1
|
Pegram C, Diaz-Ordaz K, Brodbelt DC, Chang YM, Hall JL, Church DB, O’Neill DG. Later-age neutering causes lower risk of early-onset urinary incontinence than early neutering-a VetCompass target trial emulation study. PLoS One 2024; 19:e0305526. [PMID: 38959183 PMCID: PMC11221680 DOI: 10.1371/journal.pone.0305526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 06/02/2024] [Indexed: 07/05/2024] Open
Abstract
There is growing evidence supporting clinically important associations between age at neutering in bitches and subsequent urinary incontinence (UI), although much of this evidence to date is considered weak. Target trial emulation is an innovative approach in causal inference that has gained substantial attention in recent years, aiming to simulate a hypothetical randomised controlled trial by leveraging observational data. Using anonymised veterinary clinical data from the VetCompass Programme, this study applied the target trial emulation framework to determine whether later-age neutering (≥ 7 to ≤ 18 months) causes decreased odds of early-onset UI (diagnosed < 8.5 years) compared to early-age neutering (3 to < 7 months). The study included bitches in the VetCompass database born from January 1, 2010, to December 31, 2012, and neutered between 3 and 18 months old. Bitches were retrospectively confirmed from the electronic health records as neutered early or later. The primary outcome was a diagnosis of early-onset UI. Informed from a directed acyclic graph, data on the following covariates were extracted: breed, insurance status, co-morbidities and veterinary group. Inverse probability of treatment weighting was used to adjust for confounding, with inverse probability of censoring weighting accounting for censored bitches. The emulated trial included 612 early-age neutered bitches and 888 later-age neutered bitches. A pooled logistic regression outcome model identified bitches neutered later at 0.80 times the odds (95% CI 0.54 to 0.97) of early-onset UI compared with bitches neutered early. The findings show that later-age neutering causes reduced odds of early-onset UI diagnosis compared with early-age neutering. Decision-making on the age of neutering should be carefully considered, with preference given to delaying neutering until after 7 months of age unless other major reasons justify earlier surgery. The study is one of the first to demonstrate successful application of the target trial framework to veterinary observational data.
Collapse
Affiliation(s)
- Camilla Pegram
- Pathobiology and Population Sciences, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Herts, United Kingdom
| | - Karla Diaz-Ordaz
- Department of Statistical Science, University College London, London, United Kingdom
| | - Dave C. Brodbelt
- Pathobiology and Population Sciences, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Herts, United Kingdom
| | - Yu-Mei Chang
- Research Support Office, The Royal Veterinary College, Hatfield, Herts, United Kingdom
| | - Jon L. Hall
- School of Veterinary Medicine and Science, University of Nottingham, Nottingham, Sutton Bonington, United Kingdom
| | - David B. Church
- Clinical Science and Services, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Herts, United Kingdom
| | - Dan G. O’Neill
- Pathobiology and Population Sciences, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Herts, United Kingdom
| |
Collapse
|
2
|
Neumann G, Vachon C, Culp WT, Palm C, Byron JK, Pogue J, Dunn M. Placement of an artificial urethral sphincter in 8 male dogs with urethral diverticulum. J Vet Intern Med 2024; 38:2171-2179. [PMID: 38750407 PMCID: PMC11256159 DOI: 10.1111/jvim.17102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 04/26/2024] [Indexed: 07/19/2024] Open
Abstract
BACKGROUND Urethral diverticulum (UD) is a poorly defined anomaly consisting of an outpouching of the urethra. Management without surgical resection is not previously reported in dogs. HYPOTHESIS/OBJECTIVES Report the outcome of male dogs presented for urinary incontinence with UD treated with an artificial urethral sphincter (AUS). ANIMALS Eight client-owned dogs with UD treated with an AUS. METHODS Multicenter retrospective study. Medical records from male dogs with urinary incontinence were reviewed. INCLUSION CRITERIA diagnosis of a UD by retrograde cystourethrography, cystoscopy, abdominal ultrasonography or contrast computed tomodensitometry (CT) or a combination of these modalities, AUS placement, and at least 1 follow-up. Urinary continence score (UCS) was attributed retrospectively. RESULTS Median UCS at presentation was 1/5. A contrast cystourethrogram was diagnostic in 8/8 dogs. All diverticula were saccular, and 7/8 were within the prostatic urethra and 1/8 extended up to the membranous urethra. A congenital origin was suspected in 7 dogs and acquired in 1. Concurrent anomalies included renal dysplasia or chronic pyelonephritis (n = 4), bilateral cryptorchidism (n = 3), and pelvic urinary bladder (n = 3). All dogs were poorly/moderately responsive to phenylpropanolamine. Artificial urethral sphincter placement resulted in improvement in continence in all dogs with a median UCS of 4/5 (5/5 in 2/8 dogs, 4/5 in 5/8 dogs, 3/5 in 1/8 dogs). CONCLUSION Urethral diverticulum should be considered in male dogs with persistent urinary incontinence not responding to medical management. Artificial urethral sphincter placement is an effective therapeutic option that improved continence scores in all dogs.
