– 11 year old FS Shih Tzu with 2 day history of not passing urine despite IV fluids and decreased appeitite
– abdomen has gradually filled with fluid and analysis of abodminal fluid showed a creatinine of 2000
– rDVM passed a urinary catheter prior to me scanning and collected a few mls of urine SG 1.015
– severe azotemia on blood work
– 11 year old FS Shih Tzu with 2 day history of not passing urine despite IV fluids and decreased appeitite
– abdomen has gradually filled with fluid and analysis of abodminal fluid showed a creatinine of 2000
– rDVM passed a urinary catheter prior to me scanning and collected a few mls of urine SG 1.015
– severe azotemia on blood work
– US showed marked abdominal effusion and small, collapsed urinary bladder with markedly thickened and irregular walls wth possible mineral foci, highly suspicous of TCC. In the apex, I could identify a region where urine appears to be leaking out into the abdomen
– has anyone ever seen spontaneous urinary bladder rupture secondary to neoplasia? No trauma in this patient’s history
Comments
Not seen it with neoplasia
Not seen it with neoplasia but idiopathic and with severe bacterial cystitis. Is theoretical possible that TCC can weaken the wall. Reported etiolgies for bladder rupture are: traumatic, obstructive, iatrogenic, and unknown:
Grimes JA, Fletcher JM, Schmiedt CW Outcomes in dogs with uroabdomen: 43 cases (2006-2015). J Am Vet Med Assoc. 2018 Jan 1;252(1):92-97.
OBJECTIVE To determine the rate of and factors associated with survival to hospital discharge in dogs with uroabdomen. DESIGN Retrospective case series. ANIMALS 43 dogs with uroabdomen confirmed at 2 veterinary teaching hospitals from 2006 through 2015. PROCEDURES Medical records were reviewed and data extracted regarding cause and location of urinary tract rupture, serum creatinine concentration and other variables at hospital admission, and outcomes. Variables were tested for associations with survival to hospital discharge. RESULTS Urinary tract rupture occurred in the urinary bladder (n = 24 [56%]), urethra (11 [26%]), kidney (2 [5%]), ureter (1 [2%]), both the urinary bladder and kidney (1 [2%]), and undetermined sites (4 [9%]). Rupture causes included traumatic (20 [47%]), obstructive (9 [21%]), and iatrogenic (7 [16%]) or were unknown (7 [16%]). Surgery was performed for 37 (86%) dogs; the defect was identified and surgically corrected in 34 (92%) of these dogs. Hypotension was the most common intraoperative complication. Nineteen dogs had information recorded on postoperative complications, of which 10 (53%) had complications that most often included death (n = 3) and regurgitation (3). Thirty-four (79%) dogs survived to hospital discharge. Dogs with intraoperative or postoperative complications were significantly less likely to survive than dogs without complications. Serum creatinine concentration at admission was not associated with survival to discharge. CONCLUSIONS AND CLINICAL RELEVANCE A high proportion of dogs with uroabdomen survived to hospital discharge. No preoperative risk factors for nonsurvival were identified. Treatment should be recommended to owners of dogs with uroabdomen.
Thanks for the study. I am
Thanks for the study. I am not sure how this case ended up but I believe they were taking the dog to surgery but not sure anything could be done for this case.
If going to surgery a piece
If going to surgery a piece of the affected bladder wall needs to be sent for histopathology.
For sure!
For sure!
For sure!
For sure!
Great case JP. Yes i have
Great case JP. Yes i have seen this with TCC but not this dramatic but mural degeneration from TCC can happen and likely the case here.