Basics of Uroperitoneum Flashcards
causes of uroperitoneum
bladder rupture leaky urachus (secondary to infections) congenitcal urinary defects traumatic defects
Bladder rupture happens most commonly in
males
foals between 1-3 days old
Clinical signs of Bladder rupture
depressed distended abdomen developing colic after 1-3 days of rupture stranguria ballottement of abdomen
how is Bladder rupture different to impactions?
concave back in Bladder rupture
convex in impactions
Typical lab findings with Bladder rupture (and then with older foals)
hyperkalemia hyponatremia hypochloremia azotemia Increased PCV/TP, stress leukogram older - DH and metabolic acidosis
Pathogenesis of Bladder rupture
milk is high in K and low in NaCl –> kidneys conserve Na/Cl –> urine is highK and low Na/Cl.
rupture - into abdomen –> Na/Cl from plasma goes into peritoneum, K from peritoneum goes into plasma
This causes the lab results
Diagnostic tests for Bladder rupture and what we look for…
Abdominocentesis –> periton creatinine:plasma creatinine ratio is 2:1 or higher
NMB test - catheter this stuff, then do the abdominocentesis
rads - fluid and positive contrast
U/S - free fluid
Exploratory
Treatment for Bladder rupture
SURGERY. but before, stabilize.
when can we go for surgery for Bladder rupture and how much will that be?
after K is
Pre-surgery tx for Bladder rupture
saline, 5% dextrose, sodium bicarb
Pen IV, Gent or amikacin
Slow drainage with drain (foley or chest tube)
Sx technique for Bladder rupture
traction on bladder and umbilicus stay sutures debride edges simple continuous cushing or lambert lavage with warm saline no. 1 and 2 absorbable for ventral midline 3-0 absorbable SQ 2- non-absorbale for skin
Factors affecting Prognosis
if arrhythmia from electrolytes or anes.
re-occurence if suture doesn’t hold
Levels of IgG from mother
causes of urachal leakeage
septic
premature
hypoxic-ischemic ECopathy
When and why do we see uracahl leakage
prolonged recumbency and bladder distention
5-7 days of treatment
Clinical signs of urachal leakage
similar but maybe not lab findings to Bladder rupture
