Cat with urine leakage and abdominal pressure after urethral injury

Abstract

OBJECTIVE: To describe abdominal compartment syndrome (ACS) associated with postobstructive diuresis (POD) in a cat with urethral rupture. CASE SUMMARY: A 6-month-old intact male Korean domestic shorthaired cat presented with suspected urethral rupture. Diagnostic imaging revealed multiple pelvic fractures and free fluid in the abdominal cavity, suggesting a uroabdomen secondary to traumatic urethral rupture. No evidence of urethral obstruction was observed, and the urinary bladder was empty. Uroabdomen and septic peritonitis were confirmed via abdominal fluid-to-serum creatinine and potassium concentration ratios and cytological analysis, respectively. Retrograde urethral catheterization using a 3-Fr urethral catheter was achieved and intraabdominal pressure (IAP) was measured, revealing intraabdominal hypertension with IAP of 28.5 mm Hg. Ultrasound-guided abdominocentesis removed 140 mL of free fluid, reducing IAP to 14.8 mm Hg after 30 min to alleviate the uroabdomen. Subsequent IAP measurements collected every 4 h revealed a gradual decrease. Following urethral catheterization, urine output was monitored at 1- to 4-h intervals, revealing urine output of 47.15 mL/kg/h during the first hour after catheterization, indicative of POD. Intravenous fluid therapy rate was adjusted based on urine output. Urine output progressively decreased to 5.2 mL/kg/h 14 h after catheterization and to 4.5 mL/kg/h at the time of discharge. The final IAP measurement, 24 h following abdominocentesis and urethral catheterization, was 12.1 mm Hg. NEW INFORMATION PROVIDED: This case report describes a rare occurrence of POD following the alleviation of IAP in a cat with uroabdomen-induced ACS.