What to do for a dog with ruptured bladder and fractured pelvis?

January 2, 2007

Good afternoon! I have a 5 year old,intact male cocker spaniel. He was

HBC on 12/23.Had a ruptured bladder, bilateral acetabular fractures,

and left iliac body fracture. Bladder was repaired on 12/23 and left

iliac fracture plated on 12/26. Our rehab facility is in the referral

practice that has performed the surgery so we had the luxury of

starting immediately. There was initially severe swelling and bruising

and edema of both legs. We have treated so far with laser, e-stim,

prom,and ice massage.The dog is not urinating on own yet, is getting

catheterized and may be getting urinary cathetheter placed today.

Is it too soon to put him in water? I am not getting him upright yet

as I don't want to put any pressure on the bladder by suppoting him

since he still has issues. I just feel that there must be more I can

safely do at this point. Any ideas????

Sherri

January 4, 2007

Hi Sherri,

What did they do about the acetabular fractures? Are they caudal and

they did not elect to repair them? Also, when I see dogs not urinating

on their own I typically think first of obstuction/disruption and if

not, then an upper motor neuron cord lesion. Does the dog have a

normal neuro evaluation in the hind legs? Can he support weight with

assistance? Does he have motor function/purposeful movement when he is

supported in the hind end? Normo or hyper reflexia? Other ideas are

severe trauma to the pelvic floor causing edema and inflammation around

the urethra. Trauma to the innervation to the bladder neck or trauma

in the lumbar intumescence would cause LMN signs and urinary

incontinence. As far as what you can do, I would not put him in UWTM

with a urinary catheter in and additionally, if he does have vertebral

instability/trauma/traumatic disc, he needs to have it evaluated and

addressed first. Additionally, If the acetabular fractures haven't

been addressed for some reason, then he needs to have those operated

first or much movement will be painful and damaging to the cartilage of

the joint. I don't know if this answers your question but I do think

it would be best to do more work up to get answers on the bladder,

hips, spine etc...

Mark B. Parchman, DVM, CVA, DACVS

k9habber wrote:

Good afternoon! I have a 5 year old,intact male cocker spaniel. He

was