Search

The urethral length, bladder neck position and presence of vestibulovaginal stenosis were recorded in 42 continent bitches and 57 incontinent bitches diagnosed as having sphincter mechanism incompetence. Incontinent animals had significantly shorter urethras and tended to have intrapelvic rather than intraabdominal bladder necks. There was no statistical difference in the incidence of vestibulovaginal stenosis between continent and incontinent bitches.

Disorders of the urinary system are common in geriatric dogs. Common urinary disorders that are seen in older dogs include chronic renal failure, urinary incontinence, bladder tumors, and prostate problems. Therapy for chronic renal failure is aimed at both slowing the progression of the disease and ameliorating the signs of uremia. Therapeutic recommendations for the conservative medical management of chronic renal failure include reducing dietary protein, moderately reducing salt intake, maintaining normal serum phosphorus levels, providing free access to water, avoiding stress, supplementing water soluble vitamins, using anabolic steroids to treat the anemia of chronic renal failure, treating acidosis, and controlling hypocalcemia. Urinary incontinence can often be controlled or eliminated. The appropriate approach to management of this disorder is to identify and remove specific causes. Common causes of urinary incontinence are urethral incompetence, urinary tract infection, and polyuria and polydypsia. Bladder tumors are, fortunately, not a common tumor of dogs, but are more common in geriatric dogs than in the young. The most common bladder tumor is the transitional cell carcinoma. Therapy for this tumor is usually palliative because of its malignant nature and because it is usually located in the neck of the bladder. Its location in the bladder often makes it impossible to resect the tumor completely without removing the entire bladder and diverting the ureters. New chemotherapeutic modalities are being evaluated that may increase life expectancy after diagnosis and, therefore, improve prognosis. Prostate disease is also seen in older dogs. Types of prostate abnormalities seen in dogs include prostatic hyperplasia, cysts, abscesses, acute and chronic infection, and neoplasia. The institution of proper therapy requires an accurate diagnosis; neutering is often recommended as a part of therapy regardless of the type of prostatic disease present.

Pressure changes in the urinary bladder due to respiration were measured in 75 bitches. The changes fell within a narrow range (0.5 to 2.5 cm water) and were unaffected by size or whether the bitches were entire or spayed. Significant differences were found, however, between continent (mean +/- SD, 1.1 +/- 0.4 cm water) and incontinent (mean +/- SD, 1.4 +/- 0.5 cm water) animals (P less than 0.01).

Urinary incontinence was associated with an ectopic ureter in a 5-month-old, male Wire Fox Terrier. The dog regained urinary continence after transplantation of the ureter from the urethra into the urinary bladder. Of the 3 reported cases of extopic ureters in male dogs, 2 have been associated with urinary incontinence. These observations do not support the hypothesis that ectopic ureters are more frequently recognized in female than in male dogs because urinary incontinence is more commonly associated with the disorder in female dogs.

A 16-week-old male cat with urinary incontinence was initially diagnosed as having a right ectopic ureter. Other abnormalities of the urinary system included phimosis, hydronephrosis, and localized right megaloureter. Surgical removal of the right kidney and right ureter was partially successful in stopping the urinary incontinence. Further radiographic studies and retrospective examination of initial radiographs revealed that the left ureter was also ectopic.

The clinical and radiographic findings associated with the presence of hemivertebra ("wedge-shaped"vertebra) in small and brachycephalic breeds of dogs are reported together with the results of post mortem examination in the availabel cases. The condition is characterised clinically by progressive hind-leg weakness, spinal pain, abnormalities of the nervous system and evidence of muscle atrophy or other abnormalities of conformation. Confirmation of the clinical diagnosis is by radiography. It is suggested that the condition is congenital in origin. Breed incidences are reported. The occurrence of the disorder in certain families of dogs suggests also that it may be hereditary. Other congenital abnormalities are seen in some dogs affected by hemivertebrae.

