Urothorax Associated with Uroperitoneum in a Dog Without Diaphragmatic Disruption

Abstract

Accumulation of urine in the pleural space secondary to uroperitoneum with no disruption of the diaphragm appears to be a rare pathological condition. A 2 yr old male mixed-breed dog was referred with dyspnea and abdominal pain after a road traffic accident. Plain radiographs demonstrated pleural effusion and reduced serosal detail in the abdominal cavity that was compatible with fluid accumulation. Retrograde urethrography revealed a pelvic urethra rupture. Biochemical analysis of the pleural and abdominal fluid confirmed the diagnosis of urothorax and uroperitoneum. The dog underwent a prepubic urethrostomy and intensive care management. The dog was reported to be in good health after a follow up time of 10 mo. To the authors' knowledge, this is the first reported case of urothorax associated with uroperitoneum with no detectable defects of the diaphragm in a dog.

Successful resolution of urothorax secondary to non-traumatic uroabdomen in a cat managed with peritoneal dialysis as a bridge to surgery

“…7 Two cases of urothorax have been described in dogs, both related to blunt trauma and only one where the diaphragm appeared intact. 6,8 In people, the main causes of urothorax are obstructive uropathy and trauma. A favorable clinical outcome in people with urothorax has been reported in 74/77 (96.1%) cases when the treatment was focused on the management of primary urinary pathology.…”

“…Only three case reports of urothorax are documented in the veterinary literature, all three cases (two dogs and one cat) were secondary to traumatic uroabdomen, and only in one of the canine cases was the diaphragm not compromised. [6][7][8] In the other two cases, there was a concurrent rupture of the bladder and diaphragm. In the case where the thoracic cavity was not compromised, the diagnosis of urothorax was made based on a creatinine ratio >2 ([Creatinine] pleural fluid /[Creatinine] plasma ), and other causes of pleural effusion were ruled out.…”

The laboratory diagnostic approach to thoracic and abdominal effusions in the dog, cat, and horse

“…Effusion concentration 2 times above serum levels is considered indicative of the condition. In a case reported in 2015, the same criteria were also used to detect urothorax in a dog in which the accumulation of urine in the thoracic cavity was found to be secondary to uroperitoneum (Tsompanidou et al, 2015). Fluid urea is not useful in the diagnosis of uroabdomen as it diffuses rapidly across membranes given its small size.…”

“…Potassium: The effusion:serum potassium value has been used in the diagnosis of uroabdomen (Dempsey and Ewing, 2011;Fry, 2011;Tsompanidou et al, 2015, Ben Oz et al, 2016 but it was recently proposed that it could also be indicative of gastric perforation (Ben Oz et al, 2016).…”

“…Η γνώση αυτή είναι απαραίτητη για την έγκαιρη και αποτελεσματική θεραπευτική αντιμετώπιση της υποκείμενης παθολογικής κατάστασης. pneumothorax/pneumoperitoneum, pyothorax/septic peritonitis, or even uroperitoneum/urothorax can develop (Tsompanidou, 2015).…”