Donati Pablo, Londoño Leonel A, Fravega Rodrigo, Guevara Juan M
Intensive Care Unit UCICOOP, CABA, Buenos Aires, Argentina.
Department of Small Animal Clinical Sciences, University of Florida, Gainesville, FL, USA.
JFMS Open Rep. 2021 Feb 27;7(1):2055116920984748. doi: 10.1177/2055116920984748. eCollection 2021 Jan-Jun.
A 9-year-old neutered male domestic shorthair cat was presented for evaluation of severe hemodynamic collapse and suspected lower urinary tract disease. On admission, severe metabolic acidosis, hyperkalemia and azotemia, and electrocardiographic findings consistent with cardiotoxicity were identified. The diagnosis of uroabdomen was made based on abdominal fluid to plasma concentration ratios of creatinine and potassium. A central line catheter was placed percutaneously into the abdomen for peritoneal drainage and used for peritoneal dialysis as a bridge to surgery. Retrograde contrast cystography confirmed rupture of the urinary bladder. Point-of-care ultrasound of the chest postoperatively revealed the presence of mild pleural effusion. Echocardiography was then performed showing no evidence of cardiac disease. Pleural fluid analysis revealed a transudate with a creatinine ratio of 2.38 ([Creatinine]/[Creatinine]), consistent with the diagnosis of urothorax. The cat recovered uneventfully from surgery and was monitored for signs of respiratory distress during the rest of its stay in hospital. The cat was discharged 4 days later and the pleural effusion resolved without further medical intervention.
There is limited information on the causes of urothorax and uroabdomen management of feline patients. Pleural effusion is a complication observed in critically ill cats secondary to fluid overload, underlying cardiomyopathy, primary thoracic pathology or a combination of these. To our knowledge, this is the first report of urothorax in a cat secondary to non-traumatic uroabdomen. Careful monitoring of respiratory signs consistent with pleural space disease is recommended in cases of uroabdomen.
一只9岁已绝育的雄性家养短毛猫因严重血流动力学衰竭及疑似下泌尿道疾病前来接受评估。入院时，发现有严重代谢性酸中毒、高钾血症和氮质血症，以及与心脏毒性相符的心电图表现。根据腹腔积液与血浆中肌酐和钾的浓度比值做出尿腹症的诊断。经皮在腹部置入中心静脉导管用于腹腔引流，并作为手术过渡的手段进行腹膜透析。逆行性膀胱造影证实膀胱破裂。术后床旁胸部超声显示有少量胸腔积液。随后进行的超声心动图检查未发现心脏疾病迹象。胸腔积液分析显示为漏出液，肌酐比值为2.38（[肌酐]/[肌酐]），符合尿胸症的诊断。这只猫术后恢复顺利，住院期间其余时间监测有无呼吸窘迫迹象。4天后该猫出院，胸腔积液未经进一步医疗干预即自行消退。
关于猫科动物尿胸症和尿腹症的病因及处理的信息有限。胸腔积液是危重病猫中观察到的一种并发症，继发于液体过载、潜在的心肌病、原发性胸部病变或这些因素的组合。据我们所知，这是首例非创伤性尿腹症继发猫尿胸症的报告。对于尿腹症病例，建议仔细监测与胸膜腔疾病相符的呼吸体征。
