Overview of Rupture of the Urinary Bladder
Bladder rupture is a condition in which the urinary bladder tears and releases urine into the abdominal cavity. The bladder can rupture because of trauma, urinary obstruction, tumors, severe bladder disease, and during catheterization.
There are no specific dog breed or sex predilections for this problem. Animals that experience rupture of the bladder can quickly become sick from substances in the urine that leak into the abdomen and get reabsorbed instead of being excreted.
What to Watch For
Signs of rupture of the bladder in dogs may include:
Lack of appetite
Lack of urine production
Rupture of the bladder rarely occurs without the animal first showing other symptoms of urinary tract disease such as straining to urinate, bloody urine, and inability to urinate.
Diagnosis of Urinary Bladder Rupture in Dogs
Diagnostic tests may include:
Complete physical examination, including palpation of the abdomen, to rule out other injuries caused by the trauma, or to help diagnose the urinary tract symptoms
Blood tests, including complete blood count and chemistry profile to rule-out other problems and help diagnose a ruptured bladder
Abdominal radiographs (X-rays) to help visualize the size and shape of the urinary bladder
Contrast radiographs to see if urine is leaking out of the bladder into the abdomen
Abdominal ultrasound to look for free fluid in the abdominal cavity and to visualize the walls of the bladder
Abdominocentesis, which is passing a needle through the wall of the abdomen, to help identify free fluid in the abdomen. The fluid may then be “dip stick” tested, or sent to the laboratory for more specific analysis.
Treatment of Urinary Bladder Rupture in Dogs
Abdominal exploratory surgery with repair of the bladder wall defect is the definitive course of treatment.
Sick animals are given intravenous fluids to help stabilize them prior to surgery. Animals that are too unstable to have surgery may require abdominal drainage until surgery can be done.
Home Care and Prevention
After surgery and discharge from the hospital, your pet should be restricted from excessive activity. He may be given anti-inflammatory medications or pain medications for the first few days to keep him comfortable.
Some dogs may be sent home with oral antibiotics for several days if a urinary tract infection is also present or suspected.
Once home, you need to watch your dog carefully for signs of surgical complications, including:
Incision problems such as redness, swelling or discharge
Straining or inability to urinate
Distension of the abdomen
Ruptured bladder associated with bladder stones can be prevented by early diagnosis and treatment of the stones. Bladder rupture associated with trauma can sometimes be prevented. Many traumatic events are true accidents and thus unavoidable. Avoid the chance for motor vehicle trauma by keeping your dog fenced or leashed. Other causes of ruptured bladder cannot be prevented.
In-depth Information on Urinary Bladder Rupture in Dogs
Rupture of the urinary bladder is a serious consequence of major trauma or underlying urinary tract disease and is the most common cause of uro-abdomen, which is the presence of urine within the abdominal cavity, in small animals.
Causes of Urinary Bladder Rupture in Dogs
Motor vehicle trauma is the most common cause of bladder rupture in small animals. The trauma often occurs when a dog is taken out for a walk, slips off his leash and gets hit by a car before having the chance to urinate and empty his bladder. If the bladder is full at the time of the accident, the force of the trauma can increase the pressure inside the bladder high enough to exceed the strength of the bladder muscle and a tear results.
Dogs with urinary obstruction may strain hard enough to increase bladder pressure above the breaking strength of the bladder wall and cause a rupture. Obstruction can occur secondary to stones that form within the bladder and get lodged in the urethra, or due to masses growing within the pelvic canal that compress the urethra itself.
Tumors of the bladder wall can weaken the wall and lead to rupture.
Severe inflammation of the bladder wall (cystitis) can also cause weakening of the muscle and result in rupture.
Animals with urinary tract symptoms often need to be catheterized or have a needle passed into the bladder (cystocentesis) to get a sample of urine out of the bladder or to try to relieve the urethra of an obstruction. If the bladder wall is severely affected by any underlying condition, these procedures themselves can cause the bladder to develop a tear and leak urine into the abdomen.
Male dogs are more likely to have obstruction of the urethra due to stones because the urethra is longer and narrower in males than in females. This may result in a higher risk of bladder rupture. Also male dogs can have abnormalities of the prostate gland that cause obstruction of the urethra.
Other causes do not have any breed or sex predispositions.
Once the bladder ruptures, urine begins leaking into the abdomen (uro-abdomen). The urine is the body’s vehicle for getting rid of certain waste products. Normally, the urine is voided from the body through the urethra. When the bladder has ruptured, the animal is not able to completely rid himself of these waste products and they accumulate in the abdomen.
Some of these substances, especially potassium and urea, are reabsorbed through the surfaces of the abdominal organs and can quickly reach excessive levels in the bloodstream. The consequence of the blood levels of these waste products becoming too high is that the animal starts feeling ill.
Elevated blood potassium and elevated blood urea can cause depression, anorexia, vomiting and heart rhythm abnormalities.
As the bladder continues to leak, the abdomen may become distended with free urine. Some animals may continue to urinate almost normally after rupture of the bladder, while others are unable to urinate at all. Animals that are able to urinate even a small amount can make this a difficult diagnosis to make. Eventually, so much urine accumulates in the abdomen the intra-abdominal pressure increases. This can lead to decreased blood supply to the abdominal organs and loss of their function, difficulty in moving the diaphragm to breathe, and eventually death.
Fortunately, except for the cases of traumatic bladder rupture, most animals show symptoms associated with the urinary tract prior to the bladder rupturing. If these early symptoms are addressed and the underlying problem diagnosed and treated, rupture of the bladder can usually be averted. A veterinarian should evaluate any animal showing signs such as difficulty or straining to urinate, bloody urine or inability to urinate.