Department of Small Animal Clinical Sciences, Texas A&M University Veterinary Teaching Hospital, College Station, Texas, USA.
BluePearl San Antonio Stone Oak, San Antonio, Texas, USA.
J Vet Emerg Crit Care (San Antonio). 2024 Sep-Oct;34(5):497-501. doi: 10.1111/vec.13415. Epub 2024 Aug 26.
To describe the development of uroabdomen secondary to spontaneous bladder rupture in a dog with dystocia.
A 2-year-old intact female Boston Terrier was referred for prolonged labor of 72 hours. At presentation, the dog had delivered 8 puppies at home, with the last pup being stillborn. The dog was in hypovolemic shock and had free abdominal effusion. Abdominal radiographs showed no evidence of remaining fetuses. Abdominal fluid analysis revealed a fluid potassium that was 1.8 times higher than the peripheral blood potassium. Retrograde positive contrast cystography identified leakage of contrast into the abdomen, consistent with uroabdomen secondary to bladder rupture. Bloodwork abnormalities included a mild monocytic leukocytosis with a left shift, moderate azotemia, mild hyperbilirubinemia, mild increase of alkaline phosphatase activity, moderate hyponatremia, and moderate hypochloremia. The dog was resuscitated with IV fluids and received IV antimicrobials out of concerns for septic peritonitis and sepsis. An exploratory laparotomy revealed a moderate volume abdominal effusion, uterine enlargement with no identifiable fetuses, and a small rupture of the urinary bladder wall apex. The bladder wall defect was repaired, and the dog underwent an ovariohysterectomy. Perioperative systemic hypotension was treated with a norepinephrine constant rate infusion and resolved within 24 hours. The dog was discharged 5 days later. The combined peritoneal fluid and uterine fluid culture and sensitivity testing revealed Enterococcus spp. and Staphylococcus pseudintermedius, both susceptible to amoxicillin/clavulanic acid and enrofloxacin. Bladder wall histopathology revealed severe mural congestion, edema, and hemorrhage, without evidence of neoplasia, cystitis, or urolithiasis.
This is the first case report of a dog with uroabdomen secondary to a bladder wall rupture associated with dystocia. Early recognition of this rare phenomenon and vigilance in treatment is essential for a good prognosis and outcome.
描述一只难产犬继发自发性膀胱破裂导致尿性腹的发病过程。
一只 2 岁未绝育母波士顿梗因难产 72 小时被转诊。就诊时，该犬已在家中产出 8 只幼犬，最后一只死胎。患犬出现低血容量性休克，有游离腹腔积液。腹部 X 射线检查未见其余胎儿的影像学表现。腹腔液分析显示，腹腔液钾浓度比外周血钾浓度高 1.8 倍。逆行性阳性对比膀胱造影显示造影剂漏入腹腔，提示继发于膀胱破裂的尿性腹。血液学检查异常包括轻度单核细胞增多症伴左移、中度氮血症、轻度高胆红素血症、碱性磷酸酶活性中度升高、中度低钠血症和中度低氯血症。考虑疑似感染性腹膜炎和脓毒症，该犬接受了 IV 补液和 IV 抗菌药物治疗。剖腹探查发现中等量腹腔积液、子宫肿大但无法识别胎儿，以及膀胱顶部小范围破裂。修复了膀胱壁缺陷，并进行了卵巢子宫切除术。围手术期全身低血压采用去甲肾上腺素持续输注进行治疗，24 小时内得到缓解。5 天后该犬出院。腹腔液和子宫液的联合培养和药敏试验显示肠球菌属和中间型葡萄球菌，两者均对阿莫西林克拉维酸和恩诺沙星敏感。膀胱壁组织病理学检查显示严重壁充血、水肿和出血，未见肿瘤、膀胱炎或尿路结石的证据。
这是首例与难产相关的继发于膀胱壁破裂的尿性腹的犬病例报告。早期认识到这种罕见现象并警惕治疗至关重要，有助于获得良好的预后和结果。
