Urinary Incontinence

Question 1

Define: Urinary Incontinence

Answer 1

Loss of bladder control

Question 2

What are the two major categories of urinary incontinence?

Answer 2

Small bladder and large bladder incontinence

Question 3

What is small bladder incontinence?

Answer 3

Results from failure of urine storage

Question 4

What is large bladder incontinence?

Answer 4

Result from failure of voiding or from incomplete emptying of the bladder

Question 5

What type of urinary incontinence most commonly affects spayed female dogs?

Answer 5

small bladder incontinence - primary urethral sphincter mechanism incontinence

Question 6

What is hormone (estrogen) responsive incontinence also known as?

Answer 6

Primary sphincter mechanism incontinence

Question 7

What type of urinary incontinence are urinary tract infections, chronic cystitis, bladder stones, and neoplasia examples of? What do they lead to?

Answer 7

Small bladder incontinence - inflammation of bladder leads to sensory hyperlexia and involuntary hypercontractility

Question 8

What are the two main types of large bladder urinary incontinence?

Answer 8

Lower motor neuron disease and Upper motor neuron disease

Question 9

What are some signs (6) of large bladder incontinence (lower motor disease)?

Answer 9

Distended bladder, flaccid, easily expressed, decreased anal and tail tone, fecal incontinence, and decreased perineal reflexes

Question 10

What are some signs (2) of large bladder incontinence (upper motor disease)?

Answer 10

incomplete urination and urine retention and bladder difficult to express

Question 11

What are the two main causes of lower motor disease large bladder incontinence?

Answer 11

Lesions to sacral spinal cord or the pudendal nerve

Question 12

What are the two main causes of upper motor disease large bladder incontinence?

Answer 12

Lesions to the thoracolumbar spine or more cranial spinal lesions

Question 13

What is the drug of choice for treating urethral sphincter mechanism incontinence? What type of drug is it? Effect? What are the two side effects?

Answer 13

Phenylpropanolamine (PPA) - an a-adrenergic agonist increases internal sphincter tone. Side effects include hypertension and hyperactivity

Question 14

What is a substitute for Phenylpropanolamine?

Answer 14

Ephedrine/pseudoephedrine

Question 15

What drug is used to treat urge incontinence? What type of drug is it? Effect?

Answer 15

An anticholinergic that reduces muscle contractions allowing better bladder filling

Question 16

What drug is used to treat urge incontinence and cats with FLUTD? What type of drug is it?

Answer 16

Oxybutinin (Ditropan). An anticholinergic and antispasmodic

Question 17

What drug is used to treat urethral outflow obstruction (upper motor neuron disease)? What type of drug is it? Effect?

Answer 17

Phenoxybenzamine (Dibenzyline), an a-adrenergic antagonist. Allows relaxation of internal urethral sphincter

Question 18

What drug is used to treat bladder atony? What is it usually combined with? Effect?

Answer 18

bethanechol (Urecholine) is a strong muscarinic agent that stimulates cholinergic receptors on detrusor. When combined with Phenoxybenzamine, it can increase urethrogram due to a weak nicotinic effect