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1.
OBJECTIVE: To compare the urodynamic and morphologic effects of the administration of estriol alone and in combination with phenylpropanolamine on the lower portion of the urogenital tract in female dogs. ANIMALS: 3 sexually intact and 3 spayed female Beagles without urinary incontinence. PROCEDURE: Dogs received estriol (2 mg, PO) once daily for 7 days followed by estriol (2 mg, PO) and phenylpropanolamine (1.5 mg/kg, PO) once daily for 7 days. Urethral pressure profilometry, diuresis cystometry, and vaginourethrography were performed before treatment (day 0) and at days 7 and 14. The maximum urethral pressure (MUP) and closure pressure (MUCP), urethral functional and anatomic profile lengths, integrated pressure (IP), plateau, distance before MUP, maximum meatus pressure, threshold pressure, threshold volume, compliance, urethral length, and vaginal length and width were measured. RESULTS: Before treatment, no urodynamic differences were observed between the 2 groups; however, vaginal length and width were significantly shorter in spayed dogs. Compared with day 0 values, estriol treatment significantly increased MUP, MUCP, and IP values at day 7, but at day 14, this effect decreased despite phenylpropanolamine administration. No morphologic changes from baseline were detected after either treatment in any dog. CONCLUSIONS AND CLINICAL RELEVANCE: Data suggest that estriol mainly acts on the urethral sphincter mechanism by increasing urethral resistance in sexually intact and spayed female dogs without urinary incontinence. Administration of estriol and phenylpropanolamine did not increase the urethral resistance more than estriol alone. The urodynamic effects of estriol in female dogs with urinary incontinence remain to be elucidated.  相似文献   

2.
OBJECTIVE: To determine the long-term effects of colposuspension in spayed female dogs with urinary incontinence and identify preoperative anatomic or urodynamic measurements associated with a successful outcome. DESIGN: Prospective study. ANIMALS: 23 client-owned spayed female dogs with urinary incontinence. PROCEDURE: Prior to surgery, a history was obtained, and a physical examination, CBC, serum biochemical analyses, urinalysis, bacterial culture of a urine sample, vaginourethrocystography, urethral pressure profilometry, and leak point pressure test were performed. Colposuspension was performed, and preoperative tests were repeated 2 months after surgery. Clients were interviewed 2 weeks, 1 month, and 1 year after surgery. RESULTS: 22 dogs were followed up for 1 year. Twelve had complete urinary control 2 months after surgery, and 3 had complete urinary control 1 year after surgery. Dogs with normal urinary control at 2 months had an increased leak point pressure (LPP), compared with preoperative measurements, and their LPP was the same as normal dogs. Eight dogs had complete urinary control, and 9 were considered greatly improved 1 year after surgery when medical treatment was added to the effect of colposuspension. Client satisfaction was high, with 19 of 22 (86%) owners being pleased with their decision to have surgery performed. The only predictors of complete urinary control 2 months after surgery were a more caudal position of the external urethral opening in relation to the pubis on preoperative radiographs and a longer overall urethral length. CONCLUSIONS AND CLINICAL RELEVANCE: Colposuspension alone will result in complete urinary control in few dogs with urinary incontinence but may improve urinary control sufficiently that owners will be pleased. Preoperative vaginourethrocystography may be helpful in predicting response to surgery, and the LPP test correlates with improved urinary control.  相似文献   

3.
OBJECTIVE: To evaluate use of a particulate bioscaffold consisting of the extracellular matrix (ECM) of the urinary bladder from pigs for treatment of acquired urinary incontinence in dogs resistant to medical treatment. DESIGN: Case series. ANIMALS: 9 female dogs with acquired urinary incontinence. PROCEDURE: In 6 dogs, 30 mg of particulate ECM in 1.0 mL of a carrier consisting of glycerin and saline 10.9% NaCI) solution was injected into each of 3 equally spaced sites around the circumference of the internal urethral sphincter via an endoscopic technique. In the remaining 3 dogs (control dogs), 1.0 mL of the carrier alone was injected in 3 equally spaced sites around the circumference of the internal urethral sphincter in a similar manner. RESULTS: For dogs treated with the ECM, median duration of urinary continence following treatment was 168 days (range, 84 to 616 days), whereas for the control dogs, median duration of urinary continence following the procedure was 14 days (range, 7 to 31 days). Two of the 3 control dogs were treated with the ECM at the end of the study and were continent for 119 and 252 days. No adverse effects were observed in any dog. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that endoscopically guided injection of particulate ECM into the internal urethral sphincter may be useful for the treatment of acquired urinary incontinence in female dogs.  相似文献   

