Urinary Tract Trauma in Cats: Stabilisation, Diagnosis and Management

Abstract

Practical relevance: Traumatic injury of the urinary tract may be caused by external accidental trauma or due to iatrogenic injury (typically as a result of catheterisation procedures). Thorough patient assessment and careful attention to patient stabilisation are essential, with diagnosis and surgical repair delayed until the patient is stable, if necessary. Treatment depends on the location and severity of the trauma. If diagnosed and treated promptly, the chance of survival of a patient without other concurrent injuries is good. Clinical challenges: Following accidental trauma, at the initial presentation urinary tract injury can be overshadowed by other injuries, but if left undiagnosed or untreated it can lead to serious morbidity and potentially mortality. Many of the surgical techniques described for management of urinary tract trauma can be associated with complications, and so comprehensive communication with the owners is necessary. Patient group: The main population affected by urinary tract trauma is young, adult male cats, owing to their roaming behaviour, as well as their anatomy and the resulting increased risk of urethral obstruction and its associated management. Aims: This article aims to serve as a guide to all veterinarians who treat cats for the diagnosis and management of urinary tract trauma in cats. Evidence base: This review summarises the current knowledge available from a number of original articles and textbook chapters in the literature that cover all aspects of feline urinary tract trauma, and is supported by the authors’ own clinical experience.

Diagnosis and Treatment of Constipation and Bladder Contusion Hematuria Due to Trauma in a Cat

“…Kidneys excrete the urea product when damaged, and the urea will accumulate in the blood circulation (Stockham & Scott, 2008). The urinalysis also confirmed the presence of bladder contusion and urinary bladder wall thickening, which showed the possibility of a rupture because of incomplete bladder mucosa damage (Robakiewicz & Halfacree, 2023). In addition, the diagnosis of urinary bladder contusion in the lumen was made due to the observation of the normal margin of the urinary bladder in the abdominal radiograph.…”

“…These ultrasonographic findings aligned with a slight increase in blood urea nitrogen (BUN) 34 mg/dL, indicating acute kidney injury (Thrall et al, 2012). In cats with urinary tract trauma, increased blood urea nitrogen on serum biochemistry results from urine leakage that can lead to post-renal azotemia (Robakiewicz & Halfacree, 2023). Urinary tract injuries cannot be diagnosed or treated before the shock, respiratory distress, or continuous bleeding are treated.…”

“…Urinary tract injuries cannot be diagnosed or treated before the shock, respiratory distress, or continuous bleeding are treated. Urinary tract injuries are easily ignored in trauma patients because clinical indications are ambiguous and are frequently overwhelmed by more apparent injuries or life-threatening illnesses (Robakiewicz & Halfacree, 2023). The current study gave the patient a normal saline infusion to prevent shock and phytomenadione and stop continuous urinary tract bleeding.…”

“…In this case study, the signs of urinary tract trauma were hematuria and abdominal pain. However, it is critical to remember that the capacity to urinate and the existence of a palpable bladder do not rule out urinary tract injuries (Meeson & Corr, 2011;Robakiewicz & Halfacree, 2023). Furthermore, because the leaking urine may seep subcutaneously, rupture of the intrapelvic or penile urethra may not result in immediately identifiable free peritoneal fluid.…”

Urethral entrapment by an overlapping dislocation of the pubic symphysis in a cat

“…Among these causes, vehicular trauma and iatrogenic damage resulting from attempted catheterisation are the most prevalent factors contributing to urethral injuries in cats. 9 , 10 …”