A Bladder Rupture

 D. E. Larsen, DVM

September was one of my slowest months in the large animal portion of my practice in Sweet Home. Pink eye cases probably accounted for most of my cattle calls during the summer months. Those cases were all but gone with the cooler days of fall. Cases of pneumonia were not happening yet, and the herd work usually didn’t start until October. I was happy when the phone rang, and Sandy was obviously talking about a steer.

“Alice called,” Sandy said. “She has a steer with a swollen belly. I told her she called at the right time and that you would be out shortly.”

“Must be a water belly with a ruptured bladder,” I said. “I don’t know if I will be able to help her with this one.”

I double-checked the truck. Dixie had called in sick today, so I would be on my own. With Alice to help, that would probably not be a problem.

Alice was waiting at the corral when I pulled into her driveway. The steer was in the chute. His belly filled the chute, even without any squeeze.

“I noticed this guy’s belly this morning,” Alice said. “What do you think?”

“I think he probably has a stone plugging his urethra,” I said. “When that happens, something breaks. Usually, it is his urethra. But sometimes, it’s his bladder. The bladder rupture is the most difficult to handle. I’m not sure I will be able to fix him.”

“This guy is close to weaning,” Alice said. “I can’t shoot a good-looking steer like this without trying to save him.”

“Okay, who knows, we might just get lucky,” I said. “Let’s start by seeing if I can find a stone first.”

We put a halter on the steer and tied it to a post in the corral before letting him out of the chute. When we opened the headgate, the steer had difficulty pulling his full belly through the open headgate.

Once he was out, I put a rope throw on him. I used a flying W. Once he was down, I rolled him on his back and tied his hind legs with the free ends of the throw rope. 

After clipping his belly, I could see the stone in his urethra.

“This is much easier when the urethra hasn’t been leaking urine under the skin,” I said.

I prepped the surgery site and used local anesthesia. I grabbed the penis through his skin and palpated the stone at the attachment site of the retractor penis muscle on the sigmoid flexure. The stone was easily palpated.

Holding the stone firmly, I incised through the skin and dissected it to the urethra. I made a short incision over the stone, and it popped out.

“That was simple,” Alice said as she retrieved the stone from the ground.

“I am going to leave this incision open,” I said. “He will have urine coming from it for a few days before it heals. And if there are other stones, hopefully, they will fall out of this incision rather than plugging him up again. Plus, if we can’t fix the bladder, I won’t have wasted time closing this incision.”

“How are you going to fix the bladder?” Alice asked.

“I am going to be honest with you, Alice,” I said. “This is something I have never done, and I don’t know if it is even written in the book. I did listen to a description of the procedure by Dr. Annes when I was in school. That was a clinic discussion. I probably wouldn’t have listened well if it had been in a classroom. Do you have a front-end loader on your tractor?”

“I appreciate your honesty, and no, I don’t have a front-end loader,” Alice said.

“We need to hang this guy by his hocks. That way, his guts will fall away from his pelvis, and I will be able to deal with his bladder.”

“How are we going to do that?” Alice asked.

“Maybe I can get his rear end high enough by hanging him from a fence post,” I said.

I released the throw rope, and the steer rolled to his side but did not attempt to get up. I tied his hocks together with the rope and pulled him over to the fence. 

This steer was close to five hundred pounds. I took a dally wrap with the free end of the rope on the post. I pulled hard, but the steer’s butt didn’t come off the ground.

“Let me give you a hand,” Alice said.

Alice was an older lady in her sixties and had run this ranch by herself since her husband died. She grew up on a ranch in the Dakotas, and she was tough as nails.

Alice took a grip on the rope between the steer’s hocks. We pulled together and took up the slack on the rope. With two or three pulls, we had the back half of the steer hanging from the top of the post.

“Is that going to be good enough?” Alice asked.

“I think it is going to have to be,” I said.

I prepped the steer’s abdomen and made a ventral midline incision starting at his pelvic brim. When I opened the abdomen, I was amazed and relieved that the bladder was hanging in full view. I explored the bladder, both with my gloved hands and visually. I could find no defect.

“What’s the problem?” Alice asked.

“The bladder is right here in the middle of the incision, but I don’t find a defect,” I said. “I guess it could have leaked when it stretched far enough and then closed up after it emptied some.”

“What are you going to do now?” Alice asked.

“I am going to close the abdomen and leave a drain in place to empty the urine out of his abdomen,” I said. “If he can pee normally, and if my theory is correct, we might be fine.”

Alice was quiet. I guessed she probably thought this was a goner steer. But I made a separate stab incision and placed a large penrose drain. Then I closed the abdominal incision, sprayed for flies, and gave the steer a long-acting antibiotic.

I released the rope and lowered his butt to the ground. After untying the ropes, I helped the steer to his feet.

“What do we do now?” Alice asked.

“I think just turning him out in a small pasture would be the cleanest place for him,” I said. “If you keep him in the corral or a stall, he will get dirtier than in a pasture. I will get back here in three days and take that drain out if his belly is down. Then we will just cross our fingers and watch him. With any kind of luck, we will be home free.”

***

Three days later, I was back to check the steer. I stood and watched him in the pasture while waiting for Alice to finish her work at the barn. His belly looked normal, and he was grazing well. I was lucky to see him pee, and he only had a few dribbles from the urethral incision.

When Alice was done, we ran the steer into the chute. I snipped the retaining suture on the penrose drain and pulled it out.

“He looked good out in the pasture,” I said. “Eating well, and his urine flow looked close to normal. I will check back next week. Don’t celebrate until then, but I think we may get lucky.”

***

When I stopped by Alice’s place the following week, she was not home. I watched the steer in the pasture for some time, and he looked as normal as any steer out there.

I left a note on her gate, saying she could throw a party now, we were home free.

Photo by Jorge Jimenez on Pexels.