• 1. Currao RL, Berent AC, Weisse C, et al. Use of a percutaneously controlled urethral hydraulic occluder for treatment of refractory urinary incontinence in 18 female dogs. Vet Surg 2013; 42: 440447.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 2. Holt PE. Surgical management of congenital urethral sphincter mechanism incompetence in eight female cats and a bitch. Vet Surg 1993; 22: 98104.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 3. Pisu MC, Veronesi MC. Effectiveness of deslorelin acetate subcutaneous implantation in a domestic queen with after-spaying urinary incontinence. J Feline Med Surg 2014; 16: 366368.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 4. Cullen WC, Fletcher TF, Bradley WF. Morphometry of the female feline urethra. J Urol 1983; 129: 190192.

  • 5. Frenier SL, Knowlen GG, Speth RC, et al. Urethral pressure response to alpha-adrenergic agonist and antagonist drugs in anesthetized healthy male cats. Am J Vet Res 1992; 53: 11611165.

    • Search Google Scholar
    • Export Citation
  • 6. Holt PE, Gibbs C. Congenital urinary incontinence in cats: a review of 19 cases. Vet Rec 1992; 130: 437442.

  • 7. Lappin MR, Barsanti JA. Urinary incontinence secondary to idiopathic detrusor instability: cystometrographic diagnosis and pharmacologic management in two dogs and a cat. J Am Vet Med Assoc 1987; 191: 14391442.

    • Search Google Scholar
    • Export Citation
  • 8. Carmichael KP, Bienzle D, Mcdonnell JJ. Feline leukemia virus-associated myelopathy in cats. Vet Pathol 2002; 39: 536545.

  • 9. Pavia PR, Havig ME, Donovan TA, et al. Malignant peripheral nerve sheath tumour of the urinary bladder in a cat. J Small Anim Pract 2012; 53: 245248.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 10. Forsee KM, Davis GJ, Mouat EE, et al. Evaluation of the prevalence of urinary incontinence in spayed female dogs: 566 cases (2003–2008). J Am Vet Med Assoc 2013; 242: 959962.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 11. Arnold S, Hubler M, Reichler I. Urinary incontinence in spayed bitches: new insights into the pathophysiology and options for medical treatment. Reprod Domest Anim 2009; 44 (suppl 2):190192.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 12. Scott L, Leddy M, Bernay F, et al. Evaluation of phenylpropanolamine in the treatment of urethral sphincter mechanism incompetence in the bitch. J Small Anim Pract 2002; 43: 493496.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 13. Byron JK, March PA, Chew DJ, et al. Effect of phenylpropanolamine and pseudoephedrine on the urethral pressure profile and continence scores of incontinent female dogs. J Vet Intern Med 2007; 21: 4753.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 14. Burgherr T, Reichler I, Hung L, et al. Efficacy, tolerance and acceptability of Incontex in spayed bitches with urinary incontinence [in German]. Schweiz Arch Tierheilkd 2007; 149: 307313.

    • Search Google Scholar
    • Export Citation
  • 15. Barth A, Reichler IM, Hubler M, et al. Evaluation of long-term effects of endoscopic injection of collagen into the urethral submucosa for treatment of urethral sphincter incompetence in female dogs: 40 cases (1993–2000). J Am Vet Med Assoc 2005; 226: 7376.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 16. Arnold S, Jäger P, DiBartola SP, et al. Treatment of urinary incontinence in dogs by endoscopic injection of Teflon. J Am Vet Med Assoc 1989; 195: 13691374.

    • Search Google Scholar
    • Export Citation
  • 17. Rawlings C, Barsanti JA, Mahaffey MB, et al. Evaluation of colposuspension for treatment of incontinence in spayed female dogs. J Am Vet Med Assoc 2001; 219: 770775.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 18. White RN. Urethropexy for the management of urethral sphincter mechanism incompetence in the bitch. J Small Anim Pract 2001; 42: 481486.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 19. Hussain M, Greenwell TJ, Venn SN, et al. The current role of the artificial urinary sphincter for the treatment of urinary incontinence. J Urol 2005; 174: 418424.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 20. Chartier-Kastler E, Van Kerrebroeck P, Olianas R, et al. Artificial urinary sphincter (AMS 800) implantation for women with intrinsic sphincter deficiency: a technique for insiders? BJU Int 2011; 107: 16181626.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 21. Hillary CJ, Osman N, Chapple C. Considerations in the modern management of stress urinary incontinence resulting from intrinsic sphincter deficiency. World J Urol 2015; 33: 12511256.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 22. Reeves L, Adin C, McLoughlin M, et al. Outcome after placement of an artificial urethral sphincter in 27 dogs. Vet Surg 2013; 42: 1218.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 23. Cohen TA, Westropp JL, Kass PH, et al. Evaluation of urodynamic procedures in female cats anesthetized with low and high doses of isoflurane and propofol. Am J Vet Res 2009; 70: 290296.