Collapse
Affiliation(s)
- Geoffrey Neumann
- Department of Clinical Sciences, School of Veterinary MedicineUniversity of MontrealSaint‐HyacintheQuebecCanada
| | - Catherine Vachon
- Department of Clinical Sciences, School of Veterinary MedicineUniversity of MontrealSaint‐HyacintheQuebecCanada
| | - William T.N. Culp
- Department of Veterinary Surgical and Radiological SciencesUC Davis Veterinary MedicineDavisCaliforniaUSA
| | - Carrie Palm
- Department of Veterinary Surgical and Radiological SciencesUC Davis Veterinary MedicineDavisCaliforniaUSA
| | - Julie K. Byron
- Department of Veterinary Clinical SciencesOhio State UniversityColumbusOhioUSA
| | - Joanna Pogue
- Department of Veterinary Clinical SciencesOhio State UniversityColumbusOhioUSA
| | - Marilyn Dunn
- Department of Clinical Sciences, School of Veterinary MedicineUniversity of MontrealSaint‐HyacintheQuebecCanada
| |
Collapse
|
3
|
Vaden SL, Mathews KG, Yoo J, Williams JK, Harris T, Secoura P, Robertson J, Gleason KL, Reynolds H, Piedrahita J. The use of autologous skeletal muscle progenitor cells for adjunctive treatment of presumptive urethral sphincter mechanism incompetence in female dogs. J Vet Intern Med 2022; 36:1686-1692. [PMID: 35930303 PMCID: PMC9511066 DOI: 10.1111/jvim.16505] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 07/15/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Urethral sphincter mechanism incompetence (USMI) is a common problem in female dogs, but some dogs fail to achieve continence with standard treatment. Urethral submucosal injection of autologous skeletal muscle progenitor cells (skMPCs) previously has been shown to restore urethral function in a canine model of USMI. HYPOTHESIS/OBJECTIVE To determine if urethral submucosal injection of skMPC alters continence in dogs with USMI that had previously failed standard medical management. We hypothesized that the injections would lead to improved continence. ANIMALS Fifteen client-owned dogs with USMI that had failed standard medical management. METHODS Dogs were prospectively enrolled into a single-armed clinical trial. Once enrolled, a triceps muscle of each dog was biopsied; the tissue specimens were digested, cultured, and expanded to 100 million cells before injection into the urethral submucosa using a surgical approach. Continence was assessed at baseline and 3, 6, 12, and 24 months post-injection using continence scores and urethral pressure profilometry. RESULTS Median continence scores increased significantly from baseline at 3, 6, 12, and 24 months. Increases were seen in 14 of 15 dogs with 7, 6 or 1 dog achieving scores of 5, 4 or 3, respectively. Additional medication was required to achieve continence in all but 2 dogs. CONCLUSIONS AND CLINICAL IMPORTANCE Urethral submucosal injection of skMPC can be used adjunctively to improve continence in dogs with difficult to manage USMI. The procedure is labor intensive but well tolerated; most dogs will require continued medication to remain continent.
Collapse
Affiliation(s)
- Shelly L Vaden
- Department of Clinical Sciences, North Carolina State University, Raleigh, North Carolina, USA
| | - Kyle G Mathews
- Department of Clinical Sciences, North Carolina State University, Raleigh, North Carolina, USA
| | - James Yoo
- Wake Forest Institute for Regenerative Medicine, Winston-Salem, North Carolina, USA
| | - James Koudy Williams
- Wake Forest Institute for Regenerative Medicine, Winston-Salem, North Carolina, USA
| | - Tonya Harris
- Department of Clinical Sciences, North Carolina State University, Raleigh, North Carolina, USA
| | - Patty Secoura
- NC State Veterinary Hospital, North Carolina State University, Raleigh, North Carolina, USA
| | - James Robertson
- College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | - Katherine L Gleason
- Department of Molecular Biomedical Sciences, North Carolina State University, Raleigh, North Carolina, USA
| | - Hannah Reynolds
- Department of Molecular Biomedical Sciences, North Carolina State University, Raleigh, North Carolina, USA
| | - Jorge Piedrahita
- Department of Molecular Biomedical Sciences, North Carolina State University, Raleigh, North Carolina, USA
| |
Collapse
|
4
|
Bohlen M, Nickel R. Artificial urethral sphincter in male dogs with urethral sphincter mechanism incompetence: 19 cases (2010-2017). J Small Anim Pract 2022; 63:397-402. [PMID: 35015298 DOI: 10.1111/jsap.13473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 12/06/2021] [Accepted: 12/17/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To assess the outcome and safety of surgically placed artificial urethral sphincters in male dogs with urethral sphincter mechanism incompetence. MATERIALS AND METHODS We included dogs with urethral sphincter mechanism incompetence treated by placing an artificial urethral sphincter from January 1, 2010 to December 31, 2017. The continence score (scale 1 to 5, with 5 indicating complete continence) was evaluated before and after implantation. Follow-up information was obtained from the institution's medical records (short-term up to 12 months) and questionnaires were completed by telephone (long-term ≥12 months) for evaluation. RESULTS Nineteen Medical therapy was unsuccessful in 18 dogs and unknown in one dog before the artificial urethral sphincter placement. Short-term continence improved in 16 of the 19 (84%) dogs. Four patients were lost to follow-up. Nine of 15 (60%) dogs showed long-term continence improvement, eight of 15 (53%) remained completely continent. The median follow-up was 1785 (range 2 to 3234) days. The complication rate was 56% (9/16). Minor complications, including haematoma, stranguria/temporary dyssynergia and mild inflammation at the port, were reported in four of 16 (25%) dogs. Five of 16 (31%) experienced major complications, including stranguria/mechanical urethral obstruction, persistent dyssynergia, fistula at the port and port rotation. CLINICAL SIGNIFICANCE Artificial urethral sphincter placement is a valid option for treating incontinent male dogs that show an insufficient response or become refractory to medical or other prior surgical management. A high-complication rate is associated with this procedure.
Collapse
Affiliation(s)
- M Bohlen
- Evidensia Small Animal Hospital Norderstedt, Kabels Stieg 41, Norderstedt, Germany
| | - R Nickel
- Evidensia Small Animal Hospital Norderstedt, Kabels Stieg 41, Norderstedt, Germany
| |
Collapse
|
5
|
Nishi R, Motegi T, Maeda S, Tamahara S, Momoi Y, Matsuki N, Yonezawa T. Clinical assessment of testosterone analogues for urethral sphincter mechanism incompetence in ten spayed female dogs. J Vet Med Sci 2021; 83:274-279. [PMID: 33441521 PMCID: PMC7972894 DOI: 10.1292/jvms.20-0515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Urethral sphincter mechanism incompetence (USMI) is a common cause of urinary
incontinence in dogs. Although estrogen is often prescribed for the medical therapy of
USMI for spayed female dogs, they are known to have limited effectiveness and potential
adverse effects. In castrated male dogs with USMI, testosterone reagents have been
attempted besides estrogen. In this study, the effect of testosterone drugs, mainly
methyltestosterone, on spayed female dogs with USMI was retrospectively evaluated. Ten
spayed female dogs with USMI were included. Diagnosis of USMI was based on the results of
the dogs’ medical history, clinical signs, and no abnormalities in physical examinations,
urinalysis, ultrasonography, X-ray imaging, and neurological examinations.
Methyltestosterone was administered at doses of 0.32–1.27 mg/kg BW p.o. semel in
die (sid.) to twice a week. Nine of the ten dogs had good or
excellent responses 2 to 4 weeks after the start of treatment. The minimum effective dose
was 0.32 mg/kg/day. Although no severe adverse symptoms occurred in any dog, a mild
increase in alanine aminotransferase was temporally observed at doses of 1.0 and 1.1
mg/kg/day in the two dogs. After dose reduction or withdrawal, two of eight dogs had
recurrence of urinary incontinence. Resumption of testosterone treatment clearly improved
the symptoms in the two dogs. These results indicate that testosterone reagents might be
an option for treating USMI in spayed female dogs as well.
