Aetiologie, Klinik und Prognose bei männlichen Rindern mit Harnröhrenverschluss

Aetiology, signs and prognosis of male cattle with urethral
occlusion The objective of this prospective study was a detailed
description of the clinical signs of cattle with urethral occlusion
and to define prognostic indicators. Male cattle admitted to the
clinic were included in the study if their history or initial
clinical examination suggested urethral occlusion. A total of 126
cattle one month to two years old were enrolled. For the
description of the clinical picture the relevant anamnestic
information as well as the clinical and laboratory findings are
described. Prognosis was evaluated on the basis of clinical,
laboratory and post mortem findings, as well as on the subsequent
course of survivors. The exact cause of the occlusion was
determined by post mortem examination in non-survivors. Urethral
occlusion can be diagnosed by physical examination. Failure to pass
urine in animals with a distended urinary bladder or subcutaneous
oedema or intraperitoneal urine accumulation are considered to be
diagnostic. Not only the parameters of the special but also of the
general physical examination turned out to be important in the
evaluation of the stage of the disease and the detection of
inflammatory processes. Initially a sawhorse stance, agitation and
colic were prominent, whereas animals in the advanced stage became
weak and recumbent; some of them did so after a transient period of
apparent improvement of their general condition. For cattle with
concomitant inflammatory processes an arched back with a distinctly
depressed behaviour was significant. In addition these animals were
mostly in a poor nutrional state and had a dull or shaggy haircoat.
Among the findings of the special physical examination, inspection
and/or palpation of the penis (evidence of a penis haematoma), the
ventral abdomen (evidence of oedema), the abdomen (evidence of an
intraperitoneal urine accumulation and/or peritonitis) and finally
the evaluation of the umbilicus (evidence of ascending infections),
bladder, and kidneys were found to be meaningful. Abdominocentesis
was performed, if intraperitoneal urine accumulation and/or
peritonitis was suspected. Depending on the age a rectal
examination was often impossible. Deep palpation of the abdominal
cavity couldn’t be performed in animals with a fully developed
rumen, increased tension of the abdominal wall and those with
ventral oedema or intraperitoneal urine accumulation. In these
cases the diagnostic importance of ultrasonography in the
examination of intraabdominal structures as well as the
determination of increased inflammatory alteration of the
intraabdominal fluid was evident. Among the laboratory findings,
only azotaemia was significant, whereas other parameters didn’t
show any consistent tendency with regard to the stage of disease or
the involvement of inflammatory processes. A total 42 out of 60
animals with uncomplicated urethral occlusion were discharged. Out
of 18 euthanized animals 11 were put to sleep because of extensive
inflammatory alterations, five because micturition was not restored
post operatively, and two because of other critical diseases. 41 of
the patients showed intraperitoneal urine accumulation in varying
extents with infections and accompanying irreparable inflammatory
alterations present in 23 cases. Out of 18 cattle with non-infected
intraperitoneal urine only seven could be cured, the others were
put to sleep for other reasons. In two animals with slight oedema
resorption took place within three days, whereas the massive
infiltration of urine into the subcutis resulted in necrosis of the
affected areas and was followed by gangrene in 13 cases. Except for
two animals with an uracheal abscess and a bilateral pyelonephritis
respectively all were discharged after an extended stay at the
clinic. By contrast, four cattle with infected oedema developed
cellulitis with distinct deterioration of their general condition
and had to be destroyed. Six patients were put to sleep after the
initial examination or during surgery. Therefore the further
progression of the uric oedema couldn’t be evaluated. In five of
these cases euthanasia was a consequence of urethral occlusion, in
one case it was in consequence of another disease. Thus prognosis
is mainly influenced by duration of illness as well as the
involvement of inflammatory processes. Animals at the early stage
of the disease, but also those with uric oedema in case of
uncontaminated urine have a favourable prognosis. Prognosis is
doubtful in animals with peritoneal accumulation of uninfected
urine. It is nearly hopeless in the case of infiltration of
infected urine into the subcutis (cellulitis) or in the abdominal
cavity (peritonitis). Therefore, the presence of inflammatory
processes should be ruled out as much as possible before surgical
intervention is considered.