Micturition Disorders Flashcards
what receptors does the pelvic nerve innervate in the bladder?
muscarinic
what is voluntary control of micturitions mediated through?
cerebral cortex
cerebellum
pons
spinoreticular tract
what are the two categories of disorders of micturition?
neurogenic
nonneurogenic
what are some non-neurogenic disorders?
urethral sphincter mechanism incompetence
hormone responsive incontinence
urge incontinence
ectopic ureters
pelvic bladder, urethral dysplasia
who is reflex dyssnergia more common in?
large breed male dogs
in a lower motor neuron lesion, the bladder is _____________ and _______________________
distended
easy to express
what is the most common cause of detrusor hyperreflexia/instability?
bacterial UTI
what are some diagnostics for urinary incontinence?
CBC, chemistry, urinalysis
abdominal ultrasound
cystoscopy
contrast radiography
urethral pressure profile
what are some causes of urethral incompetence?
puppy piddler
pelvic bladder
what are some treatment options for urethral incompetence?
nonmedical management
colposuspension
imbrication techniques
collagen injections
hydraulic occlude
vetfoam urethral bulking agent- gelatin based
what are some causes of urge incontinence?
neurogenic
inflamed or irritated bladder
main differential diagnosis is cystitis
what is the definition of ectopic ureters?
ureteral opening in any area other than the normal position in the trigone of the bladder
who is ectopic ureters most common in?
female large breed dogs
young dogs
what are the clinical signs of ectopic ureters?
urinary incontinence most common
less than one year of age typically
uncommonly diagnosed in male dogs: longer urethra
what breeds are predisposed to ectopic ureters?
golden retrievers
labrador retrievers
siberian huskies
newfoundlands
english bulldogs
what are some causes of urinary incontinence other than ectopic ureters?
stones
vaginal tumors
recessed, infantile, or deep set vulva
what should you ask when getting a history for urinary incontinence?
age of onset
sexual status of animal
age of neutering
current medications
history of trauma or previous urinary tract disorders
what makes up the storage phase of micturition?
bladder: low resistance and high capacity
urethra: high resistance barrier
what are some neurogenic disorders?
lower motor neuron: atonic bladder
upper motor neuron: automatic bladder
detrusor-urethral dyssynergia
what are some disorders of voiding?
urethral sphincter mechanism incompetence
ectopic ureters
detrusor instability
what are some disorders of storage?
functional outflow obstruction
mechanical outflow obstruction
atonic bladder
what are some causes of lower motor neuron lesions?
trauma or surgery in pelvic region
lesion below L5
what do lower motor neuron lesions cause?
sphincter and detrusor hyporeflexia
in upper motor neuron lesions, the urethral sphincter shows _______________
hyper-excitability
what happens in reflex dyssnergia?
active contraction of detrusor without relaxation of the internal or external urethral sphincters
what can an outflow obstruction lead to?
paradoxic incontinence
is an outflow obstruction easy to catheterize?
no
who is urethral sphincter mechanism incompetence most common in?
middle aged or older neutered or spayed dogs
what is the most common cause of detrusor hyperreflexia/instability (urge incontinence)?
bacterial UTI
what is urethral sphincter mechanism incompetence a common cause of?
acquired urinary incontinence
what is normal urethral pressure for urethral pressure profilometry?
exceeds intravesical pressure during all phases of bladder filling
when should you perform a urethral pressure profilometry?
when animal fails medical management
what are the indications for a urethral pressure profilometry?
urethral sphincter mechanism incompetence
suspected increased urethral tone
reflex dyssnergia
ureteral ectopia
what are some causes of stress incontinence/urethral incompetance?
urethral smooth muscle incompetence or urethral malposition
what is detrusor atony from overdistension?
separation of tight junctions of the detrusor muscle
what are the clinical signs of detrusor atony?
dribbling urine
large distended bladder
stranguria/dysuria
where are the locations for ectopic ureters?
bladder urethral junction
various locations along urethra
rarely within vestibule
what breeds are more likely to get ectopic ureters?
golden retriever
labrado retriever
siberian husky
newfoundland
english bull dog
how can you diagnose ectopic ureterss?
abdominal ultrasound
cystoscopy
excretory urography
fluoroscopic urethrography
urethral pressure profile
CT
who can have a recessed, infantile, or deep set vulva?
conformational predisposition
overweight dogs
dogs spayed young
what specific things should you look at with a dog with a micturition disorder?
evaluate perineum
palpation of bladder to assess size
rectal exam
digital vaginal exam
observe dog urinate
neurologic exam
what should you do during a neurologic exam for a dog with a micturition disorder?
perineal reflex
bulbospongiosus reflex
