Uroabdomen (Urine Leaking in Abdominal Cavity) in Cats
The normal urinary tract is composed of two kidneys, two ureters, a urinary bladder and a urethra. As blood flows through the kidneys of the cat, waste products are removed and pass through thin tubes called ureters into the bladder. The urinary bladder is a reservoir for these waste products.
When the bladder is sufficiently full, there is an urge to urinate and the urine is voluntarily released from the bladder, through the urethra and out the body. Any damage of the urinary tract can lead to leakage of urine outside of the urinary tract, resulting in urine accumulation within the abdomen. This is referred to as uroabdomen or uroperitoneum.
A uroabdomen is a life threatening condition. Accumulation of urine in the abdomen creates serious disturbances in electrolytes such as potassium, which has adverse effects on the heart. Waste products that normally are cleared by the kidneys and eliminated in the urine are retained within the abdomen causing serious elevations in kidney values. Additionally, irritation and inflammation of the lining of the abdomen (peritonitis) results. If a urinary tract infection was present at the time of urine leakage, then septic peritonitis may result.
Uroabdomen can result from various causes, but the most common is related to trauma. Damage to the kidney, ureter, bladder, or urethra may cause urine to leak into the abdomen. Some common forms of trauma that can result in a disruption of the urinary tract in cats include:
Various diseases can also lead to disruption of the urinary tract and subsequent uroabdomen. Some of these include:
Unsupervised outdoor cats are at an increased risk for traumatic injuries due to automobiles, malicious individuals or animal attacks. This results in an increased risk of developing uroabdomen.
Cats with Feline Lower Urinary Tract Disease (FLUTD) are at an increased risk as these cats often require bladder palpation and cystocentesis for diagnostic purposes or passage of a urinary catheter for therapeutic purposes.
What to Watch For
Diagnosis of Uroabdomen in Cats
As with any illness, a medical history is taken and a thorough physical examination is performed. Your veterinarian will likely ask how long the pet has been ill, if there is any possibility of trauma, and about your pet’s urination habits. The physical examination will concentrate on the abdomen and rear areas of the pet. Normal urination does not mean the pet does not have a ruptured bladder. Small bladder tears can cause leakage of urine into the abdomen but the bladder can still fill and urine can be voided.
Various tests may be necessary to determine if there is fluid in the abdomen, what type of fluid is present and the cause of the fluid accumulation.
Treatment in Uroabdomen in Cats
Uroabdomen is a serious illness. Aggressive treatment is necessary to prevent continued illness and potential death. Hospitalization with intravenous fluids is the first step in treatment. Antibiotics are often administered to fight any infection. Uroabdomen and the cause of the uroabdomen can be painful, so pain medications are typically administered to help ease the discomfort.
The majority of uroabdomen cases require surgical repair. The animal is anesthetized and the lower abdomen is surgically opened. The urine is suctioned from the abdomen and the tear in the urinary tract is identified. The most common source of urine in the abdomen is from a tear in the bladder. If present, the rupture site of the bladder is sutured.
Tears in the ureters can also be sutured, but this procedure may require the experience and equipment of a veterinary surgeon. If the kidney is badly damaged, surgical removal may be performed.
After surgical repair of the rupture site, the abdomen is flushed and cleaned with sterile saline. All traces of urine should be removed. The urinary tract is then tested to make sure there are no more leaks. The abdominal incision is then closed with sutures or staples.
A urinary catheter is often placed during surgery and left in place for 2-3 days after surgery to keep the urinary bladder and urinary tract empty. This allows the urinary tract to heal.
For some causes of uroabdomen, such as a very small tear in the urinary bladder or a tear of the urethra, medical therapy may be effective. A urinary catheter is placed and left in for 5 to 7 days. The hope is that without the continual irritation of urine, the small tear will have a chance to heal. After 5 to 7 days, the urinary catheter is removed and the pet is allowed to urinate on his own. The pet is closely monitored for poor response and may need surgical repair in the future.
Home Care and Prevention
There is no home care for uroabdomen. Any animal that sustains a blunt trauma or is unable to urinate should be examined by a veterinarian. After treatment, the pet must be closely monitored for normal urination, blood in the urine, straining or painfulness. Vomiting and lack of appetite should prompt a visit to the veterinarian. Some pets may be sent home with a temporary urinary catheter in place. The catheter must be monitored for normal urine flow and the pet must be prevented from attempting to remove the catheter.
The best way to prevent uroabdomen is to reduce the risk of blunt trauma by keeping your cats indoors. Illness that causes uroabdomen usually cannot be prevented.