Bladder rupture in late-pregnancy mares: Four cases.

Overview

• This study examines four cases of bladder rupture in late-pregnancy mares, discussing their clinical signs, diagnostic methods, and outcomes.

Introduction and Case Background

• The study focuses on broodmares that were at or past their expected foaling date, a critical period in late pregnancy when complications can arise.
• Bladder rupture, a rare but serious condition, was diagnosed in four late-pregnancy mares presenting various clinical symptoms.

Clinical Presentations

• Initial symptoms included abdominal discomfort in three mares and dystocia (difficult labor) in one mare.
• Additional signs related to bladder rupture were observed in three of the mares:
  • Pollakiuria (frequent urination) in two mares.
  • Hematuria (blood in urine) in one mare.
• All mares were either overdue or at their expected delivery time, indicating that bladder rupture may often occur late in pregnancy.

Diagnostic Approaches

• Diagnosis involved several clinical and laboratory evaluations:
  • Measurement of creatinine levels in peritoneal fluid, which was increased in three mares.
  • The peritoneal to serum creatinine ratio averaged 4.1, a key indicator of uroperitoneum (urine in the peritoneal cavity).
  • Cystoscopy allowed direct visualization of the bladder tear in three cases, confirming rupture.
  • Repeated ultrasonographic examinations and clinicopathological assessments were essential when initial free peritoneal fluid accumulation was absent.
• Notably, in three mares, no free peritoneal fluid was detected initially, which may have delayed diagnosis for several days until uroperitoneum became apparent.

Management and Outcomes

• Two of the four mares were successfully treated and discharged from the hospital.
• Comprehensive evaluation using multiple diagnostic modalities was critical for timely diagnosis and treatment planning.

Clinical Implications and Recommendations

• Veterinarians should consider bladder rupture in late-pregnancy broodmares especially if they present signs such as colic, pollakiuria, or hematuria.
• Awareness that free peritoneal fluid may not be present initially can prompt repeated examinations to avoid delays in diagnosis.
• Timely diagnosis and intervention can improve outcomes for mares with bladder rupture occurring in late pregnancy.