Ruptured Bladder

Also Known As

Bladder trauma, Uroperitoneum

Description

A ruptured bladder sometimes occurs in a foal during the delivery process, although they may occur in older horses because of an injury or an obstruction. A bladder rupture is usually the result of too much pressure on the abdomen of the foal during delivery. In some cases, a weakness in the bladder wall may cause it to rupture.

When the bladder ruptures, urine flows into the abdominal cavity, although the foal may attempt to urinate normally. As the urine leaks into the abdomen, it increases in size. Severe metabolic disturbances result because of the increase of potassium, the decrease of sodium and chloride, and the presence of urea in the blood.

Conditions known as hyperkalemia (increased potassium), hyponatremia (decreased sodium), hypochloremia (decreased chloride), andazotemia (urea in the blood) develop. The condition of having urine in the abdomen is known as uroperitoneum.

Symptoms

  • Increased frequency of urination or straining to urinate
  • Depression and dullness
  • Increase in size of abdomen

Causes

Pressure on the bladder during delivery is the main cause of a ruptured bladder, although a weakness in the bladder wall may make it susceptible to a rupture. In older horses, a ruptured bladder may be caused by an accident or related to a urinary obstruction.

Prevention

Care and attention to delivering the foal without creating pressure on the internal organs such as the bladder is important during the foaling process. Foals should be thoroughly examined after birth to make sure no injuries have occurred in the process, and they should be observed for several days to make sure they are urinating satisfactorily. At the first sign of a distended abdomen, a veterinarian should be called to diagnose any problems.

Treatment

A ruptured bladder leading to uroperitoneum is a medical rather than a surgical emergency, although once the animal is stabilized, surgery will be needed to repair the ruptured bladder. The assistance of a veterinarian to properly diagnose the condition and begin treatment is essential.

Initial treatment for a ruptured bladder consists in correcting fluid and electrolyte balances as soon as the condition is discovered. Since hyperkalemia is a life-threatening condition, fluids containing potassium should not be administered. In most cases a 0.9% chloride sodium is used to correct the fluid and electrolyte imbalances.

Before surgery to correct the ruptured bladder, the urine that has accumulated in the abdomen should be slowly drained. Your veterinarian will be able to recommend the best procedure in each case.

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