Collapse
Affiliation(s)
- Reo Nishi
- Department of Veterinary Clinical Pathobiology, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-0032, Japan
| | - Tomoki Motegi
- Veterinary Medical Center, Department of Veterinary Medical Sciences, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-0032, Japan
| | - Shingo Maeda
- Department of Veterinary Clinical Pathobiology, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-0032, Japan
| | - Satoshi Tamahara
- Department of Veterinary Clinical Pathobiology, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-0032, Japan
| | - Yasuyuki Momoi
- Department of Veterinary Clinical Pathobiology, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-0032, Japan
| | - Naoaki Matsuki
- Department of Veterinary Clinical Pathobiology, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-0032, Japan
| | - Tomohiro Yonezawa
- Department of Veterinary Clinical Pathobiology, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-0032, Japan
| |
Collapse
|
6
|
Chen H, Shipov A, Segev G. Evaluation of cross-linked gelatin as a bulking agent for the management of urinary sphincter mechanism incompetence in female dogs. J Vet Intern Med 2020; 34:1914-1919. [PMID: 32686187 PMCID: PMC7517489 DOI: 10.1111/jvim.15857] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 06/20/2020] [Accepted: 06/26/2020] [Indexed: 11/28/2022] Open
Abstract
Background Bulking agent implantation is a minimally invasive intervention for the management of urethral sphincter mechanism incompetence (USMI). Hypothesis/Objectives To evaluate the efficacy and safety of the novel bulking agent VetFoam for the management of urinary incontinence in female dogs diagnosed with USMI. Animals Fifteen client‐owned female dogs. Methods Prospective study. Female dogs diagnosed with USMI, refractory, or unamenable to medical treatment were included. VetFoam was injected under endoscopic guidance into the urethral submucosa. Continence score was evaluated before and after the procedure and monthly thereafter. Results Twenty‐two injection procedures were performed in 15 dogs (5 dogs underwent >1 procedure). Median age of all dogs at the time of the procedure was 111 months (range, 18‐180). Median continence score significantly increased after, compared with before bulking agent injection (1.5; range, 1.0‐3.5 versus 4.0; range, 1.5‐5 respectively; P < .001; effect size, 2.6). Continence was achieved in 13/15 (87%) dogs after the first procedure and in 7/7 (100%) repeated procedures. Overall, 20/22 (91%) procedures resulted in high (≥4) continence scores at time of first follow‐up. Mean duration of continence was 11.1 months (SD, 10.7) after the first injection. One dog (7%) developed self‐limiting stranguria, pollakiuria, and tenesmus while no other apparent adverse effects were recognized in the other dogs. Conclusions and Clinical Importance VetFoam is an apparently safe, effective novel bulking agent, which can be used as an alternative for the management of USMI.
Collapse
Affiliation(s)
- Hilla Chen
- Veterinary Teaching Hospital, Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Anna Shipov
- Veterinary Teaching Hospital, Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Gilad Segev
- Veterinary Teaching Hospital, Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
| |
Collapse
|
7
|
Lutz KM, Hartnack S, Reichler IM. Do prevalence rates and severity of acquired urinary incontinence differ between dogs spayed by laparoscopy or laparotomy? Comparing apples with apples with a matched-pair cohort study. Vet Surg 2019; 49 Suppl 1:O112-O119. [PMID: 31680282 DOI: 10.1111/vsu.13343] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 07/23/2019] [Accepted: 09/10/2019] [Indexed: 01/21/2023]
Abstract
OBJECTIVE To compare the prevalence rates and severity of acquired urinary incontinence (AUI) between dogs spayed with laparoscopic and open laparotomy approaches. STUDY DESIGN Retrospective matched-pair cohort study. ANIMALS In total, 1285 privately owned dogs spayed >5 years previously were included in the study. METHODS Laparoscopically spayed dogs were matched with dogs spayed by traditional laparotomy. Matching variables were breed, bodyweight, age at spaying, time of spaying in relation to the onset of puberty, time interval since spaying, and age. In 400 matched-paired dogs, the outcome of AUI was assessed by using an owner questionnaire. A conditional logistic regression for matched pairs was performed on the data of 308 dogs. RESULTS Among 308 dogs, 30 and 29 dogs spayed by laparotomy and laparoscopy, respectively, were affected by AUI. The identified risk factors for AUI were age and time interval since spaying. The surgical approach (laparoscopy or laparotomy) was neither revealed as a risk factor nor did it influence the severity of AUI. CONCLUSION The risk of AUI after spaying is not influenced by the surgical approach, (laparoscopy or laparotomy). Nearly every fifth dog spayed by laparotomy or by laparoscopy was affected by AUI. A relatively longer time interval since spaying and increased age of the dog increased the risk for AUI. CLINICAL SIGNIFICANCE Owners of dogs with a predisposition for AUI must be counseled about this risk when they present their dogs for spaying, regardless of surgical approach chosen.
Collapse
Affiliation(s)
- Katharina-M Lutz
- Clinic of Reproductive Medicine, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Sonja Hartnack
- Section of Epidemiology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Iris M Reichler
- Clinic of Reproductive Medicine, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| |
Collapse
|
8
|
Abstract
Incontinence is a frustrating condition for both pet owners and their veterinarians. Fortunately, most causes are easily diagnosed and most dogs respond to appropriate therapy. This article reviews normal urine storage and voiding, causes of incontinence, typical clinical presentation, diagnostics, and treatment.
Collapse
Affiliation(s)
- Mark J Acierno
- Department of Medicine, Midwestern University, 5715 West Utopia Road, Glendale, AZ 85308, USA
| | - Mary Anna Labato
- Cummings School of Veterinary Medicine, Tufts University, 200 Westboro Road, North Grafton, MA 01536, USA.
| |
Collapse
|
9
|
Owen LJ. Ureteral ectopia and urethral sphincter mechanism incompetence: an update on diagnosis and management options. J Small Anim Pract 2018; 60:3-17. [DOI: 10.1111/jsap.12950] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2017] [Revised: 03/18/2018] [Accepted: 09/20/2018] [Indexed: 02/02/2023]
Affiliation(s)
- L. J. Owen
- Department of Veterinary Medicine; University of Cambridge; Cambridge CB3 0ES UK
| |
Collapse
|
10
|
Acierno MJ, Brown S, Coleman AE, Jepson RE, Papich M, Stepien RL, Syme HM. ACVIM consensus statement: Guidelines for the identification, evaluation, and management of systemic hypertension in dogs and cats. J Vet Intern Med 2018; 32:1803-1822. [PMID: 30353952 PMCID: PMC6271319 DOI: 10.1111/jvim.15331] [Citation(s) in RCA: 262] [Impact Index Per Article: 43.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 08/29/2018] [Indexed: 12/12/2022] Open
Abstract
An update to the 2007 American College of Veterinary Internal Medicine (ACVIM) consensus statement on the identification, evaluation, and management of systemic hypertension in dogs and cats was presented at the 2017 ACVIM Forum in National Harbor, MD. The updated consensus statement is presented here. The consensus statement aims to provide guidance on appropriate diagnosis and treatment of hypertension in dogs and cats.
