Uroabdomen (Urine leaking in abdominal cavity) in Dogs

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Overview of Uroabdomen (Ruptured Urinary Tract) in Dogs

The normal urinary tract is composed of two kidneys, two ureters, a urinary bladder and a urethra. As blood flows through the kidneys, 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 include:

  • Blunt trauma such as automobile injury, a kick to the abdomen, or a fall
  • Penetrating abdominal trauma with knives, bullets, arrows, needles, scalpels, bite wounds or fractured bone fragments from pelvic trauma

    Various diseases can also lead to disruption of the urinary tract and subsequent uroabdomen. Some of these include:

  • An attempt at palpation or expression of the bladder by the veterinarian may cause the bladder to rupture. This generally occurs only when the bladder wall is compromised or weakened by an underlying problem
  • Rupture or laceration of the bladder during cystocentesis, placement of a urinary catheter, placement of a peritoneal dialysis catheter or during surgical procedures.
  • Cancer of the bladder

    Unsupervised outdoor animals 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.

  • What to Watch For

  • External signs of injury such as bruising, broken bones, or changes in behavior that may indicate the pet has been traumatized
  • Lack of urination or production of very little urine within a 24 hour period following a traumatic event
  • Bloody urine
  • Distension of the abdomen as urine accumulates
  • Lethargy, depression, loss of appetite, vomiting, abdominal pain
  • Increased respiratory rate due to pain
  • Fever
  • Diagnosis of Uroabdomen in Dogs

    As with any illness, a medical history is taken and a thorough physical examination is performed. Your veterinarian will likely ask how long the dog has been ill, if there is any possibility of trauma, and about your dogs urination habits. The physical examination will concentrate on the abdomen and rear areas of the dog. Normal urination does not mean the dog 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.

  • A complete blood count (CBC) can help determine the white blood cell, red blood cell and platelet counts. In a uroabdomen, these results may be normal.
  • A biochemistry profile will evaluate the function of the liver and kidneys and can detect abnormalities in the electrolytes.
  • Urinalysis is performed if urine is obtained from the bladder.
  • Abdominocentesis is one of the most important tests performed in diagnosing uroabdomen. A needle is inserted into the abdominal cavity and any fluid present is collected an analyzed. To determine if the fluid is urine, the creatinine level of the fluid is compared to the creatinine level of the blood. Creatinine is a by-product of waste production in the kidneys. Typically excreted in the urine, the level of creatinine will be higher in urine than in the blood. If the creatinine of the fluid is higher than the creatinine of the blood, the fluid is urine.
  • Blood gas tests are used to determine the acid base status of the pet.
  • Radiographs +/- contrast radiography are important in determining where a leak has occurred within the urinary tract.
  • Abdominal ultrasound is sometimes helpful in determining if there is an abnormality within the urinary tract.
  • Bacterial culture and sensitivity may be needed to determine if there is a bacterial component to the uroabdomen.
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