Introduction
- Relatively uncommon.
- Lack of voluntary control over flow of urine.
- Cause : neurogenic disease, anatomic abnormality, acquired urinary tract disease, paradoxic incontinence (with urethral obstruction, eg urolith and full bladder, urine can leak past obstruction).
- Diagnosis : needs to be differentiated from dysuria, polyuria, abnormal urination behavior
. - Prognosis : depends on underlying cause.
Diagnosis
Clinical signs
- Small bladder on abdominal palpation in congenital abnormalities, urge incontinence and urethral hypotonia.
- Evidence of urine scalding.
- Overflow (full) bladder in upper and lower motor neuron disease.
- Possibility of manual expression of the bladder depends on urethral resistance:
- Flaccid bladder: full but easily expressed = lower motor neurone disease.
- Spastic bladder: full but hard to express = upper motor neurone disease.
- Other signs of dysautonomia .
- Decreased anal tone and sensation in pudendal nerve dysfunction.
- Sacral/lumbar pain +/- tail paralysis if trauma.
Diagnosis
Differential diagnosis
- Polyuria /polydipsia.
- Increased frequency of urination due to lower urinary tract disease, eg cystitis, urethritis (but can also be associated with urge incontinence due to detrusor muscle instability).
- Iatrogenic (diuretics, barbiturates, glucocorticoids).
Sequelae
Prognosis
- Good: if underlying cause can be treated.
- Guarded: if neurological in origin.
Expected response to treatment
- Resolution of incontinence.
Reasons for treatment failure
- Underlying cause not treated.
- Concurrent urinary tract infection.
- Detrusor muscle permanently overstretched.
Sources
Publications
Refereed papers
- King G J & Johnson E H (2000)Hypospadias in a Himalayan cat.JSAP41(11), 508-510.
- Baines S J, Speakman A J, Williams J M and Cheeseman M T (1999)Genitourinary dysplasia in a cat.JSAP40(6), 286-290.