4.
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.  相似文献   

5.
A recently developed urodynamic testing procedure was used to evaluate disorders of micturition in 2 dogs. The procedure simultaneously recorded intravesical pressure and urine flow during micturition. In an 11-year-old spayed female Sheltie that could not urinate normally, a micturition study demonstrated functional outflow obstruction of the urinary bladder. Although the urethra was patent, the urethral resistance factor, as calculated from pressure and flow data, was extremely high during voiding efforts. A urethral transitional cell carcinoma along with secondary infection, inflammation, and fibrosis were found to be responsible for the dog's problem. Ability to urinate was restored following removal of the affected portion of the urethra. In a 6-year-old spayed female Doberman Pinscher with urinary incontinence during sleep, a micturition study demonstrated urethral incompetence. During infusion of 0.9% NaCl solution into the bladder, the fluid flowed through the urethra before the detrusor muscle contracted, and urethral resistance during voiding was low. The dog's incontinence was responsive to estrogen administration.  相似文献   

6.
OBJECTIVE: To evaluate long-term success of endoscopic injection of collagen into the urethral submucosa in female dogs with urinary incontinence caused by urethral sphincter incompetence. DESIGN: Retrospective study. ANIMALS: 40 incontinent female dogs. PROCEDURE: Medical records were reviewed for outcome and other results for dogs in which a cystoscope was passed into the urethra for deposition of 3 collagen deposits into the submucosa. RESULTS: 27 (68%) dogs were continent for 1 to 64 months (mean, 17 months) after the collagen injection. In another 10 dogs, incontinence improved and in 6 of these dogs, full continence was regained with administration of additional medication. In 3 dogs, incontinence was unchanged. As long as 12 months after injection, there was a deterioration in the initial result in 16 dogs, after which their condition stabilized. Mild and transient adverse effects developed in 6 (15%) dogs. CONCLUSIONS AND CLINICAL RELEVANCE: Long-term success of endoscopic injection of collagen was satisfactory. Relapse of incontinence might be caused by flattening of the collagen deposits rather than resorption of the collagen.  相似文献   

7.
Thirty-two spayed bitches with urinary incontinence due to urethral sphincter incompetence, non-responsive to phenylpropanolamine administration, were treated by urethral submucosal injection of glutaraldehyde cross-linked collagen. Urinary incontinence resolved after a single injection in 19 of the bitches. Additional medication with phenylpropanolamine was necessary in five of these dogs, however. Of the 13 bitches that remained incontinent, the injections were repeated in nine. This resulted in a return to continence in five dogs, although two of these required additional medication for complete continence. The cure rate due to collagen injections alone is 53 per cent (17 of the 32 cases). A total of 41 injections were performed and no postoperative complications were observed.  相似文献   

8.
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.  相似文献   

9.
Objective— To evaluate the efficacy of a surgically placed, static hydraulic urethral sphincter (SHUS) for treatment of urethral sphincter mechanism incompetency (USMI).
Study Design— Prospective study.
Animals— Spayed female dogs (n=4) with acquired USMI.
Methods— Urinary incontinence was assessed using a subjective continence score before and after implantation of an SHUS on the proximal urethra via ventral median celiotomy. Dogs were assessed for urinary continence, urinary tract infections, and implant-associated complications for 30 months. Residual incontinence was treated with percutaneous inflation of the SHUS with sterile saline solution through a biocompatible subcutaneous administration port.
Results— At last follow-up (26–30 months after surgery), continence scores improved from a median preoperative score of 3/10 to a median postoperative score of 10. One dog developed wound drainage over the subcutaneously placed administration port but remained continent after port removal. Three occluders were percutaneously filled with additional saline (median, 0.18 mL; mean, 0.16 mL) to improve continence after surgery.
Conclusions— Application and adjustment of an SHUS provided sustained improvements in continence score in all dogs.
Clinical Relevance— In this pilot study, 3 of 4 dogs with hydraulic urethral sphincter implantation had successful percutaneous adjustment and maintained improved continence scores for 2 years after surgery. Continence was maintained in the 4th dog even after administration port removal. Based on this pilot study, the SHUS warrants further clinical evaluation for treatment of dogs with USMI unresponsive to medical management.  相似文献   