A technique was developed for recording urethral pressure profiles (UPP) in mares. Profiles were obtained from 12 clinically normal mares and from 3 mares with urinary incontinence. Variables measured on the profile included intravesicular pressure and maximal urethral closure pressure. The mean maximal urethral closure pressure of the incontinent mares was significantly less (P less than or equal to 0.001) than that of the normal mares. The technique is simple and reliable for objectively evaluating urethral pressures in mares.

A follow up study was performed in 412 spayed bitches in order to determine the incidence of urinary incontinence. The period between the operation being performed and the survey being made varied between 3 and 10 years. 83 animals (20.1%) were incontinent independent of the surgical procedure (ovariectomy versus ovariohysterectomy). The onset of incontinence varied between immediately to 12 years with an average period of 2.9 years after surgery. 57 of these incontinent bitches were treated with ephedrine or estrogen. In 73.7% a good response was achieved with ephedrine and a further 23.7% showed some improvement. Generally ephedrine was more successful than estrogen in the treatment of incontinence. There appears to be a strong connection between body weight and the incidence of incontinence. Of bitches with a body weight of less than 20 kg only 9.3% were incontinent. Whereas in bitches with a body weight of more than 20 kg the incidence was 30.9%. Of the breeds Boxers showed a high incidence of incontinence (65%) while breeds such as German Shepherds (10.6%) or Dachshunds (11.1%) showed a low incidence in relation to the average incidence rate (20.1%).

Twenty-two dogs with urethral sphincter incompetence, nonresponsive to phenylpropanolamine administration, were treated by urethral submucosal injection of Teflon. Urinary continence was achieved in all dogs for at least 2 months. Urinary incontinence recurred in 14 dogs (64%) and was controlled by a second Teflon injection in 11 of 12 dogs (92%). Minor complications included transient stranguria, with or without hematuria, after 4 of 35 injection procedures. One dog had temporary partial urethral obstruction after treatment.

A modified technique for transposition of the internal obturator muscle was used to repair perineal hernias in 100 dogs. Complications and long-term results are described. The most important complications were wound infection (45%), faecal incontinence (15%), and perineal fistula (7%). These complications often occurred in combination. The recurrence rate of perineal hernia was 5%. Nine of the 15 patients with faecal incontinence had paresis of the external anal sphincter or faecal incontinence before surgery. We suggest that in numerous patients, faecal incontinence is a complication of the condition rather than a complication of treatment. The owner's assessment of the surgical result was good in 71% and moderate in 18% of the cases.

Idiopathic detrusor instability was diagnosed as the cause of urinary incontinence in 2 dogs and a cat. The diagnosis was based on abnormal cystometrographic findings and by exclusion of other causes of detrusor hyperactivity. Anticholinergic or combined anticholinergic, antispasmodic, and local anesthetic treatment resolved the clinical signs in all 3 animals. Increased threshold volumes after treatment were documented by cystometrography in one dog and in the cat.

Prostatectomy in dogs with clinical prostatic disease has been associated with a high incidence of urinary incontinence. In this study, urodynamic alterations after prostatectomy in 10 dogs without clinical prostatic disease were evaluated. Measurements of residual urine volume, simultaneous urethral pressure profilometry and electromyography, and carbon dioxide cystometry were made before and 14 and 20 weeks after prostatectomy. Voiding was observed daily for 20 weeks after prostatectomy. All dogs remained continent for 20 weeks after prostatectomy, and only minor urodynamic abnormalities were noted. Castration had no effect on urodynamic changes associated with prostatectomy. Prostatectomy produced minimal functional changes in dogs without clinical prostatic disease.

A comparison was made between urethral pressure profiles obtained using a single sensor and 'subtracted' urethral pressure profiles resulting from double sensor recordings in 50 bitches. There were small but significant differences in the functional profile lengths and maximum urethral closure pressures between the two types of recording. The differences were partially explained by a significant fall in the intravesical pressure recorded during profilometry and variations due to respiration. The profiles from single and double sensor recording were of equal significance in the diagnosis of sphincter mechanism incompetence.

