Equis ISSN 2398-2977

Bladder: rupture

Contributor(s): Rachael Conwell, Graham Munroe, Katrin Schmallenbach, Wendy E Vaala

Introduction

  • Cause:
    • Foals: associated with excessive compression of the abdomen during parturition.
    • Adults: bladder rupture can occur during parturition, associated with trauma or as a result of urinary tract obastruction.
  • Signs: similar in both adults and foals; include depression, abdominal distension, reduced appetite, stranguria, and mild to moderate colic.
  • Diagnosis: based on history and clinical signs, in conjunction with evidence of electrolyte abnormalities on blood biochemistry, presence of increased intra-abdominal free fluid identified by transabdominal ultrasound and comparison of creatinine values in serum and peritoneal fluid. Additional diagnostic tests include endoscopy (in adults), contrast radiography and instillation of dyes into the bladder.
  • Treatment: fluid therapy to correct dehydration and electrolyte disturbances; abdominal drainage to remove the fluid; surgical repair of the bladder rupture.
  • Prognosis:
    • Foals: good if uncomplicated bladder rupture; reduced if concurrent septicemia.
    • Adults: generally good with surgical repair, however early diagnosis is often difficult.
  • See Abdomen: uroperitoneum Abdomen: uroperitoneum for further information.
Print off the Owner factsheet on Bladder rupture Bladder rupture to give to your clients.

Pathogenesis

Etiology

Foals

  • Bladder tears occur during parturition due to compression and subsequent increased pressure in the foal's abdomen, sufficient to cause rupture.
  • Ruptured bladder can also occur secondary to generalized sepsis or infected urachus.

Adults

  • Bladder rupture during parturition may occur due to the bladder being trapped between the pelvic brim and bony prominence of the foal.
  • Alternatively, urethral occlusion during dystocia results in increased intravesicular pressure in conjunction with significant increased abdominal pressure, causing bladder rupture.
  • Other causes include urinary tract obstruction, such as urethral stricture and external trauma.

Predisposing factors

General

  • Parturition, dystocia, trauma, urinary tract obstruction, plus sepsis and/or urachal infection in foals.

Specific

  • Male foals are at higher risk of bladder rupture due to long, narrow urethra and increased resistance when the bladder is compressed.

Pathophysiology

Foals

  • Site of rupture occurs most commonly at the dorsal and dorsocranial aspects of the bladder due to an inherently thin wall in this section.
  • Generalized sepsis or infected urachus can result in rupture of the ventral aspect.

Timecourse

  • Clinical signs are often not apparent for several days.

Epidemiology

  • The following are reported to be affected by bladder rupture:
    • 2.5% foals.
    • 0.01% periparturient mares.

Diagnosis

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Treatment

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Outcomes

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Jenei T M (2012) Bladder rupture in a mature horse: Diagnostic techniques. Equine Vet Educ 24 (10), 517-519 Wiley Online Library.
  • Rijkenhuizen A (2012) Megavesica and bladder rupture in foals. Equine Vet Educ 24 (8), 404-407 Wiley Online Library.
  • Castagnetti C et al (2010) Urethral and bladder rupture in a neonatal colt with uroperitoneum. Equine Vet Educ 22 (3), 132-138 VetMedResource.
  • Cousty M et al (2010) Inguinal rupture with herniation of the urinary bladder through the scrotal fascia in a Shetland pony foal. Equine Vet Educ 22 (1), 3-6 VetMedResource.
  • Ragle C A (2008) Decision-making and options: Surgical approach and repair of the equine bladder. Equine Vet Educ 20 (4), 191-193 VetMedResource.
  • Rijkenhuizen A B M, van Loon T J A M & Boswinkel M (2008) Laparoscopic repair of a ruptured bladder in an adult mare. Equine Vet Educ 20 (4), 183-189 VetMedResource.
  • Kablack K A et al (2000) Uroperitoneum in the hospitalised equine neonate - restrospective study of 31 cases, 1988-1997. Equine Vet J 32 (6), 505-507 PubMed.
  • Booth T M, Howes D A & Edwards G B (2000) Bethanechol-responsive bladder atony in a colt foal after cystorrhaphy for cystorrhexis. Vet Rec 147 (11), 306-308 PubMed.
  • Edwards R B 3rd, Ducharme N G and Hackett R P (1995) Laparoscopic repair of a bladder rupture in a foal. Vet Surg 24 (1), 60-63 PubMed.

Other sources of information

  • Bahanon T C (2005) Urinary Problems in the Equine Neonate. In: Proc NAVC Large Animal. Volume 19, Orlando, Florida, USA. pp127-128.


ADDED