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Brendan B. Anders Garden State Veterinary Specialist, 1 Pine St, Tinton Falls, NJ 07753.

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Roxane L. Collins Garden State Veterinary Specialist, 1 Pine St, Tinton Falls, NJ 07753.

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 DVM, DACVIM

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History:

A 4-month-old sexually intact female Golden Retriever was referred for evaluation of persistent urinary incontinence. Urination during conscious micturation was considered normal; however, the dog had nocturnal incontinence, and its perivulvar area was persistently damp. Treatment with amoxicillin (10 mg/kg [4.5 mg/lb], PO, q 12 h) for 4 weeks did not result in substantial improvement.

On initial physical examination, the dog was in good body condition and had a rectal temperature of 39.7°C (103.4°F; reference range, 37.5° to 39.2°C [99.5° to 102.5°F]).1 Urinary incontinence or perivulvar moisture was not detected during the examination. Analysis of a urine sample obtained by cystocentesis revealed a specific gravity of 1.014 (reference range, 1.015 to 1.050),a trace blood, a pH of 6.0, and trace proteins. Microscopic examination of the urine sediment revealed numerous bacteria (rods) and WBCs. Urine was submitted for bacterial culture at this time; however, results were not available for interpretation. The Hct was 35.5% (reference range, 36% to 60%),a and serum biochemical results indicated hyperphosphotemia (7.68 mg/dL; reference range, 2.50 to 6.80 mg/dL).a A ventrodorsal radiographic view of the abdomen was obtained (Figure 1).

Figure 1—
Figure 1—

Ventrodorsal radiographic view of the abdomen of a 4-month-old sexually intact Golden Retriever evaluated for persistent urinary incontinence.

Citation: Journal of the American Veterinary Medical Association 229, 1; 10.2460/javma.229.1.35

Radiographic Findings and Interpretation

The pubic and pelvic symphyses are absent, which is compatible with congenital malformation of the pelvis (Figure 2).

Figure 2—
Figure 2—

Same radiographic view as in Figure 1. Notice absence of the acetabular branch of the pectin and pubis and the ishiatic arch (arrows).

Citation: Journal of the American Veterinary Medical Association 229, 1; 10.2460/javma.229.1.35

Comments

Intravenous urography revealed poor filling of the renal pelves; filling of the urinary bladder was considered normal (Figure 3). Radiographically, the ureters were considered to be the appropriate size and there was no indication of ectopia. The urinary bladder was positioned caudally within the abdomen, and the neck of the urinary bladder was located within the pelvic canal.

Figure 3—
Figure 3—

Lateral (A) and ventrodorsal (B) radiographic views of the abdomen of the dog in Figure 1 obtained after IV administration of contrast medium. Notice the abnormal location of the urinary bladder (arrowhead).

Citation: Journal of the American Veterinary Medical Association 229, 1; 10.2460/javma.229.1.35

Juvenile urinary incontinence can result from numerous causes such as ectopic ureter, infection, urethral sphincter mechanism incompetence (USMI), and behavioral changes.2 In the dog reported here, ectopic ureter and USMI were considered most likely on the basis of history, lack of response to antimicrobial treatment, and radiographic detection of an anatomic pelvic anomaly.

Exploratory surgery was performed because the urinary incontinence was believed to have been associated with absence of a pelvic floor, which allowed the bladder to be located within the pelvis. Ovariohysterectomy was scheduled at the same time. After ovariohysterectomy, a cystotomy was performed to identify the ureters and to place a Foley catheter in the bladder. The position and morphology of both ureters were considered normal; however, the abdominal portion of the urethra was subjectively shorter than normal. Because of poor response to medical management, the minimal additional anesthesia time that would be required, and the lack of notable surgical complications, colpolsuspension was performed by placing mattress sutures of 2-0 nylon through a ligamentous structure in the region of the pubic defect to pull the urinary bladder cranially.

After surgery, diethylstilbestrol (50 mg, PO, q 96 h) was administered. Four years after surgery, the dog was reported to be completely continent. Discontinuation of diethystilbestrol resulted in recurrence of urinary incontinence; the problem responded well to periodic treatment with phenylpropanolamine (75 mg, PO) administered once to twice daily and antimicrobial medication.

To our knowledge, the congenital defect reported here has not been described previously, and we believe it was the primary cause of urinary incontinence. Bacteriuria and changes consistent with pyelonephritis may have also contributed to urinary incontinence in the dog.

a.

Antech Diagnostics, Farmingdale, NY.

  • 1

    Donald Plumb. Veterinary drug handbook. 4th ed. Ames, Iowa: Iowa State Press, 2002.

  • 2

    Hoelzler MG, Lidbetter DA. Surgical management of urinary incontinence. Vet Clin North Am Small Anim Pract 2004;34;10571073.

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