Collapse
Affiliation(s)
- Mark J Acierno
- Department of Medicine, College of Veterinary Medicine, Midwestern University, 5715 W. Utopia Rd, Glendale Arizona 85308
| | - Scott Brown
- College of Veterinary Medicine, University of Georgia, Athens, Georgia
| | - Amanda E Coleman
- College of Veterinary Medicine, University of Georgia, Athens, Georgia
| | - Rosanne E Jepson
- Department of Clinical Science and Services, Royal Veterinary College, London, United Kingdom
| | - Mark Papich
- College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina
| | - Rebecca L Stepien
- Department of Medical Sciences, University of Wisconsin School of Veterinary Medicine, Madison, Wisconsin
| | - Harriet M Syme
- Department of Clinical Science and Services, Royal Veterinary College, London, United Kingdom
| |
Collapse
|
11
|
Bennett TC, Matz BM, Henderson RA, Straw RC, Liptak JM, Selmic LE, Collivignarelli F, Buracco P. Total prostatectomy as a treatment for prostatic carcinoma in 25 dogs. Vet Surg 2018; 47:367-377. [DOI: 10.1111/vsu.12768] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 07/03/2017] [Accepted: 07/28/2017] [Indexed: 11/28/2022]
Affiliation(s)
| | - Brad M. Matz
- Auburn University College of Veterinary Medicine; Auburn Alabama
| | | | - Rodney C. Straw
- Australian Animal Cancer Foundation; Brisbane Queensland Australia
| | | | - Laura E. Selmic
- College of Veterinary Medicine; University of Illinois Urbana-Champaign; Urbana Illinois
| | | | | |
Collapse
|
12
|
Applegate R, Olin S, Sabatino B. Urethral Sphincter Mechanism Incompetence in Dogs: An Update. J Am Anim Hosp Assoc 2018; 54:22-29. [DOI: 10.5326/jaaha-ms-6524] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
ABSTRACT
Urethral sphincter mechanism incompetence (USMI) is the most common cause of acquired urinary incontinence in dogs. The pathogenesis of USMI is multifactorial and complex. Studies have shown variable results regarding the effects and timing of sterilization on the incidence of USMI. Diagnosis of USMI is often based on history, physical examination, and elimination of other differentials. Treatment options for USMI include medications, such as α-adrenergic agents and estrogen products, minimally-invasive urethral bulking procedures, surgical procedures (e.g., indwelling urethral occluders), or combination therapy. The overall prognosis for USMI is typically fair to good with long-term therapy.
Collapse
Affiliation(s)
- Rory Applegate
- From the University of Tennessee, Knoxville, Tennessee (R.A., S.O.); and Affiliated Veterinary Specialists, Gainesville, Florida (B.S.)
| | - Shelly Olin
- From the University of Tennessee, Knoxville, Tennessee (R.A., S.O.); and Affiliated Veterinary Specialists, Gainesville, Florida (B.S.)
| | - Bethany Sabatino
- From the University of Tennessee, Knoxville, Tennessee (R.A., S.O.); and Affiliated Veterinary Specialists, Gainesville, Florida (B.S.)
| |
Collapse
|
13
|
Kilpatrick S, Hill T. Submucosal Collagen Injection for Management of Urinary Incontinence Following Urethral Stent Placement. Top Companion Anim Med 2017; 32:55-57. [PMID: 28992904 DOI: 10.1053/j.tcam.2017.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 07/19/2017] [Indexed: 11/11/2022]
Abstract
An 8-year-old, entire, male British Bulldog was referred for a week-long history of severe stranguria and dysuria. A prostatic wash was diagnostic of prostatic carcinoma. A transluminal urethral stent was placed in the proximal urethra, which resulted in resolution of the urinary obstruction, however, the dog developed severe urinary incontinence after the procedure. Cystoscopically-guided submucosal collagen injections were performed immediately proximal to the os penis. The dog's incontinence resolved with a single collagen injection for the 10-month follow-up period.
Collapse
Affiliation(s)
- Scott Kilpatrick
- The Hospital for Small Animals, Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Roslin, Midlothian, UK
| | - Tracy Hill
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA.
| |
Collapse
|
14
|
Palerme JS, Mazepa A, Hutchins RG, Ziglioli V, Vaden SL. Clinical Response and Side Effects Associated with Testosterone Cypionate for Urinary Incontinence in Male Dogs. J Am Anim Hosp Assoc 2017; 53:285-290. [DOI: 10.5326/jaaha-ms-6588] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
ABSTRACT
Urethral sphincter mechanism incompetence (USMI) is reported much more seldom in male dogs than in female dogs. The few existing reports evaluating the efficacy of medical therapy in controlling USMI in males have demonstrated limited success. In this case series, we report the effect of testosterone cypionate, given at a median dose of 1.5 mg/kg intramuscularly every 4 wk, in eight male dogs with USMI. Response was evaluated through the review of medical records and telephone interviews with the clients. Based on owners’ assessments, a good to excellent response was reported in three of eight dogs (38%), a slight response was reported in one of eight dogs (12%), and a poor response was reported in four of eight dogs (50%). Adverse effects were not reported, and benefit was judged sufficient to continue therapy in two cases. The results reported in this case series suggest that testosterone cypionate might be an effective and safe treatment option for male dogs with USMI.
