Uroabdomen

From Dog

Uroabdomen is defined as the presence of urine within the peritoneal cavity.

This condition is relatively common in canine medicine, but more rarely, cases of urothorax have also been reported[1] in cases of severe motor vehicle accidents.

This is frequently observed in dogs as a result of blunt abdominal trauma due to motor vehicle accidents, leading to rupture of the urinary bladder or ureters[2].

Uroabdomen can also be observed following obstructive urolithiasis, traumatic bladder expression or catheterization, transitional cell carcinoma, or postoperative leakage following cystotomy procedures[3].

Urine is normally toxic to serosal surfaces and contact with the peritoneum usually induces a sterile peritonitis within a 12 hour period in dogs.

Clinically affected dogs usually present with physical depression and abdominal pain. Blood tests frequently reveal azotemia and hyperkalemia.

Diagnostic peritoneal lavage and abdominocentesis usually shows a creatinine level > 2:1 with serum creatinine[4].

Confirmation can be established on abdominal ultrasonography showing an abdominal effusion and lack of bladder wall continuity.

Medical treatment is the first recommended step to management, with intravenous fluid and treatment of hyperkalemia.

Urinary diversion and, in some cases, peritoneal dialysis may be necessary to stabilize the patient[5].

Once the patient is stable for anesthesia, surgical repair, if indicated, may be performed.

References

  1. Klainbart S et al (2011) Traumatic urothorax in a dog: a case report. J Small Anim Pract 52(10):544-546
  2. Hamilton MH et al (2006) Traumatic bilateral ureteric rupture in two dogs. J Small Anim Pract 47(12):737-740
  3. Thieman-Mankin KM et al (2012) Comparison of short-term complication rates between dogs and cats undergoing appositional single-layer or inverting double-layer cystotomy closure: 144 cases (1993-2010). J Am Vet Med Assoc 240(1):65-68
  4. Connally HE (2003) Cytology and fluid analysis of the acute abdomen. Clin Tech Small Anim Pract 18(1):39-44
  5. Stafford JR & Bartges JW (2013) A clinical review of pathophysiology, diagnosis, and treatment of uroabdomen in the dog and cat. J Vet Emerg Crit Care (San Antonio) Mar 7