Free fluid is seen as an ill-defined anechoic area (arrow) cranial to the bladder apex

Abstract

Uroabdomen is a life-threatening condition occurring in dogs and cats, caused by loss of integrity of the urinary tract. A prompt diagnosis can be achieved by recognition and analysis of abdominal free fluid. A clinician's initial focus should be on treating potentially fatal complications, such as shock and hyperkalaemia, and providing adequate analgesia to the animal. Different urinary diversion techniques can then be considered, according to the site of leakage within the urinary tract, to stabilise the animal before a definitive treatment is performed. This article discusses how to diagnose uroabdomen and treat the early life-threatening complications.

Uroabdomen, defined as collection of urine within the peritoneal cavity or the retroperitoneal space, is an uncommon but life-threatening condition seen in small animal practice. It is caused by loss of integrity in any part of the urinary tract from the kidneys proximally to the pelvic urethra distally.

Abdominal trauma is the most common cause of uroabdomen in dogs, and the urinary bladder is the site of leakage in more than 50% of cases (Grimes et al, 2018). Traumatic injury to the pelvic and prostatic urethra has been reported in conjunction with pelvic fractures (Aumann et al, 1998; Hoffberg et al, 2016). Male dogs are more commonly affected than females, as the long and narrow urethra in males cannot quickly adapt to a sudden increase in intra-vescicular pressure (Thornhill and Cechner, 1981). Iatrogenic uroabdomen can occur after any surgery involving the abdominal portions of the urinary tract, or secondary to traumatic urethral catheterisation. Cystocentesis of a healthy bladder rarely results in uroabdomen, although underlying pathological conditions of the bladder may increase the risk.

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