Collapse
Affiliation(s)
- Jean-Sébastien Palerme
- From Iowa State University College of Veterinary Medicine, Ames, Iowa (J-S.P.); and Blue Pearl, Eden Prairie, Minnesota (A.M.); and Veterinary Specialty Hospital of the Carolinas, Cary, North Carolina (R.G.H.); and Upstate Veterinary Specialists, Greenville, South Carolina (V.Z.); and North Carolina State University College of Veterinary Medicine, Raleigh, North Carolina (S.L.V.)
| | - Allison Mazepa
- From Iowa State University College of Veterinary Medicine, Ames, Iowa (J-S.P.); and Blue Pearl, Eden Prairie, Minnesota (A.M.); and Veterinary Specialty Hospital of the Carolinas, Cary, North Carolina (R.G.H.); and Upstate Veterinary Specialists, Greenville, South Carolina (V.Z.); and North Carolina State University College of Veterinary Medicine, Raleigh, North Carolina (S.L.V.)
| | - Rae G. Hutchins
- From Iowa State University College of Veterinary Medicine, Ames, Iowa (J-S.P.); and Blue Pearl, Eden Prairie, Minnesota (A.M.); and Veterinary Specialty Hospital of the Carolinas, Cary, North Carolina (R.G.H.); and Upstate Veterinary Specialists, Greenville, South Carolina (V.Z.); and North Carolina State University College of Veterinary Medicine, Raleigh, North Carolina (S.L.V.)
| | - Vincent Ziglioli
- From Iowa State University College of Veterinary Medicine, Ames, Iowa (J-S.P.); and Blue Pearl, Eden Prairie, Minnesota (A.M.); and Veterinary Specialty Hospital of the Carolinas, Cary, North Carolina (R.G.H.); and Upstate Veterinary Specialists, Greenville, South Carolina (V.Z.); and North Carolina State University College of Veterinary Medicine, Raleigh, North Carolina (S.L.V.)
| | - Shelly L. Vaden
- From Iowa State University College of Veterinary Medicine, Ames, Iowa (J-S.P.); and Blue Pearl, Eden Prairie, Minnesota (A.M.); and Veterinary Specialty Hospital of the Carolinas, Cary, North Carolina (R.G.H.); and Upstate Veterinary Specialists, Greenville, South Carolina (V.Z.); and North Carolina State University College of Veterinary Medicine, Raleigh, North Carolina (S.L.V.)
| |
Collapse
|
15
|
Byron J, Taylor K, Phillips G, Stahl M. Urethral Sphincter Mechanism Incompetence in 163 Neutered Female Dogs: Diagnosis, Treatment, and Relationship of Weight and Age at Neuter to Development of Disease. J Vet Intern Med 2017; 31:442-448. [PMID: 28256023 PMCID: PMC5354041 DOI: 10.1111/jvim.14678] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 12/16/2016] [Accepted: 01/18/2017] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Urethral sphincter mechanism incompetence (USMI) is the most common cause of urinary incontinence in neutered bitches and is most common in dogs weighing >20 kg. OBJECTIVES To describe a population of neutered bitches with USMI and investigate their initial presentation, the relationship between weight and age at neuter, and treatment. ANIMALS One hundred and sixty-three female dogs with USMI (UI) diagnosed between January 2009 and December 2012, and 193 continent neutered control (C) bitches. METHODS Retrospective data were collected from neutered female dogs with USMI and healthy, continent neutered females presented between January 2009 and December 2012. RESULTS Urinary incontinent dogs weighed more than C dogs (P = .003), and there was no difference in age at neuter. The relationship between weight at diagnosis and age at neuter was found to impact the hazard of USMI. A decrease in the hazard of USMI was found in dogs weighing >25 kg for every month delay of neuter in the first year. The hazard did not change for dogs <15 kg. Median time from neuter to development of incontinence was 3.73 years. Phenylpropanolamine was prescribed in 75.5%, diethylstilbestrol in 21.5%, and both in 3.1% of dogs. CONCLUSIONS AND CLINICAL IMPORTANCE Neutering bitches expected to be >25 kg adult weight later in their first year may decrease the hazard of developing USMI, whereas age at neutering of bitches <25 kg may not impact continence. Heavier dogs have increased risk of USMI, and onset occurs within a few years of neuter.
Collapse
Affiliation(s)
- J.K. Byron
- Department of Veterinary Clinical SciencesCollege of Veterinary MedicineAmesIA
| | - K.H. Taylor
- Department of Veterinary Clinical SciencesCollege of Veterinary MedicineAmesIA
- Present address: Airway Animal Clinic4092 Colonel Glenn HwyDaytonOH45431
| | - G.S. Phillips
- Department of Biomedical Informatics, College of MedicineCenter for BiostatisticsThe Ohio State UniversityColumbusOH
| | | |
Collapse
|
16
|
Wilson KE, Berent AC, Weisse CW. Use of a percutaneously controlled hydraulic occluder for treatment of refractory urinary incontinence in three female cats. J Am Vet Med Assoc 2016; 248:544-51. [DOI: 10.2460/javma.248.5.544] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
17
|
|
18
|
Reichler IM, Hubler M. Urinary incontinence in the bitch: an update. Reprod Domest Anim 2015; 49 Suppl 2:75-80. [PMID: 24947864 DOI: 10.1111/rda.12298] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Urinary incontinence (UI), defined as the involuntary loss of urine during the filling phase of the bladder (Abrams et al. 2002), is a commonly seen problem in veterinary practice. Urinary sphincter mechanism incompetence (USMI) after spaying is the most common micturition disorder, and its medical treatment is normally successful, even though the underlying pathophysiological mechanism is not fully understood. Hormonal changes inducing structural and functional alterations in the bladder, as well as in the urethra composition, are discussed. To manage incontinent patients successfully, possible underlying abnormalities besides USMI should be ruled out. In the majority of cases, history, physical examination and simple tests including urinalysis and urine bacterial culture lead to a presumed aetiology. If USMI is the most likely cause, then the advantage of further diagnostic tests should be discussed with the owner before starting a trial therapy with alpha-adrenergic drugs. Potential side effects of this therapy have to be mentioned even though they rarely occur. It is important to thoroughly evaluate the success of the initial treatment. Its failure should lead to further diagnostic testing. Specialized clinical assessments may provide an aetiological diagnosis, and this could serve as a basis for discussing further treatment options. Surgical procedures, which may in rare cases cause irreversible side effects, may be instituted. If incontinence reoccurs after initial treatment was successfully performed, the diagnostic work-up including urinalysis should always be repeated. As results of urinalysis did not correlate well with results of bacterial culture, a urine culture is recommended (Comer and Ling 1981). Cystocentesis is the preferred method of urine collection (Bartges 2004). Equivocal results of quantitative cultures of urine samples obtained during midstream voiding or by catheterization require repeat collection by cystocentesis (Comer and Ling 1981).