10.
A clinical study about efficacy and acceptance of Incontex in spayed bitches with urinary incontinence was performed. In a randomised, double-blinded study the efficacy and acceptance of Incontex (Dr. E. Gr?ub AG, Bern, Schweiz) in bitches with urethral sphincter incompetence due to spaying was evaluated under field conditions. The active ingredient of the Incontex Syrup is phenylpropanolamine (PPA), an alpha1-adrenergic agonist. The study was performed using 24 spayed, incontinent bitches. Over a first period of treatment of 30 days the bitches received either Incontex, at 1.5 mg/kg twice per day, or a placebo. In the second period of 30 days all 24 bitches were treated with Incontex at the recommended dose. Any changes in the incontinence compared with the situation before the study were evaluated. RESULTS: Of 24 bitches 21 (88%) became continent and in 2 bitches (8%) urinary incontinence improved. In only 1 bitch (4%) the medication did have no effect. Five bitches (21%) showed side effects. The acceptance of Incontex was good. CONCLUSION AND CLINICAL RELEVANCE: Incontex can be recommended as an efficient and well-tolerated medication for the treatment of bitches with urinary incontinence after spaying. The oral application of 1.5mg/kg BW phenylpropanolamine twice daily has been approved.  相似文献   

11.
The objective of this retrospective study was to determine the efficacy of a single daily oral dose of phenylpropanolamine (PPA) in the treatment of urethral sphincter mechanism incompetence (USMI) in bitches. Nine bitches diagnosed with USMI were treated with a single daily dose [1.5 mg/kg body weight (BW)] of PPA for at least 1 month. Urethral pressure profiles (UPP) were performed in 7 dogs before treatment and repeated in 4 of them after treatment. Treatment with PPA resulted in long-term continence in 8/9 bitches. One dog did not respond to PPA and was treated surgically later. Recheck UPPs showed a significant increase in maximal urethral closure pressure in the 4 bitches after treatment with PPA compared to before treatment. In conclusion, long-term continence can be achieved in bitches affected with USMI after administration of a single daily dose of PPA (1.5 mg/kg BW).  相似文献   

12.
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.  相似文献   

13.
Possible correlations were investigated between the clinical and urodynamic findings in 77 neutered female dogs with urinary incontinence refractory to standard medical management. The clinical data used in the analysis were age, bodyweight, breed, the characteristics of the dribbling of urine and whether it developed before or after neutering, the type of response to previous treatments, signs of polyuria/polydipsia, and the results of urinalysis and culture. In 50 of the dogs, a standardised contrast radiographic examination was made to locate the neck of the bladder and to assess the morphology of the bladder. These findings were analysed for their correlation with the results of multichannel urethral pressure profilometry and diuresis cysto-urethrometry. Logistic regression analysis revealed that neither the clinical nor the radiographic findings could predict any of the abnormal urodynamic findings. Functional abnormalities of the bladder, such as a low compliance, detrusor instability, or a low bladder capacity may therefore be particularly difficult to detect in dogs with urinary incontinence.  相似文献   

