Lower urinary tract rupture in cats and dogs following severe blunt trauma

The medical records of cats and dogs admitted to the Department of Small Animal Surgery of the Centre Hospitalier Vétérinaire Pommery (Reims, France) with a history of vehicular trauma or falls from the first floor or higher were screened for occurrences of a lower urinary tract (LUT) rupture. Signalment, reported injuries, diagnostic imaging findings, and blood test results were extracted from the medical records.

A total of 585 animals were included in the study: 339 cats and 246 dogs. The overall prevalence of LUT rupture was 1.36% (8/585) and was 1.2% (3/246) in dogs and 1.4% (5/339) in cats. The most common site of rupture was the bladder (5/8 cases). All orthopaedic injuries were pelvic fractures and animals with pelvic fractures were 6.4 (95% CI: 1.67-24.41; p = 0.012) times more likely to incur urinary tract rupture than those without pelvic fractures. However, three cases had LUT rupture without associated orthopaedic injury. All affected patients had free abdominal fluid identified by abdominal focused assessment with sonography for trauma. Serum urea and creatinine concentrations were elevated in 5/8 cases of LUT rupture, and 4/8 cases were able to urinate.

Although LUT injury and pelvic fracture were significantly associated in this study, 3/8 cases of LUT rupture in this study had no orthopaedic injury and half retained the ability to urinate. Thus, lack of associated fractures and ability to urinate should not be used to rule out a LUT rupture. The possibility of bladder or urethral rupture should be considered in all patients with a history of severe blunt trauma.