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Nursing the uroabdomen patient

02 April 2021
16 mins read
Volume 12 · Issue 3
Figure 1. Tachycardic patient with peaked T waves on an electrocardiogram.


Uroabdomen, the presence of urine in the abdominal cavity, commonly occurs in dogs and cats, particularly following a trauma. Initial stabilisation of the patient is essential to treat the multisystemic effects of electrolyte and metabolic derangements, including hyperkalaemia, azotaemia and metabolic acidosis. Diagnosis is confirmed by comparing laboratory analysis of abdominal fluid and serum. Urinary diversion is required, often via placement of a urinary catheter, to prevent continuing urine accumulation.

Once haemodynamically stable, diagnostic imaging may be performed to confirm the location of the urinary tract rupture, with several modes of imaging available. Surgical intervention may be necessary to repair the urinary leak, this is dependent on the location and severity of the trauma to the urinary tract.

Registered veterinary nurses play an important role in the management of the uroabdomen patient, from initial triage and stabilisation, to assisting with imaging, anaesthetic monitoring and postoperative care. This article will discuss the aetiology of the uroabdomen, patient presentation and how to effectively treat the critical patient. Nursing care is vital for ensuring patient welfare and identifying complications that may arise.

Uroabdomen refers to the presence of urine in the abdomen, which occurs secondary to a rupture in the urinary tract. Urine leakage accumulates in the peritoneal or retroperitoneal cavity (or both), resulting in an effusion (Valtolina, 2018). Uroperitoneal effusion is most commonly seen in dogs and cats, with multiple causes including trauma, following obstruction, iatrogenic damage from urinary catheter placement or the presence of neoplasia (Stilwell, 2017; Press and Balakrishnan, 2018). Uroperitoneal effusions occur secondary to a rupture in the lower urinary tract, i.e. the urethra, urinary bladder or distal ureter, whereas a uroreteroperitoneal effusion occurs with injury to the kidney or proximal ureter (Stilwell, 2017; Foster and Humm, 2018).

Hypovolaemia and electrolyte and metabolic disturbances occur secondary to a uroabdomen, with derangements including hyperkalaemia, azotaemia and metabolic acidosis. Prompt stabilisation is required to prevent multisystemic effects becoming life threatening (Stafford and Bartges, 2013; Stilwell, 2017).

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