URINOGENITAL SYSTEM INJURIES 2
The Bladder
Injuries:
1) Blunt trauma, Rupture ( either due to excessive internal pressure or external trauma)
Most blunt bladder damage is the result of a road accident, although cats particularly are vulnerable to kicks, and occasionally abdominal damage results from a heavy door shutting on the animal or a Springer (!) squeezing through too narrow a gap in the fence.
Blunt trauma can cause damage ranging from serious rupture to less serious haematoma or bruise formation.
Ruptured bladders can occur in cases of UROLITHIASIS in which the bladder exit is blocked by calculi or bladder stones.
2) Herniation
If a perineal hernia occurs or there is a tear (rupture) in the body wall, then the bladder can HERNIATE through the hole which is formed. This traps urine in the bladder. In the case of perineal hernia, the bladder flips back-to-front into the hernia.
This also blocks off the outflow of urine.
Signs:
Simple bruising gives signs of cystitis as the bladder is sore, i.e. frequency, straining, possibly haematuria and/or proteinuria. The protein is not coming out of the kidney tubules so there are no casts in it. Rupture and other causes of failure to evacuate urine causes signs of renal failure to develop, as the waste products from the kidneys are retained in the body. AZOTAEMIA develops as urea accumulates. This is accompanied by oliguria or anuria. Halitosis may develop as renal toxins are lost on the breath.
BEWARE!: URINATION MAY OCCUR IN CASES OF RUPTURED BLADDER
Always: Palpate for the bladder; check urine output; watch for abdominal swelling; monitor blood urea regularly.
First Aid
None obvious apart from routine measures to make the patient more comfortable, fluids may be necessary but may contribute to the problem if the patient cannot urinate.
The Urethra
Injuries:
Trauma due to pelvic fractures, bite wounds (in male dogs, in which the urethra has a long course past the back of the pelvis), rough catheterisation, and calculi.
The animal may be able to urinate initially, but lose this ability with post-trauma swelling. Leaking urine will cause local inflammation.
Obvious problems due to calculi are much more common in males due to a longer and narrower urethra. Cats develop sand-like material in the urine (feline urolithiasis syndrome or FUS).
First Aid
Control any haemorrhage associated with the primary injury
Catheterisation
Can be attempted in the conscious standing male dog if necessary, but is not possible in fully conscious tom cats or female dogs or cats due to their anatomy. Tom cats require the use of a Jackson cat catheter. The value of catheterisation is in establishing urine output
-Quantity (should be up to 50ml / kg / day)
-Quality (Test for SG, protein, other abnormalities on dipstick)