Case of the Month: Fall Injuries

Luna’s Story*

One evening, 5 year-old Luna was called in from playing in the back yard.  As she was running up the back steps, she fell, landing hard on her belly.  She cried out, and went directly to her bed after coming inside – an unusual behaviour for the normally very social pup.  She seemed uncomfortable, getting up and down, and panting on and off. Soon afterward, Luna began vomiting, and she was taken to the emergency veterinarian.

At the hospital, Luna’s veterinary team noticed that she had considerable abdominal pain, and was dehydrated.  Bloodwork showed that urea and creatinine, compounds that are normally eliminated in urine, were elevated.  An ultrasound showed free fluid in her abdomen that was collected and appeared to be urine. Luna was diagnosed with a traumatic bladder rupture as a result of her fall.

About the Condition: Bladder Rupture

Blunt trauma and falls don’t just cause broken bones and bruises, they can also cause serious damage to vital internal organs. 

The urinary system’s job is to maintain hydration, balance electrolytes, and rid the body of metabolic wastes.  The kidneys filter waste and excess salts out of the blood, and concentrate it within the urine.  Urine is stored in the bladder until it is an appropriate time and place for a bathroom break.

When the bladder is damaged, urine escapes into the abdominal cavity.  Not only can this be very irritating to the abdominal tissues and organs, but it also means that harmful compounds are trapped inside the body. 

Symptoms of a bladder rupture include:

• Lethargy  
• Abdominal pain
• Abdominal distension
• Vomiting
• Appetite loss
• Incontinence or abnormal urination
• Electrolyte imbalances
• Elevated blood urea and creatinine

Treatment

Initial treatment of this internal organ injury involves management of pain, and correction of dehydration and electrolyte balances using IV fluids.  A urinary catheter can be placed to empty the bladder, reducing pressure on the bladder wall, and minimizing leakage into the abdominal cavity.

A CT scan can be performed to evaluate the rupture and scan the abdominal organs for additional injuries.

Once the patient is stable, surgery can be performed to repair the tear in the bladder wall.

Luna was hospitalized for 24 hours to manage her pain, nausea, and dehydration before she went to surgery.  Her bladder repair went smoothly, and no other injuries were discovered.  After surgery, Luna stayed for another two days to ensure that she could empty her bladder comfortably on her own.  She was then discharged with pain medication and antibiotics to continue her recovery at home.

Claim Outcome

Luna’s treatment for her fall injuries cost her family more than $14,000.00**.  Their Pets Plus Us Accident and Illness More plan reimbursed them to the plan’s annual limit of $7,500.00, making the top tier care that Luna received much more achievable.  Be careful on those stairs, Luna!