Uroabdomen in the cat: stabilise before surgery
5-year-old male cat hit by a car 30 hours ago. He is depressed, with abdominal pain and bradycardia. Abdominocentesis confirms uroabdomen (fluid creatinine much higher than serum).
| Parameter | Result | Reference |
|---|---|---|
| Serum potassium | 8.4 mmol/L | 3.5–5.5 |
| Heart rate | 130 bpm | 140–220 |
| ECG | Tall T waves, no P waves | — |
What is the most appropriate plan?
chevron_right Show answer and explanation
A. Immediate laparotomy to repair the bladder, because urine in the abdomen keeps causing hyperkalaemia
Anaesthetising a cat with severe hyperkalaemia, bradycardia and acidosis carries a high risk of arrhythmias and arrest. Surgery is necessary, but after stabilisation.
B. Intravenous furosemide to eliminate potassium in the urine
Urine is leaking into the abdomen, so increasing diuresis does not remove potassium from the body; the diuretic also worsens hypovolaemia.
C. Fluid therapy and wait for the rupture to close on its own without draining the abdomen
As long as urine remains in the peritoneum, potassium and creatinine are reabsorbed and chemical peritonitis progresses. The urine must be diverted.
D. Protect the heart with calcium gluconate, lower potassium, place an abdominal drain and a urinary catheter, and operate once stable
Correct. Calcium protects the myocardium within minutes; insulin with glucose and fluid therapy lower potassium. Draining the abdomen and diverting urine with a catheter correct the cause of the hyperkalaemia and azotaemia. Surgery is performed once potassium is falling and the patient is stable.
lightbulb Key takeaway
Uroabdomen is not an immediate surgical emergency but a metabolic one. Stabilise potassium, drain the abdomen and divert urine; then identify the site of leakage (cystography or urethrography) and operate. Being able to urinate does not rule out bladder rupture.
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Updated: October 31, 2026 · Educational content for veterinary professionals. It does not replace current clinical guidelines or the judgement of the attending veterinarian.