KEY FACTS Uroabdomen in Dogs and Cats

Uroabdomen is a condition commonly associated with abdominal or pelvic trauma that is seen in human and veterinary patients. Other etiologies of uroabdomen include urinary obstructive disorders (e.g., urolithiasis, feline lower urinary tract disease, neoplasia) and iatrogenic causes (e.g., urethral catheterization, aggressive bladder palpation, cystoscopy, cystocentesis). Uroabdomen results rapidly in life-threatening dehydration, metabolic acidosis, and electrolyte abnormalities. The first steps in treatment are fluid resuscitation and removal of urine from the abdomen. With early diagnosis and aggressive patient stabilization, this condition can be managed successfully. Uroabdomen refers to the accumulation of free urine in the abdominal cavity caused by leakage from the kidneys, ureters, bladder, and/or urethra. The term uroabdomen includes urine accumulation in both the peritoneal and/or the retroperitoneal spaces. The veterinary literature is limited to individual case reports, a small number of retrospective studies, and one prospective study. The frequency of occurrence in veterinary patients appears to be low. Aumann and colleagues recently reported that uroperitoneum accounted for 0.1% of the hospital’s feline population. This article reviews the causes and pathophysiology of uroabdomen as well as discusses diagnosis and management of patients with this condition. CAUSES The causes of uroabdomen are believed to vary with species, gender, and age. It has been reported in humans, cattle, horses, dogs, and cats. In humans and small animals, uroabdomen is most frequently associated with bladder and urethral rupture caused by abdominal or pelvic trauma. As in humans, abdominal and pelvic trauma are the most common causes of uroabdomen in dogs and cats. In 1961, Meynard reported that in 7 of 9 dogs (77%) urinary bladder rupture was caused by a traumatic event. Burrows and colleagues reported that of the 40 small animal patients diagnosed with uroabdomen at the University of Pennsylvania between 1966 and 1971, 84.6% of the cases were caused by trauma. It was also reported that 42.3% had concurrent pelvic fractures. In 1982, Selcer reported that 16% of 100 dogs that had susCE 604 Vol. 24, No. 8 August 2002 V n Uroabdomen should be suspected in all veterinary patients presented for abdominal or pelvic trauma. n A palpable bladder and the ability to void urine do not rule out uroabdomen. n A definitive diagnosis of uroabdomen can be made by simultaneous measurement of creatinine of the patient’s abdominal fluid and serum. n Emergency treatment of patients with uroabdomen must include aggressive fluid therapy and urine drainage from the abdomen.