14.
Objective —To evaluate a sling procedure using a polyester ribbon passed through the obturator foramen, around the urethra, and fixed outside the pelvis for the treatment of female dogs with refractory urethral sphincter mechanism incompetence (USMI). Animals —26 female dogs with USMI that had not improved with medical management. Methods—All dogs underwent a transpelvic sling procedure, and in 13, with a radiographic diagnosis of a pelvic bladder, additional colposuspension was performed. Multichannel urethral pressure profilometry (UPP) and diuresis cystourethrometry (UCM) were performed in all dogs before and in seven dogs 2 to 14 months after surgery. Long-term results of surgery and medical therapy were determined. Results — 13 dogs (50%), 6 of these without additional colposuspension, were continent after surgery and remained continent during a follow-up period of 12 to 36 months (mean, 19 months). Seven, three of which had colposuspension, had improved markedly. Four of these dogs became continent with additional medical therapy. Five dogs did not improve, and three of these were eventually euthanatized. In one dog, the sling was removed after 5 days because of persistent stranguria. Surgery and medical therapy together resulted in continence in 17 dogs (65%) during a follow-up period of 6 to 36 months (mean, 22 months). Postoperative dysuria or stranguria occurred in six dogs, and four of these underwent a colposuspension procedure. Two dogs developed a fistula, 2 and 3 years after surgery. Preoperatively, decreased urethral resistance was suggested by the findings of UPP and UCM in 25 dogs, and an abnormally high compliance was found in 3, detrusor instability in 2, and a low threshold pressure in 1 dog. There was no apparent correlation between these findings and the outcome of surgery. Urethral closure pressures measured after surgery were significantly increased but were still lower than the normal range in all dogs with persistent or recurrent incontinence. Conclusions —A transpelvic sling procedure, with or without additional colposuspension, can be useful in the management of dogs with refractory urinary incontinence. The procedure is not beneficial if it does not increase urethral pressure close to, or within, the normal range.  相似文献   

15.
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.  相似文献   

16.
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.  相似文献   

17.
Cystourethropexy was performed in 10 bitches with refractory urinary incontinence due to urethral sphincter mechanism incompetence. All animals had an abnormally shaped vesico-urethral junction. The bladder neck was located in the pelvic canal in nine dogs (pelvic bladder). Surgery alone restored urinary continence in two cases and markedly improved incontinence in two cases. Surgery combined with medical therapy (phenylpropanolamine, 1.5 mg/kg orally once or twice a day, using a sustained-action preparation) restored urinary continence in four cases and markedly improved continence in one case. Surgery, with medical therapy, was completely ineffective in one case. No major complications were encountered in any dogs. In four cases, histopathologic evaluation of the dorsal bladder wall and neck revealed the presence of a single, perinuclear, clear vacuole in the cytoplasm of smooth muscle fibers. Electron microscopic examination showed that the vacuoles represented a dilatation of normal membrane organelles. Such abnormalities have the potential to alter the smooth muscle motility. This study indicates that cystourethropexy alone restored urinary continence only temporarily in the majority of the patients. The significance and frequency of the histopathologic findings requires further investigation.  相似文献   

18.
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.  相似文献   

19.
Treatment of urinary incontinence in dogs by endoscopic injection of Teflon   总被引：1，自引：0，他引：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.  相似文献   

20.
Reconstruction of the proximal urethra using a distally based tube flap mobilized from the ventral bladder wall was performed on 12 clinically normal dogs after total prostatectomy and resection of 2 cm of membranous urethra. One dog was euthanized at 6 hours and one at 36 hours after surgery because of surgical complications. Five dogs were euthanized at 10 days, two dogs at 6 weeks and three dogs at 12 weeks. Advancement of the tube flap allowed for tension-free anastomosis to the membranous urethra. Vascular integrity was maintained in all flaps. Intermittent to continuous postoperative urinary incontinence occurred in 7 of 10 dogs. The incontinence was transient in all 6 and 12 week dogs except one in which a persistent stress incontinence developed. Mild to severe dysuria was noted in 8 of 10 dogs, but was also transient in all of the 6 and 12 week dogs, with the exception of one dog. Postoperative urethral closure pressure profilometry revealed decreased tone in the membranous urethra in all 6 and 12 week dogs. It was concluded that proximal urethral reconstruction, using a ventral bladder tube flap, is a viable technique that may permit functional urodynamic recovery in dogs with significant proximal urethral loss.  相似文献   

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