Summary
The most common lower urinary tract (LUT) trauma in cats is urethral rupture, which is most commonly iatrogenic. Bladder ruptures are also encountered and most commonly result from blunt trauma to the abdomen. LUT ruptures are best diagnosed by positive contrast radiography. Their emergency management must be directed at evaluating and correcting the metabolic disturbances resulting from the potential associated uroperitoneum, diagnosing and prioritising the treatment of any concurrent lesions and temporarily diverting urine if definitive treatment of the LUT rupture must be delayed. Treatment of significant bladder rupture consists of surgical repair of the bladder wall, combined with placement of a means of temporary urine diversion (urethral catheter or cystostomy tube) if necessary. Whenever possible, urethral ruptures are treated conservatively by second intention healing around a retrograde urethral catheter. When this is unsuccessful, or when the urethral defect is too large, urethral repair or permanent urine diversion is performed surgically. Permanent urine diversion is achieved by urethrostomy. The technique allowing preservation of the longest portion of urethra is chosen, depending on the location of the urethral rupture – for example, perineal, transpelvic, subpubic or antepubic.
