Uroabdomen in Cats

The rupture can happen anywhere in the urinary tract, however, bladder and urethra issues are more commonly to blame due to their location. If major trauma has caused the ribs to fracture, the kidneys and ureters may be damaged. The condition becomes far more severe if the cat is already suffering from a urinary tract infection. This can lead to septic shock as the infection travels to other locations in the body. If too much urine is lost into the abdominal cavity, hypovolemic shock can also occur and make regular blood flow impossible. If uroabdomen is left untreated, the cat will likely die within three days of the rupture. 

If a tear is created somewhere along the urinary tract, urine will leak into the abdominal cavity, creating the condition of uroabdomen. This can lead to a large electrolyte imbalance within the body which hinders organ function. As the urine is made up of waste removed from the bloodstream, it can also greatly irritate the lining of the abdomen. Normal urine expulsion sometimes carries on during a uroabdomen episode. Worsening symptoms will develop as more of the major internal organs are affected. 

If the urine leakage is slow, symptoms may not show up right away. As soon as you note any of the following symptoms, be sure to rush your cat to a veterinary clinic or animal hospital, as early treatment before major organ damage has occurred is more successful. 

• Anorexia
• Vomiting
• Labored breathing
• Irregular heartbeat
• Weak pulse
• Tachycardia (racing heartbeat)
• Abdominal pain and distention
• Inability to lay down comfortably
• Restlessness
• Dysuria (difficulty urinating)
• Hematuria (blood in urine)
• Bruising of the perineum (genital area)
• Pale or tacky nose, lips, and gums
• Confusion

Any ailment that causes damage to the urinary tract can lead to uroabdomen. Cats who suffer from feline lower urinary tract disease (FLUTD) may be more likely to experience uroabdomen from ongoing manual manipulation of the bladder. All known causes are listed below.

• Major trauma (often from a car accident)
• Urinary obstruction leading to the rupture of the kidneys or bladder
• Cancer along the urinary tract
• Iatrogenic (caused by medical intervention) injury, often related to bladder expression or catheter insertion

You will need to provide your cat's full medical history to your veterinarian. A complete physical examination will be needed. The kidneys and bladder will be palpated to check for enlargement or tenderness. If the cat has suffered from a major traumatic event, all present injuries will be evaluated. The cat may need stabilization before uroabdomen can be addressed. Full blood work will need to be run, including a complete blood count and a biochemical profile. An electrolyte panel showing decreased levels suggests uroabdomen as the cause of fluid in the abdominal cavity.

Urinalysis will be performed to measure the function of the bladder and the kidneys. Abdominocentesis is a general procedure for diagnosing uroabdomen. It includes removing the fluid in the abdomen with a syringe. Once removed, the fluid can be assessed and confirmed as urine. An ultrasound may be needed to locate all pockets of fluid within the body, and to find the exact location of the rupture. Cardiac rhythm should be monitored to assess how the heart is functioning. A bacterial culture of the urine should be performed to identify any bacteria present in the urinary tract.

If other life-threatening injuries are present, they may need to be treated first. While uroabdomen is a medical emergency, it requires stabilization before surgery can be performed. A stabilized cat will respond much better to anesthesia.

Supportive Care 

General care may be administered from 12-24 hours to prepare a cat for surgery. Intravenous fluids may be given at this time, especially if the cat is dehydrated. Fluids should be gradually applied. A urethral catheter may be inserted. A large gauge catheter may also be placed in the perineum to drain high volumes of urine from the abdomen. Painkillers will often be administered during this time.

Surgical Repair

Once a rupture has been located, surgery can be performed to repair the tear. It is very important that the exact location of the issue be identified before the surgery has started. Sutures may be used to close urinary tract openings that are spilling urine. In some cases an affected kidney may need to be removed to rectify the issue, but only if the remaining kidney is strong enough to handle such a procedure. 

Antibiotics

If a bacterial infection has been found in any of the urinary organs, antibiotics specific to the identified bacteria may be prescribed. Post-surgery, broad spectrum antibiotics are often administered to prevent infection. These prescriptions generally last from one to four weeks.

If the cat has undergone surgery, be sure to follow all home care guidelines. Check the incision site daily to monitor the area for signs of infection such as redness or swelling. Keep the wound clean throughout the healing process. Administer all medications as prescribed by your veterinarian. Some cats may be sent home with a catheter still in place. Watch to ensure it does not move out of place, and that urine is collecting in a regular manner. 

If the cat recovers from a surgical repair, the prognosis is fairly good. Any kidney damage that has occurred will often be permanent. This can worsen the long-term outlook for the cat. Outdoor cats are at a much higher risk for experiencing severe trauma. Keeping your cat indoors can greatly reduce the chance of injury-related uroabdomen from happening.