Unilateral ureteral ectopia was diagnosed in three-year-old and 10-month-old fillies exhibiting urinary incontinence since birth. In one case reimplantation of the ureter onto the bladder was planned but considered to be impractical intra-operatively. Unilateral nephrectomy was performed successfully in both cases which alleviated the urinary incontinence. Both horses had normal urinary function postoperatively and became healthy, serviceable animals.

An unusual anatomic variation of bilateral ectopic ureters was diagnosed in a 6-week-old female Siberian Husky with urinary incontinence. Assessment during surgery revealed bilateral ectopic ureters with a common opening in the proximal portion of the urethra. Ureteroneocystostomy was performed bilaterally. After surgery, intermittent urinary incontinence continued, but was less severe. After resection of a persistent hymen in the 6-month-old dog, incontinence appeared to resolve, but then recurred, and has been controlled by phenylpropanolamine administration.

Nine cases of urinary incontinence in dogs were evaluated by various diagnostic methods, including the urethral pressure profile (UPP). The UPP was derived from a need to study th dynamics of the urethra in patients with urinary tract obstruction or incompetence of the urethral sphincteric mechanism and was obtained in dogs with similar problems. The method involved slowly withdrawing a fluid-filled catheter through the urethra while a chart recorder graphed the pressure changes within the urethral lumen. The graphs obtained from clinical cases were compared with normal values established for the UPP in dogs. The UPP proved to be a simple and reliable means by which to determine intraurethral events and aided in establishing the cause of urinary incontinence in several dogs. The profile provided a graphic description of intraurethral resistance in each case and was valuable in localizing areas of increased urethral resistance or obstructions and decreased urethral resistance or incompetence. Frequently, specific therapy for the urinary incontinence was instituted on the basis of the UPP.

Two mares were examined because of urinary incontinence. Abnormalities of the genitourinary tract were identified and were corrected surgically. Urinary incontinence in mares generally is associated with a poor prognosis. The importance of a thorough physical examination of the genitourinary tract in the mare is emphasized, and the simple and successful surgical correction of structural abnormalities of the tract in 2 mares is described.

The blood and urine biochemical profiles of two color strains of mink, Demi-Buff and Pastel, were studied. Changes associated with the incidence of wet belly disease in some of them were determined by comparison with unaffected animals. Chloride and potassium were the only blood parameters significantly different between these two strains of mink. In blood, PO2 was the only significant difference detected between wet belly affected and unaffected mink. Pastel mink excreted significantly more potassium and nitrogen in the daily urine excretion than did the Demi-Buff strain. The most significant findings were observed in the urine of mink affected with wet belly disease when compared with unaffected animals. Twenty-four hour urine excretion volume was significantly reduced in mink with wet belly disease. Chloride, ammonia, and net acid were significantly higher than normal in the urine of mink with wet belly disease.

Based on clinical response, urethral pressure profile changes, and lack of side effects, phenylpropanolamine was effective and safe in treating dogs with primary sphincter incompetence. Primary sphincter incompetence was diagnosed in 11 female and 8 male dogs with urinary incontinence. Urodynamics of the dogs were assessed, using a combined urethral pressure profile and urethral sphincter electromyography. Male and female dogs had significantly (P less than 0.05) lower maximal urethral closure pressures, when compared with clinically normally dogs (36.91 +/- 8.20 cm of H2O vs 79.72 +/- 4.61 cm of H2O for female dogs and 48.63 +/- 8.68 cm of H2O vs 99.77 +/- 11.71 cm of H2O for male dogs). After treatment with phenylpropanolamine, there was a significant increase in maximal urethral closure pressure in both sexes to within normal range (77.73 +/- 8.70 cm of H2O in females and 92.50 +/- 14.60 cm of H2O in males). Electromyographic activity was normal before and after treatment. Urinary incontinence resolved clinically in all but 1 male and 1 female dog; however, the condition in these 2 dogs improved considerably. Minimal side effects were seen clinically. Mean arterial blood pressure was not altered by treatment. Plasma estrogen and testosterone concentrations in 8 female dogs were not different from those in continent female dogs. The incontinence in these dogs was considered a sphincter incompetence rather than estrogen responsive.

