Browsing by Author "Börman, Julianne"

Urinary incontinence is a fairly common problem in neutered female dogs with a prevalence of 5 – 20 %. There are different causes behind urinary incontinence that are divided into being of either neurogenic or non-neurogenic origin that can either be congenital or acquired. The most common type of incontinence in neutered female dogs is urethral sphincter mechanism incompetence (USMI) with a prevalence of up to 60 %. Despite having been researched for nearly 40 years neither the etiology nor pathophysiology of USMI are completely understood. While an estimate of 75-97% of medically treated dogs respond to medication, USMI can become refractory over extended periods of medical administration. There are also some cases where medical management isn’t an option due to contraindicative illnesses or severe side effects from the medicine. Some owners also find it too laboursome to administer lifelong medication thrice a day. Injecting bulking agents into the lumen of the urethra is a way of regaining continence through increased urethral resistance. It’s a minimally invasive technique with minimal side effects and high continence rates. However, the effect can be passing, and additional medication might be needed. More invasive surgical techniques are colposuspension, urethropexy, artificial sphincters and different transpelvic sling techniques. These are associated with lower continence rates, more side effects and longer recovery times. None of these options, however, have been successful in treating all dogs. In this literature review I strive to collect the available information on USMI focusing on the treatment when medication is insufficient, with special focus on bulking agents. I hope to form a better understanding of the disease and to be able to highlight the areas in need of further studies, so that more treatment options to resolve USMI could be developed. There needn’t be one treatment to cure them all, however there should be a more systematic approach to diagnosing USMI in order to facilitate the recognition of the best course of treatment for each dog.