Collapse
Affiliation(s)
- I M Reichler
- Small Animal Reproduction, Clinic for Reproductive Medicine, Vetsuisse-Faculty, University of Zurich, Zurich, Switzerland
| | | |
Collapse
|
19
|
Noël S, Massart L, Hamaide A. Urodynamic investigation by telemetry in Beagle dogs: validation and effects of oral administration of current urological drugs: a pilot study. BMC Vet Res 2013; 9:197. [PMID: 24099564 PMCID: PMC3852831 DOI: 10.1186/1746-6148-9-197] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2012] [Accepted: 10/02/2013] [Indexed: 11/10/2022] Open
Abstract
Background Vesico-urethral function may be evaluated in humans and dogs by conventional urodynamic testing (cystometry and urethral pressure profilometry) or by electromyography. These techniques are performed under general anaesthesia in dogs. However, anaesthesia can depress bladder and urethral pressures and inhibit the micturition reflex. The primary objective of this pilot study was to evaluate the use of telemetry for urodynamic investigation in dogs. We also aimed to determine the applicability of telemetry to toxicologic studies by assessing the repeatability of telemetric recordings. Results Conventional diuresis cystometry was performed in six continent adult female Beagle dogs prior to surgical implantation of telemetric and electromyographic devices. In the first phase of the telemetric study, continuous recordings were performed over 8 days and nights. Abdominal, intravesical and detrusor threshold pressures (Pdet th), voided volume (Vv), urethral smooth muscle electrical activity and involuntary detrusor contractions (IDC) were measured during the bladder filling phase and during micturition episodes. Vv recorded during telemetry was significantly lower than bladder volume obtained by diuresis cystometry. Repeatability of telemetric measurements was greater for observations recorded at night. IDC frequency and Pdet th were both lower and Vv was higher at night compared to values recorded during daytime. In the second phase of the telemetric study, phenylpropanolamine, oestriol, bethanechol, oxybutynin or duloxetine were administered orally for 15 days. For each drug, continuous recordings were performed overnight for 12 hours on days 0, 1, 8 and 15. Electromyographic urethral activity was significantly increased 8 days after oestriol or duloxetine administration. No significant changes in bladder function were observed at any time point. Conclusions In dogs, the high repeatability of nocturnal telemetric recordings indicates that this technique could provide more informative results for urologic research. Urethral smooth muscle electrical activity appears to be modified by administration of drugs with urethral tropism. In this pilot telemetric study, bladder function was not affected by oral administration of urological drugs at their recommended clinical dosages. Experimental studies, (pharmacokinetic and pharmacodynamic) and clinical studies are warranted to further define the effects of these drugs on vesico-urethral function in dogs.
Collapse
Affiliation(s)
- Stéphanie Noël
- Department of Companion Animal Clinical Sciences, College of Veterinary Medicine, University of Liège, 4000 Liège, Belgium.
| | | | | |
Collapse
|
20
|
Reeves L, Adin C, McLoughlin M, Ham K, Chew D. Outcome after Placement of an Artificial Urethral Sphincter in 27 Dogs. Vet Surg 2012; 42:12-8. [DOI: 10.1111/j.1532-950x.2012.01043.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Lauren Reeves
- Department of Veterinary Clinical Sciences; The Ohio State University; Columbus; OH
| | - Christopher Adin
- Department of Veterinary Clinical Sciences; The Ohio State University; Columbus; OH
| | - Mary McLoughlin
- Department of Veterinary Clinical Sciences; The Ohio State University; Columbus; OH
| | - Kathleen Ham
- Department of Veterinary Clinical Sciences; The Ohio State University; Columbus; OH
| | - Dennis Chew
- Department of Veterinary Clinical Sciences; The Ohio State University; Columbus; OH
| |
Collapse
|
21
|
Ginn JA, Bentley E, Stepien RL. Systemic hypertension and hypertensive retinopathy following PPA overdose in a dog. J Am Anim Hosp Assoc 2012; 49:46-53. [PMID: 23148140 DOI: 10.5326/jaaha-ms-5692] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A 4 yr old spayed female Labrador retriever was examined 4 hr after ingesting an overdose of phenylpropanolamine (PPA). Clinical signs included anxiety, piloerection, mucosal ulceration, cardiac arrhythmia, mydriasis, and hyphema. Clinicopathologic abnormalities included elevated creatine kinase (CK) and aspartate aminotransferase (AST), proteinuria, and pigmenturia. Ventricular tachycardia and severe systemic hypertension were documented. Hyphema and retinal detachment were documented oculus uterque (OU). Phenoxybenzamine, sotalol, and esmolol resolved the ventricular tachycardia, and blood pressure was controlled with nitroprusside. All clinicopathologic and cardiac abnormalities resolved within 7 days, and ocular changes resolved within 1 mo. Monitoring of blood pressure and rapid pharmacologic intervention were successful in controlling hypertension secondary to PPA overdose and minimizing retinal damage.
Collapse
Affiliation(s)
- Jennifer A Ginn
- Department of Medical Sciences, University of Wisconsin School of Veterinary Medicine, Madison, WI, USA.
| | | | | |
Collapse
|
22
|
Beauvais W, Cardwell JM, Brodbelt DC. The effect of neutering on the risk of urinary incontinence in bitches - a systematic review. J Small Anim Pract 2012; 53:198-204. [DOI: 10.1111/j.1748-5827.2011.01176.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
23
|
Peterson KL, Lee JA, Hovda LR. Phenylpropanolamine toxicosis in dogs: 170 cases (2004–2009). J Am Vet Med Assoc 2011; 239:1463-9. [DOI: 10.2460/javma.239.11.1463] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
24
|
Byron JK, Chew DJ, McLoughlin ML. Retrospective evaluation of urethral bovine cross-linked collagen implantation for treatment of urinary incontinence in female dogs. J Vet Intern Med 2011; 25:980-4. [PMID: 21781163 DOI: 10.1111/j.1939-1676.2011.0759.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Transurethral collagen injections are an alternative treatment for canine urinary incontinence. There is controversy regarding the long-term effectiveness of collagen and the impact urethral coaptation and injection site have on outcome. HYPOTHESIS/OBJECTIVES To evaluate outcome and client satisfaction after urethral collagen injections, and correlation between degree of urethral coaptation and collagen placement with outcome. ANIMALS Thirty-six procedures on 31 dogs, 10 with ureteral ectopia. METHODS Retrospective review of records and video evaluation of injection procedures. Follow-up communication with owners was performed between 1 and 56 months after bovine cross-linked collagen implantation to evaluate duration of continence, need for additional medical therapy, and owner satisfaction. Continence score was evaluated before and after the procedure, and after additional medical therapy, if needed. Injection location and degree of urethral coaptation was assessed with respect to duration of continence. RESULTS Dogs had a significant increase in continence score after the procedure. Mean (SD) duration of continence in dogs without addition of medication was 16.4 (15.2) months, and 5.2 (4.3) months in dogs needing additional medical therapy. No significant difference was found with respect to degree of coaptation. Median client satisfaction with the procedure was 100%. CONCLUSIONS AND CLINICAL IMPORTANCE Transurethral collagen implantation may be a viable option for treatment of female dogs with urethral sphincter mechanism incompetence, particularly after medical failure. Duration and degree of improvement are variable. Client satisfaction was excellent despite lack of complete continence in some dogs, and highlights the importance of discussing outcome expectations with owners.
