Detrusor urethral dyssynergy in dogs: 35 cases (2007-2019)

The use of a percutaneous cystostomy tube as an adjunctive treatment option for dogs with idiopathic functional outflow tract obstruction

BACKGROUND

Functional outflow tract obstruction (FOO) remains a challenging disease to manage in male dogs. Cystostomy tubes have been used to relieve urethral obstruction while allowing time to achieve effective medical management, avoiding the need for emergency visits and repeat urinary catheterizations.

OBJECTIVES

To describe a series of dogs with FOO and categorize the most successful management strategies including medical management alone or with the support of cystostomy tubes for urinary diversion.

ANIMALS

Twelve client-owned dogs with FOO were included.

METHODS

Medical records of dogs presented from August 2012 to September 2021 with a presumptive diagnosis of FOO were retrospectively reviewed and findings recorded.

RESULTS

Seven dogs were managed with a cystostomy tube and 5/7 (71%) had a good-excellent outcome. Five dogs were managed without a tube and 1/5 (20%) had a good outcome. Eight dogs were refractory to medical management; 5 managed with a cystostomy tube and 3/5 (60%) had a good-excellent outcome; 3 managed without a cystostomy tube and 0/3 had a good or excellent outcome. Overall, dogs with cystostomy tubes had better outcomes but also had mild, moderate, and severe complications (100%, 71%, and 71%, respectively) reported.

CONCLUSIONS AND CLINICAL IMPORTANCE

Most dogs that received a percutaneous cystostomy tube as part of their management plan had a good to excellent outcome, particularly when compared to those that did not, despite the high rate of tube-related complications. Percutaneous cystostomy tubes could be considered early during management for FOO to improve overall outcomes.

ACVIM consensus statement on diagnosis and management of urinary incontinence in dogs

Urinary incontinence (UI) is a disorder of micturition that can occur in dogs of any age, sex, and breed depending on the underlying cause and time of onset. Diagnosis and treatment for various causes of UI in dogs have been described by multiple comprehensive single author review articles, but large prospective clinical trials comparing treatment outcomes in veterinary medicine are lacking. The objectives of this consensus statement therefore are to provide guidelines on both recommended diagnostic testing and treatment for various causes of UI in dogs. Specifically, pathophysiology directly related to the canine urinary system will be reviewed and diagnostic and therapeutic challenges will be addressed. A panel of 12 experts in the field (8 small animal internists [L. Adams, J. Bartges, A. Berent, J. Byron, J. Foster, A. Kendall, S. Vaden, J. Westropp], 2 neurologists [J. Coates, N. Olby], 1 radiologist [G. Oetelaar], and 1 surgeon [C. Adin]) was formed to assess and summarize evidence in the peer-reviewed literature and to complement it with consensus recommendations using the Delphi method. Some statements were not voted on by all panelists. This consensus statement aims to provide guidance for management of both male and female dogs with underlying storage or voiding disorders resulting in UI.

Idiopathic functional urinary outflow tract obstruction in dogs, a retrospective case series (2010-2021): 31 cases

BACKGROUND

Idiopathic functional urinary outflow tract obstruction (iFUOTO) is an uncommon but life-limiting disease whose etiology and clinical course of disease remain poorly understood.

OBJECTIVE

Characterize signalment, clinical signs, clinicopathologic findings, treatments, and propose a standardized response score for dogs with iFUOTO.

ANIMALS

Thirty-one client-owned dogs diagnosed with iFUOTO.

METHODS

Retrospective case series. Medical records from 2010 to 2021 were reviewed and findings recorded. Dogs were categorized based on the presence or absence of overt signs of neurological disease. Response to treatment was scored.

RESULTS

Thirty-one dogs were included. All dogs had stranguria and 14 (45%) had overflow urinary incontinence. Mean age of onset for signs was 6.9 years±8 months. Twenty-four dogs (77%) were castrated males, 5 (16%) intact males, and 2 (6%) spayed females. Eight (26%) of dogs had overt neurological deficits. Follow-up data were available for 29 dogs (median 38 days, range: 2-1277). Final outcome scores were not significantly different among dogs with overt signs of neurological disease (median score 2.5; range: 0-3) and those without (median score 1; range; 0-3; P = .35). Treatments included alpha antagonists, skeletal muscle relaxants, parasympathomimetics, anti-inflammatories, castration, temporary placement of a urethral catheter, or a combination of these.

CONCLUSIONS AND CLINICAL RELEVANCE

Multimodal treatment was frequently prescribed, but a standard outcome score is needed to evaluate the effectiveness of these therapies. Serial neurological examinations and monitoring of the dogs' dysuria are warranted.

Neurogenic Bladder in Dogs, Cats and Humans: A Comparative Review of Neurological Diseases

Lower urinary tract disease (LUTD) includes abnormalities in the structure and function of the bladder and the urethra. LUTD caused by neurological disease is defined neurogenic bladder (NB). The integrity of the central nervous system (CNS) and peripheral nervous system (PNS) is required to explicate normal micturition, maintaining the proper function of bladder and urethra. The location and type of neurological lesions influence the pattern of clinical manifestations, potential treatment, and prognosis. Though, in dogs and cats, spinal cord injury is considered mainly responsible for bladder and/or urethra incompetence, other disorders, congenital or acquired, involving CNS or PNS, could play a role in NB. In veterinary medicine, the information about the epidemiology, prevalence, etiopathogenesis, diagnosis and treatment of NB are scattered. The aim of this study is to provide an overview of the epidemiology, prevalence, clinical findings, diagnosis and prognosis for NB in dogs and cats compared with humans.