Recipient Organization
UNIVERSITY OF TENNESSEE
2621 MORGAN CIR
KNOXVILLE,TN 37996-4540
Performing Department
Small Animal Clinical Sciences
Non Technical Summary
Canine urinary incontinence is due to several factors including neurological, anatomical, behavioral and hormonal abnormalities. Mechanisms include increased or decreased urethral sphincter constriction, detrusor muscle instability, and anatomical changes. Of these, the most common is decreased urethral sphincter constriction in spayed female dogs and has been reported in 20% of spayed dogs. Pharmacological agents have been found effective; however not all dogs respond to the available medications, and determining the correct dose can be difficult. Additionally, as urinary incontinence episodes continue the quality of life for the owner and pet decrease and in some cases, pets end up being euthanized due to the severity of clinical signs and/or their effect in the household. The purpose of this single-center study is to evaluate the efficacy of a urethral bulking agent (UBA) injection in female dogs for the treatment of urinary incontinence. This UBA is transurethrally injected with a cystoscope under general anesthesia into the urethral walls to decrease the lumen of the urethra and to eliminate clinical signs.
Animal Health Component
(N/A)
Research Effort Categories
Basic
(N/A)
Applied
(N/A)
Developmental
(N/A)
Goals / Objectives
Canine urinary incontinence is due to several factors including neurological, anatomical, behavioral and hormonal abnormalities. Mechanisms include increased or decreased urethral sphincter constriction, detrusor muscle instability, and anatomical changes. Of these, the most common is decreased urethral sphincter constriction in spayed female dogs and has been reported in 20% of spayed dogs. Pharmacological agents such as DES (diethylstilbesterol), PPA (phenylpropanolamine) and other medications have been found effective, however not all dogs respond to the available medications, and determining the correct dose can be difficult. Additionally, as urinary incontinence episodes continue the quality of life for the owner and pet decrease and in some cases, pets end up being euthanized due to the severity of clinical signs and/or their effect in the household. The purpose of this single-center study is to evaluate the efficacy of a urethral bulking agent (UBA) injection in female dogs for the treatment of urinary incontinence. This UBA is transurethrally injected with a cystoscope under general anesthesia into the urethral walls to decrease the lumen of the urethra and to eliminate clinical signs.
Project Methods
A total of 22 female spayed dogs will be treated in this study. Owners will be contacted by telephone the day after the initial treatment or retreatment and at 1, 9, 18 and 24 months post injection. Scheduled in clinic follow-up visits are at 1 week, 3, 6 and 12 months post injection. Inclusion and exclusion criteria will be evaluated. Dogs will be pretreated with a broad-spectrum antibiotic and anesthetized for surgery in dorsal recumbency. Using standard procedure, the bladder will be filled to approximately 50% of its capacity with sterile water or sterile saline. Cystoscopy will be performed with a rigid cystoscope. The cystoscope will be checked for correct placement and the product injected slowly. Once desired tissue-bulking is achieved, the injection procedure will be repeated in the other location(s) to achieve urethral coaptation. Broad spectrum antibiotics will be administered post treatment for 2 days. An anti-inflammatory medication and an alpha-blocking agent to induce urethral relaxation may be prescribed. Re-treatments will be allowed at least 3 months after prior treatment and between 3-12 months from initial injection if the subject continues to have urinary incontinence. All re-treatments should follow the same implant procedure with product being placed either slightly distal to the first injection, or into circumferential locations where a urethral gap appears. The maximum time a subject could participate in this study is 36 months, if a subject receives a re-treatment at 12 months. Owner questionnaires will be completed before and after treatment to identify the subject's urinary incontinence symptoms and to evaluate the clinical treatment outcome of injection. Investigator questionnaires will evaluate canine clinical incontinence symptoms pre and post injection. A physical exam will be performed to ensure the health of the subject during her participation in the study. A complete blood count and chemistry panel will be performed at baseline to ensure the subject is in otherwise adequate health for anesthesia and surgery. Urinalysis will be completed at baseline to ensure results do not preclude subject from receiving treatment. A urine culture will be performed within 14 days of a treatment to verify the subject does not have a urinary tract infection. Urine cultures will be repeated at 7 days post-treatment, and at the 3, 6, and 12 month follow-up visits or at any time the dog shows clinical signs of infection. At each follow up visit, we will evaluate the subject for adverse events and treatment clinical effectiveness and complete questionnaire forms to document outcome results. Ifa follow-up visit cannot be completed as required, data should be collected via telephone.