Intermittent urinary obstruction after pelvic trauma: a rare feline bladder displacement solved surgically

Trauma-associated dynamic intrapelvic urinary bladder displacement in a cat corrected with surgical cystopexy

Caroline Calabro; Kyle L. Granger Jr; Benjamin Goldblatt; Yuvani Bandara; Anna Price; Kate McCaw; Ashley Villatoro

Background

Dynamic intrapelvic urinary bladder displacement (DIUBD) is an uncommon condition in which the urinary bladder intermittently shifts caudally into the pelvic canal, leading to episodic lower urinary tract obstruction. While this phenomenon is more frequently described in dogs, feline cases are rarely reported, potentially delaying diagnosis. Trauma and healed pelvic fractures may weaken pelvic support structures, allowing abnormal bladder mobility. This report aimed to describe the clinical presentation, diagnostic challenges and successful surgical management of DIUBD in a cat with a history of pelvic trauma.

Methods

An 8-year-old spayed female domestic shorthair cat with a history of multiple healed pelvic fractures presented with progressive stranguria and tenesmus. Diagnostic evaluation included serial abdominal radiography, ultrasonography, blood gas analysis, serum biochemistry and urinalysis. Imaging was repeated at different time points to assess bladder position. Due to persistent clinical signs and imaging evidence of bladder mobility, exploratory laparoscopy was performed, followed by laparoscopic-assisted cystopexy to stabilize the bladder in a cranial position.

Results

Imaging demonstrated intermittent caudal displacement of the urinary bladder into the pelvic canal, with associated post-renal azotemia and mild bilateral hydronephrosis. Intraoperatively, the bladder was found to be excessively mobile without a discrete pelvic diaphragm defect. Cystopexy successfully anchored the bladder cranially. Postoperatively, stranguria resolved rapidly, renal values improved and follow-up radiographs confirmed persistent cranial bladder positioning. The cat remained clinically normal with no recurrence of urinary signs at 6 months.

Limitations

This report describes a single clinical case, limiting generalizability. Dynamic contrast studies and functional urodynamic testing were not performed, restricting physiologic characterization of the obstruction. The contribution of concurrent factors such as colonic distension could not be fully assessed.

Conclusions

DIUBD, although rare in cats, should be considered in patients with recurrent lower urinary tract obstruction and a history of pelvic trauma. Serial or repeat imaging is critical, as bladder position may appear normal on static studies. Surgical cystopexy effectively resolved intermittent obstruction in this case, supporting its use as a definitive treatment once DIUBD is identified.

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