Emergency care of a cat with a ruptured bladder

Abstract

A 7-month-old domestic short-hair male neutered cat, Crumble, arrived at hospital after falling from a first floor window. He had vomited after the fall, presented as tachypnoeic, with pale pink mucus membranes and poor peripheral pulses. Crumble required shock rate intravenous fluids, methadone (Comfortan; Dechra) given at 0.3 mg/kg for analgesia, diagnostic imagining and blood tests. Blood tests showed uremia which indicated uroabdomen. Diagnostic imaging was limited because of pain. Additional analgesic methadone was given at 0.2mg/kg. The serosanguinous fluid drained from abdomen confirmed ruptured bladder. Continuous rate infusion (CRI) of fentanyl (Dechra) running at 3 mcg/kg/hour was initiated, and a plasma volume substitute as a bolus of gelofusine 5mg/kg bolus over 15 minutes was given to help stabilise hypotension. A urinary catheter was placed in preparation for surgery and noradrenaline CRI was started once under anaesthesia. Intravenous fluids were continued to help with uremia, and the broad spectrum antimicrobial co-amoxiclav 20 mg/kg was given, as well as fentanyl CRI for further analgesia. The patient remained in hospital to monitor uremia, hypotension and pain, as well as urine output. He was discharged after 3 days and seen back after 2 days to review.