1. Retrograde Cystography on Roxanne By : Michelle Mobley, LVT

2. History A 9 month old 10 pound female spayed Miniature Schnauzer came into the clinic after being missing for 2 days. When Roxanne the puppy was found she was favoring her right rear leg and had a few scrapes on her abdomen. She was really scared. A 9 month old 10 pound female spayed Miniature Schnauzer came into the clinic after being missing for 2 days. When Roxanne the puppy was found she was favoring her right rear leg and had a few scrapes on her abdomen. She was really scared.

3. Physical Examination: No central neurologi8c dysfunction No central neurologi8c dysfunction Mild hindlimb paresis Mild hindlimb paresis Abdominal laceration that did not puncture the abdomen Abdominal laceration that did not puncture the abdomen Temperature – 97.4°F (hypothermia) Pulse – 175 bpm (tachycardia) Respiration – 48 rpm (panting) Weight – 10 pounds Blood Pressure – 86/34 (low diastolic BP) Mucous Membranes – pale ECG - tachycardia

4. Diagnostic Test and Results:

5. Radiograph Finding Revealed numerous pelvic fractures Revealed numerous pelvic fractures Long axis fracture of the right ilial body Long axis fracture of the right ilial body Fractures to the right ischium Fractures to the right ischium

6. Radiographs Cont. Abdomen appeared pendulous Inability to visualize the bladder Differential diagnosis for the loss of abdominal and dorsal retroperitoneal detail with hemmorrhage, urine leakage, and peritonitis

7. Positive Contrast Cystography Was performed to assess the bladder integrity because the urinary bladder was not visualized on the radiographs Was performed to assess the bladder integrity because the urinary bladder was not visualized on the radiographs

8. Positive Contrast Cystography Cont. Urinary bladder rupture was highly suspected, the catheter balloon was deflated and 9 ml of the contrast agent was administered again Urinary bladder rupture was highly suspected, the catheter balloon was deflated and 9 ml of the contrast agent was administered again

9. Possible Hit By Car The bladder rupture occurred from acute trauma by the car. Positive – contrast cystography is the best way of confirming a bladder rupture. Other indications include clinical signs that indicate bladder rupture such as anuria, hematuria, or dysuria. The bladder rupture occurred from acute trauma by the car. Positive – contrast cystography is the best way of confirming a bladder rupture. Other indications include clinical signs that indicate bladder rupture such as anuria, hematuria, or dysuria.

10. Treatment Plan Lactated Ringer’s Solution (50ml / hour) Lactated Ringer’s Solution (50ml / hour) Oxygen supplementation Oxygen supplementation Prednisolone (10mg orally) Prednisolone (10mg orally) Hydromorphone (0.3mg IV) Hydromorphone (0.3mg IV) The abdominal skin lesion was closed with sutures The abdominal skin lesion was closed with sutures

11. Home Instructions Exercise – limited for 10-14 days Diet – can eat normal food Incision – keep clean and dry for 7-10 days (no baths) sutures need to be removed in 7-10 days – please call to make an appointment

12. References: Retrieved from http://www.online- vets.com/contrast_4.html Retrieved from http://www.online- vets.com/contrast_4.htmlhttp://www.online- vets.com/contrast_4.htmlhttp://www.online- vets.com/contrast_4.html Retrieved from http://veterinarymedicine.dvm360.com/positive- contrast-cystography-dog-with-hard-detect- bladder-rupture?rel=canonical Retrieved from http://veterinarymedicine.dvm360.com/positive- contrast-cystography-dog-with-hard-detect- bladder-rupture?rel=canonical http://veterinarymedicine.dvm360.com/positive- contrast-cystography-dog-with-hard-detect- bladder-rupture?rel=canonical http://veterinarymedicine.dvm360.com/positive- contrast-cystography-dog-with-hard-detect- bladder-rupture?rel=canonical