Collapse
Affiliation(s)
- J K Byron
- Department of Veterinary Clinical Medicine, University of Illinois, Urbana, IL, USA.
| | | | | |
Collapse
|
25
|
Noël S, Massart L, Hamaide A. Urodynamic and haemodynamic effects of a single oral administration of ephedrine or phenylpropanolamine in continent female dogs. Vet J 2011; 192:89-95. [PMID: 21715199 DOI: 10.1016/j.tvjl.2011.05.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2011] [Revised: 05/05/2011] [Accepted: 05/05/2011] [Indexed: 11/19/2022]
Abstract
This study investigated the effects of a single oral administration of ephedrine (2 mg/kg) or phenylpropanolamine (PPA) (1.5 mg/kg) on the vesico-urethral and cardiovascular functions in continent female dogs. Urethral pressure profilometry (UPP), arterial blood pressures and heart rate were measured in five control dogs and after single-dose treatment with ephedrine or PPA at T(0), T(2h), T(4h), T(6h), T(12h), T(18h) and T(24h). UPPs were performed under propofol anaesthesia and other measurements were performed on awake dogs. A telemetric urodynamic investigation was performed on three additional dogs for 24 h after the administration of each drug. Urethral pressures increased over 4-6 h and urethral functional lengths increased 2-6h after administration of both drugs. During micturition, a decrease in detrusor pressure coupled with an increase in bladder volume was observed after ephedrine administration and there was also an increase in bladder volume after PPA had been given. With both drugs increased arterial blood pressures at 4-6 h were compensated by a decreased heart rate over 12 h. Urethral function was improved after both ephedrine and PPA, and bladder function also improved during micturition following ephedrine.
Collapse
Affiliation(s)
- Stéphanie Noël
- Department of Companion Animal Clinical Sciences B44, College of Veterinary Medicine, University of Liège, 4000 Liège, Belgium
| | | | | |
Collapse
|
26
|
Claeys S, Ruel H, de Leval J, Heimann M, Hamaide A. Transobturator vaginal tape inside out for treatment of urethral sphincter mechanism incompetence in female dogs: cadaveric study and preliminary study in continent female dogs. Vet Surg 2010; 39:957-68. [PMID: 20880142 DOI: 10.1111/j.1532-950x.2010.00735.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES (1) To describe a surgical technique adapted from the "transobturator vaginal tape inside-out" (TVT-O) used in women and to define the trajectory of the tape on canine cadavers, and (2) to determine the urodynamic and morphological effects of the TVT-O in continent bitches. STUDY DESIGN Cadaveric and experimental in vivo study. ANIMALS Fresh female canine cadavers (n=12) and spayed female Beagle dogs (2). METHODS (1) TVT-O was inserted in 12 cadavers. Dissection was performed and distances between the tape and neighboring structures were recorded. (2) TVT-O was inserted in 2 continent female Beagle dogs. Urethral pressure profilometry and vaginourethrograms were performed preoperatively, immediately after surgery, and 2, 4, and 6 months postoperatively. Histopathology was performed 6 months after surgery. RESULTS (1) TVT-O tape was consistently located in a perineal space before entering the obturator foramina and was located at a safe distance from major neurovascular structures including the femoral vessels and obturator nerve. (2) TVT-O was performed without any surgical or postoperative complications in 2 continent bitches. Histopathologic examination of the tissues surrounding the tape revealed a mild fibroblastic proliferation with a mild to minimal lymphoplasmacytic inflammatory infiltration. CONCLUSIONS TVT-O is a feasible and accurate procedure that can be performed in continent bitches with a low risk of complications.
Collapse
Affiliation(s)
- Stéphanie Claeys
- Department of Clinical Sciences (Companion Animals), School of Veterinary Medicine, University of Liège, Liège, Belgium.
| | | | | | | | | |
Collapse
|
27
|
Claeys S, de Leval J, Hamaide A. Transobturator vaginal tape inside out for treatment of urethral sphincter mechanism incompetence: preliminary results in 7 female dogs. Vet Surg 2010; 39:969-79. [PMID: 20880143 DOI: 10.1111/j.1532-950x.2010.00737.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To evaluate the clinical efficacy of the transobturator vaginal tape inside-out (TVT-O) in incontinent female dogs affected with urethral sphincter mechanism incompetence (USMI) and to determine its urodynamic and morphologic effects. STUDY DESIGN Case series. ANIMALS Incontinent spayed female dogs (n=7). METHODS TVT-O tape was inserted in 7 incontinent female dogs diagnosed with USMI. Urethral pressure profilometry (UPP) and vaginourethrograms were performed preoperatively, and 1 and 3 months postoperatively. Clinical efficacy of the technique was evaluated and complications reported. Follow-up information was evaluated by a telephone questionnaire. RESULTS All dogs were continent immediately after the procedure. Incontinence recurred 2 months after surgery in 1 dog and was treated by phenylpropanolamine administration. At mean follow-up time of 11.3 months, 6 of 7 dogs were continent. An iatrogenic urethral tear occurred intraoperatively in 1 dog. No postoperative complications were encountered. The postoperative UPPs showed significantly increased maximal urethral closure pressure and integrated pressure. Postoperative vaginourethrograms were unremarkable. The surgical procedure did not modify the location of the urinary bladder neck in dogs with a "pelvic urinary bladder" preoperatively. CONCLUSIONS TVT-O was efficient in maintaining short term continence in 6 of 7 dogs affected with USMI.