    • Crossref
    • Search Google Scholar
    • Export Citation

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Use of a percutaneously controlled hydraulic occluder for treatment of refractory urinary incontinence in three female cats

Kendall E. WilsonDepartment of Interventional Radiology and Endoscopy, The Animal Medical Center, 510 E 62nd St, New York, NY 10065.

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Allyson C. BerentDepartment of Interventional Radiology and Endoscopy, The Animal Medical Center, 510 E 62nd St, New York, NY 10065.

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Chick W. WeisseDepartment of Interventional Radiology and Endoscopy, The Animal Medical Center, 510 E 62nd St, New York, NY 10065.

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Abstract

CASE DESCRIPTION 3 cats were referred for evaluation of chronic urinary incontinence.

CLINICAL FINDINGS A presumptive diagnosis of urethral sphincter mechanism incompetence (USMI) was made in all 3 cats. Preoperatively, incontinence was mild in 1 cat (incontinence during sleep) and moderate to severe (incontinence while awake and at rest) in 2. Structural abnormalities noted during cystoscopy included urethrovestibular junction stenosis (n = 1), vaginal stenosis (1), short urethra (1), and intrapelvic bladder (1).

TREATMENT AND OUTCOME All 3 cats were treated by means of implantation of an inflatable silicone hydraulic occluder (HO) via a ventral midline celiotomy. Immediately prior to HO implantation, patients underwent cystoscopy to detect any anatomic abnormalities and confirm the absence of ureteral ectopia. Following surgery, all 3 patients attained complete continence, needing 0 or 1 inflation of the device. Complications included cystoscopy-associated urethral tear (n = 1), constipation (1), stranguria (1), hematuria (2), and urinary tract infection (2). Device explantation was performed 14 weeks after surgery in 1 cat because of postoperative constipation. Constipation persisted and urinary incontinence recurred but was markedly improved following device removal in this cat (leakage of urine only when sleeping at follow-up 29 months after surgery [26 months after device explantation]). At the time of last follow-up, 2 of the 3 cats remained fully continent approximately 3 and 6 years after device implantation.

CLINICAL RELEVANCE Findings suggested that implantation of an HO may be a safe and effective long-term treatment for some cats with USMI. Further studies are necessary to evaluate the potential for treatment-related complications and the long-term outcome.

Abstract

CASE DESCRIPTION 3 cats were referred for evaluation of chronic urinary incontinence.

CLINICAL FINDINGS A presumptive diagnosis of urethral sphincter mechanism incompetence (USMI) was made in all 3 cats. Preoperatively, incontinence was mild in 1 cat (incontinence during sleep) and moderate to severe (incontinence while awake and at rest) in 2. Structural abnormalities noted during cystoscopy included urethrovestibular junction stenosis (n = 1), vaginal stenosis (1), short urethra (1), and intrapelvic bladder (1).

TREATMENT AND OUTCOME All 3 cats were treated by means of implantation of an inflatable silicone hydraulic occluder (HO) via a ventral midline celiotomy. Immediately prior to HO implantation, patients underwent cystoscopy to detect any anatomic abnormalities and confirm the absence of ureteral ectopia. Following surgery, all 3 patients attained complete continence, needing 0 or 1 inflation of the device. Complications included cystoscopy-associated urethral tear (n = 1), constipation (1), stranguria (1), hematuria (2), and urinary tract infection (2). Device explantation was performed 14 weeks after surgery in 1 cat because of postoperative constipation. Constipation persisted and urinary incontinence recurred but was markedly improved following device removal in this cat (leakage of urine only when sleeping at follow-up 29 months after surgery [26 months after device explantation]). At the time of last follow-up, 2 of the 3 cats remained fully continent approximately 3 and 6 years after device implantation.

CLINICAL RELEVANCE Findings suggested that implantation of an HO may be a safe and effective long-term treatment for some cats with USMI. Further studies are necessary to evaluate the potential for treatment-related complications and the long-term outcome.

Contributor Notes

Address correspondence to Dr. Berent (allyson.berent@amcny.org).