An ectopic ureter extending to the urinary bladder and to the proximal portion of the urethra was diagnosed in a 6-month-old dog with urinary incontinence. The diagnosis was made by use of excretory urography. The kidney and ureter were removed. When urinary incontinence continued, positive-contrast cystography was performed. The ectopic ureter was found to bypass the bladder via a submucosal extension that emptied into the urethra.

Nonneurogenic incontinence was observed in a 1-year-old Pekingese X Poodle with female pseudohermaphroditism. The dog had male external genitalia as well as a well-developed vagina, uterus, and ovaries. Urinary incontinence was caused by an anomalous communication of the prostatic urethra with the vagina. Ovariohysterectomy and surgical correction of the urethrovaginal fistula was followed by remission of urinary incontinence. Subsequently, the dog developed estrogen responsive urinary incontinence. Nonneurogenic incontinence to be a common finding in canine pseudohermaphroditism associated with abnormalities of the vagina or urethra (or both). Surgical correction should be considered to correct anomalous communications between the genital and lower urinary tracts.

Contrast radiography enabled identification of 17 dogs with pelvic location of the caudal portion of the urinary bladder. The caudal pole of each bladder consistently was more blunted than expected. The range of craniocaudal dimension within the pelvic canal was 6% to 26% of the distended bladder. Ten dogs were females with urinary incontinence. Seven dogs did not have incontinence; 4 were males and 3 were intact females. Six dogs had associated anatomic abnormalities: urachal diverticulum (3), bladder adhesions (1), rectovaginal fistula (1), and inverted vulva (1). Eleven dogs had urinary tract infection. In addition, urinary incontinence and pelvic bladder without urinary tract infection or other anatomic abnormalities was identified in 4 large-breed spayed females. These dogs responded poorly to diethylstilbestrol therapy. Three of the 4 subsequently were treated with ephedrine, and all had their incontinence effectively controlled by its continued use. Four of the 10 incontinent dogs in this series were Doberman Pinschers, suggesting breed predisposition. These data indicated an association between pelvic bladder and urinary incontinence in the spayed female dog, but also indicated that pelvic bladder can be found in both sexes and that it is associated with urologic abnormalities other than incontinence.

The field experience of a method of surgical treatment of bitches showing urinary incontinence following castration is reported.

Ten bitches with urinary incontinence due to incompetence of the urethral sphincter mechanism were treated with phenylpropanolamine hydrochloride at a dose of either 1 mg/kg orally three times daily or 2 mg/kg orally once daily in a prolonged release formulation. The signs of incontinence resolved in all the bitches, and improvements were maintained over periods ranging from one to more than two years, except in one bitch which became refractory to treatment after three months. One bitch which was inadvertently treated at a dose rate of 2.5 mg/kg showed signs of lethargy and inappetence but returned to normal when the dose rate was reduced.

A case of vesical calculus in which haematuria was not a presenting sign is described. Methods of removal of vesical calculi are discussed. In this case, urethral sphincterotomy facilitated delivery.

After grazing forage sorghum and grain sorghum regrowth, 54 of 330 breeding cows became ataxic and developed urinary incontinence. Three cows became recumbent, 2 of which died and the third was killed and autopsied. Wallerian degeneration of the white matter of the spinal cord, cerebellar peduncles and cerebellum was seen histologically. Other affected animals began to recover on removal from the crop, complete clinical recovery taking from a few days to over a month. About 5% of affected cows develped purulent cystitis.

Three epidemiological observational studies, utilising data from the computerized data base at the Royal (Dick) School of Veterinary Studies, Edinburgh, are presented: the association between tail injuries and docking in dogs; a study of breed and sex in relation to canine degenerative heart valve disease, the association between urinary incontinence and spaying in bitches.