Renal parenchymal rupture, pelvic rupture and uroabdomen secondary to bilateral renal hemorrhage and pyelonephritis in a cat.

Case summary: An 8-month-old male castrated domestic shorthair cat was presented for acute stranguria, pollakiuria and vocalization. The patient was diagnosed with urethral obstruction and hospitalized for medical management. At 36 h after discharge, the cat started passing severely hemorrhagic urine and was diagnosed with a uroperitoneum and uroretroperitoneum. An abdominal ultrasound and fluoroscopic retrograde positive contrast cystourethrogram did not identify a source of urinary tract rupture. An exploratory laparotomy revealed urine leakage from both kidneys, with evidence of rupture involving both the renal pelvis and parenchyma. It is suspected that sterile pyelonephritis and renal hemorrhage resulted in bilateral ureteral obstruction, and subsequent uroretroperitoneum, extending to cause uroperitoneum. Left ureteronephrectomy and right subcutaneous ureteral bypass placement was offered as a salvage procedure; however, euthanasia was elected intraoperatively because of a poor prognosis. Relevance and novel information: Renal pelvic and parenchymal rupture is a poorly reported cause of uroabdomen in the cat. Furthermore, although severe renal hemorrhage has not been described in cats, it may lead to bilateral ureteral obstruction and uroabdomen.