Rupture of the Bladder in Dogs

Rupture of the Bladder in Dogs

By: Dr. David Diamond

Section: Veterinary Care In-depth

Diagnosis In-depth

  • Animals brought to the veterinarian after a motor vehicle trauma or for urinary tract symptoms should be given a thorough physical examination. Palpation of the abdomen may give the veterinarian clues about the size and shape of the urinary bladder and whether there are large tumors involving the bladder or a large amount of free fluid in the abdomen. A digital rectal examination may reveal intra-pelvic tumors or abnormalities of the prostate gland.

  • Animals with symptoms of urinary tract disease often have a complete blood count and chemistry profile recommended by the veterinarian. These tests check for abnormal function of the kidneys and liver, electrolyte imbalances, and can indicate if infection or anemia is present.

  • When your veterinarian begins to suspect that the urinary bladder may be ruptured, abdominal radiographs may help with the diagnosis.
    They can show the size and shape of the bladder and the presence of abdominal fluid. This test is not very specific for bladder rupture and your veterinarian may still be unsure of the diagnosis after taking these X-rays.

  • In order to demonstrate that urine is leaking out of the bladder into the abdomen, contrast material can be put directly into the bladder through a urethral catheter or is given intravenously for excretion into the urine by the kidneys. If contrast material is seen free in the abdomen on subsequent radiographs, the diagnosis of bladder rupture is made, although the underlying cause may not be.

  • Another useful diagnostic tool is the abdominal ultrasound. This test allows the abdominal contents to be visualized and is very sensitive for finding free fluid in the abdomen and for looking at the bladder. Bladder tumors and stones can be seen with ultrasound and a tear in the wall of the bladder can sometimes be found.

  • Abdominocentesis is a procedure in which a needle is passed through the abdominal wall to retrieve a sample of fluid. This fluid can then be analyzed to see if it is likely to be urine, indicating that a leakage of urine is occurring. The most definitive test for uro-abdomen is to measure the level of creatinine in the abdominal fluid. Creatinine, a large molecule that is normally excreted by the kidneys into the urine, cannot be reabsorbed through the surfaces of the abdominal organs back into the bloodstream. With rupture of the bladder or any other site in the urinary tract, the creatinine level in the abdominal fluid reaches very high levels when compared to a simultaneous blood level.

  • Animals with high blood potassium levels should be monitored with an EKG for cardiac arrhythmias until the potassium level is back to normal.

    Treatment In-depth

  • In rare cases, the urinary bladder can seal on its own after it has ruptured provided it is kept empty via the use of a urinary catheter. In those cases in which this method of treatment is attempted, the dog must be monitored closely for continued leakage of urine into the abdomen.

  • In most cases, the only way to treat the ruptured bladder is by surgery. The animal is anesthetized and an incision is made into the rear section of the abdomen. The bladder is examined, biopsy or culture samples are obtained or stones are removed, and the tear in the bladder wall is repaired. The abdomen is flushed thoroughly to remove and dilute the leaked urine and the abdomen is sutured closed.

  • Prior to anesthesia, some animals may require medical stabilization to make them strong enough candidates for the stress of the surgery. Intravenous fluids may be all that is needed for some animals to help correct their electrolyte imbalances, while others may require fluids and drainage of the urine from the abdomen or diversion of urine through a temporary cystostomy tube. Also, animals that sustained a major trauma may have other concurrent injuries, especially pneumothorax and pulmonary contusions, that may preclude anesthesia and surgical correction until they are under control.

     
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