Collapse
Affiliation(s)
- Stéphanie Claeys
- Department of Clinical Sciences (Companion Animals), School of Veterinary Medicine, University of Liège, Liège, Belgium.
| | | | | |
Collapse
|
28
|
Noël S, Claeys S, Hamaide A. Acquired urinary incontinence in the bitch: update and perspectives from human medicine. Part 2: The urethral component, pathophysiology and medical treatment. Vet J 2010; 186:18-24. [PMID: 20655776 DOI: 10.1016/j.tvjl.2010.06.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2009] [Revised: 06/17/2010] [Accepted: 06/19/2010] [Indexed: 11/19/2022]
Abstract
Various pathologies can affect the bladder and/or urethral contractility causing signs of urinary incontinence. In this second part of a three-part review, the pathophysiology of impaired urethral contractility (including urethral hyper- and hypotonicity) in the bitch and in women is discussed. Urethral sphincter mechanism incompetence (USMI) is the most common form of acquired urinary incontinence in bitches and is characterized by a decreased urethral tone. The pathophysiology and current recommended medical treatment options for USMI and cases of modified urethral tonicity due to a neurological disorder or functional outlet obstruction are discussed. Treatment options in human medicine in cases of impaired urethral contractility are described.
Collapse
Affiliation(s)
- Stéphanie Noël
- Department of Companion Animal Clinical Sciences B44, College of Veterinary Medicine, University of Liège, 4000 Liège, Belgium
| | | | | |
Collapse
|
29
|
Lew S, Majewski M, Radziszewski P, Kuleta Z. Therapeutic efficacy of botulinum toxin in the treatment of urinary incontinence in female dogs. Acta Vet Hung 2010; 58:157-65. [PMID: 20460215 DOI: 10.1556/avet.58.2010.2.2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Urinary incontinence in animals poses a growing therapeutic problem. Satisfactory results in the treatment of incontinence are not reported despite the wide availability of pharmaceuticals addressing the problem. The growing number of side effects and the need for sustained pharmacotherapy have prompted a search for new treatment methods. The experiment described in this study was performed on 11 bitches with clinical symptoms of urinary incontinence. The dogs underwent cystoscopy during which botulinum toxin solution was injected into the wall of the urinary bladder (50-100 botulinum toxin units were given per animal in 10 injections), causing changes in its innervation. Positive therapeutic effects lasting for 5 months in average were noted in 70% of the treated animals.
Collapse
Affiliation(s)
- Sylwia Lew
- 1 University of Warmia and Mazury in Olsztyn Department of Internal Diseases, Faculty of Veterinary Medicine PL-10-719 Olsztyn Oczapowskiego 14 Poland
| | - Mariusz Majewski
- 2 University of Warmia and Mazury in Olsztyn Department of Human Physiology, Faculty of Medical Sciences Olsztyn Poland
| | - Piotr Radziszewski
- 3 Medical University of Warsaw Department and Clinic of Urology Warsaw Poland
| | - Zygmunt Kuleta
- 1 University of Warmia and Mazury in Olsztyn Department of Internal Diseases, Faculty of Veterinary Medicine PL-10-719 Olsztyn Oczapowskiego 14 Poland
| |
Collapse
|
30
|
ROSE SCOTTA, ADIN CHRISTOPHERA, ELLISON GARYW, SEREDA COLINW, ARCHER LINDAL. Long-Term Efficacy of a Percutaneously Adjustable Hydraulic Urethral Sphincter for Treatment of Urinary Incontinence in Four Dogs. Vet Surg 2009; 38:747-53. [DOI: 10.1111/j.1532-950x.2009.00560.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
31
|
Use of a rigid endoscope to teach urethral catheterization of the female dog. Lab Anim (NY) 2009; 38:271-4. [PMID: 19626020 DOI: 10.1038/laban0809-271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2009] [Accepted: 05/06/2009] [Indexed: 11/09/2022]
Abstract
Urethral catheterization of the female dog is known to be a challenging procedure. The authors describe a catheterization technique in which they use a rigid endoscope to visualize the canine urogenital vestibule during the procedure. The technique is particularly helpful as a training tool for students who are not yet experienced with the canine anatomy. The endoscope is attached to a video camera and monitor, allowing others to observe and learn the procedure.
Collapse
|
32
|
Cohen TA, Westropp JL, Kass PH, Pypendop BH. Evaluation of urodynamic procedures in female cats anesthetized with low and high doses of isoflurane and propofol. Am J Vet Res 2009; 70:290-6. [DOI: 10.2460/ajvr.70.2.290] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
33
|
Klinck MP, Shofer FS, Reisner IR. Association of pruritus with anxiety or aggression in dogs. J Am Vet Med Assoc 2008; 233:1105-11. [PMID: 18828721 DOI: 10.2460/javma.233.7.1105] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the association between pruritus and anxiety-related and aggressive behaviors in dogs. DESIGN Cross-sectional survey. ANIMALS 238 dogs between 1 and 8 years old. PROCEDURES Information including a score for general degree of pruritus (visual analogue scale from 0 to 10) and frequency of anxiety-related and aggressive behaviors was collected via a survey distributed to clients at 3 privately owned practices. RESULTS Median score for pruritus was 2.4. Dogs were assigned to 2 groups on the basis of pruritus score (nonpruritic [0 to 2.4] and pruritic [2.5 to 10]). There was no significant difference between pruritic and nonpruritic dogs with regard to aggression or with regard to reactivity to being alone; to thunderstorms or noises; or to unfamiliar people, animals, or objects. Post hoc analysis revealed significantly more reactivity to thunderstorms or noises in dogs treated with glucocorticoids (18/37 [49%]) than in those not administered glucocorticoids (57/197 [29%]). CONCLUSIONS AND CLINICAL RELEVANCE An association was not detected between pruritus and aggressive, anxious, or fearful behavior in dogs. There was greater reactivity to thunderstorms or noises in glucocorticoid-treated dogs. These findings do not preclude the possibility of a relationship between certain dermatoses or pruritic conditions and behavior. However, a concurrent behavioral abnormality cannot be assumed to result from a dermatosis and be expected to resolve with treatment of only the skin disease. Dogs with behavioral disorders and pruritic disease require primary treatment of both conditions. Additional studies to examine the effect of disease and glucocorticoids on canine behavior are warranted.
Collapse
Affiliation(s)
- Mary P Klinck
- Department of Clinical Studies-Philadelphia, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104-1060, USA
| | | | | |
Collapse
|