Atrial standstill is an abnormal heart rhythm that is seen on an electrocardiogram (ECG). The rhythm is characterized by the absence of P waves on the ECG machine.1 If left untreated, an atrial standstill can lead to asystole, or cardiac arrest.
Top 3 complications from urinary obstructions
The number 1 complication can lead to cardiac arrest if not treated in time.
In this clip, Melissa Evans, CVT, LVT, VTS (ECC), owner and founder of Melissa Evans, VTS (ECC) Veterinary Nurse Consulting, discusses the top 3 complications that can occur from urinary obstructions. She explains that the number 1 complication is hyperkalemia, which can lead to atrial standstill and then asystole if not treated in time.
Below is a transcript of the video, which has been lightly edited for improved clarity.
Melissa Evans, CVT, LVT, VTS (ECC): Number one is hyperkalemia—that can really cause some major heart issues. And so, if we don't get that dealt with—if a patient doesn't get treatment in time—it can, in fact, lead to something called atrial standstill and then to asystole, where [patients] can die. So [that is] definitely [the] top complication.
Secondarily, we often see patients get very dehydrated and so after being obstructed, we have something called post obstructive diuresis, where we are giving them fluids, and we want the fluids that go into the patient to match the fluids that the patient excretes. And so, we will see them start to excrete more fluid than we are actually giving them, which can also cause dehydration. So, we want to try and match that [intake and excretion] as much as possible.
And then number 3, I'd say, is fairly rare, but it can happen when [patients] come in...late [and] it's been a while: that bladder can actually pop, basically. And then we have a uroabdomen. This can also happen when we're unblocking. Sometimes if we cause a tear in the urethra when it's being unblocked that can also cause a uroabdomen, and so we have to be really careful with that.
Reference
- Atrial standstill. Animal Care Hospital. Accessed September 10, 2025. https://www.animalcarehospital.vet/sites/site-4271/documents/Atrial%20Standstill.pdf
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