Practical relevance: Traumatic injury of the urinary tract may be caused by external accidental trauma or due to iatrogenic injury (typically as a result of catheterisation procedures). Thorough patient assessment and careful attention to patient stabilisation are essential, with diagnosis and surgical repair delayed until the patient is stable, if necessary. Treatment depends on the location and severity of the trauma. If diagnosed and treated promptly, the chance of survival of a patient without other concurrent injuries is good. Clinical challenges: Following accidental trauma, at the initial presentation urinary tract injury can be overshadowed by other injuries, but if left undiagnosed or untreated it can lead to serious morbidity and potentially mortality. Many of the surgical techniques described for management of urinary tract trauma can be associated with complications, and so comprehensive communication with the owners is necessary. Patient group: The main population affected by urinary tract trauma is young, adult male cats, owing to their roaming behaviour, as well as their anatomy and the resulting increased risk of urethral obstruction and its associated management. Aims: This article aims to serve as a guide to all veterinarians who treat cats for the diagnosis and management of urinary tract trauma in cats. Evidence base: This review summarises the current knowledge available from a number of original articles and textbook chapters in the literature that cover all aspects of feline urinary tract trauma, and is supported by the authors’ own clinical experience.
Tube cystostomy is the placement of a catheter into the urinary bladder, via the body wall, allowing drainage of urine. This technique is used for temporary or permanent management of functional or mechanical obstruction of the bladder or urethra or to achieve bypass of the lower urinary tract. The techniques for tube cystostomy placement, at midline laparotomy or via a minimally invasive inguinal approach, are described step by step with illustrative pictures. Management, monitoring and removal of a tube cystostomy are described.
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