A retrospective analysis of urethral rupture in 63 cats

Abstract

The aim of this study was to investigate the short- and long-term morbidity and mortality associated with urethral rupture in cats. Medical records were reviewed from four veterinary hospitals. Diagnosis was made from retrograde urethrography or direct visualisation during surgery. Location of rupture was categorised as pre-, intra- or post-pelvic. Follow-up data were collected from referring veterinarians. Sixty-three cats were included in the study of which, males predominated (88.9%). Trauma was the most common cause (n = 35; 55.6%) with the remainder due to iatrogenic injury. Forty-eight cats (88.9%) were treated surgically and six (11.1%) managed conservatively. Significant differences between cats suffering traumatic versus iatrogenic injury included the presence of musculoskeletal injuries ( P <0.001); the location of rupture ( P <0.001); the degree of rupture ( P <0.001); definitive management ( P <0.001) and short-term complications ( P = 0.026). Short-term complications were significantly associated with the following: musculoskeletal injuries ( P = 0.012); uroabdomen/uroretroperitoneum ( P = 0.004); azotaemia ( P = 0.021); postoperative urinary diversion ( P = 0.036) and >1 surgery performed ( P = 0.006). Forty-seven cats (74.6%) survived to discharge. Prognostic factors associated with survival to discharge included the presence of musculoskeletal injuries ( P = 0.017); cause of rupture ( P = 0.017); location of rupture ( P = 0.039) and definitive management ( P = 0.020). Twenty-four cats (57.1%) suffered short-term complications and 10 (27.0%) suffered long-term complications. Of those cats surviving to discharge 30 (71.4%) had a good outcome. Median follow-up was 16 months. Outcome was significantly associated with cause of rupture ( P = 0.04); short-term complications ( P = 0.03) and long-term complications ( P <0.001). In conclusion, a significantly greater proportion of cats with iatrogenic injuries survived to discharge and had a good outcome compared with those that suffered trauma.