Micturition Disorders

Question 1

what receptors does the pelvic nerve innervate in the bladder?

Answer 1

muscarinic

Question 2

what is voluntary control of micturitions mediated through?

Answer 2

cerebral cortex
cerebellum
pons
spinoreticular tract

Question 3

what are the two categories of disorders of micturition?

Answer 3

neurogenic
nonneurogenic

Question 4

what are some non-neurogenic disorders?

Answer 4

urethral sphincter mechanism incompetence
hormone responsive incontinence
urge incontinence
ectopic ureters
pelvic bladder, urethral dysplasia

Question 5

who is reflex dyssnergia more common in?

Answer 5

large breed male dogs

Question 6

in a lower motor neuron lesion, the bladder is _____________ and _______________________

Answer 6

distended
easy to express

Question 7

what is the most common cause of detrusor hyperreflexia/instability?

Answer 7

bacterial UTI

Question 8

what are some diagnostics for urinary incontinence?

Answer 8

CBC, chemistry, urinalysis
abdominal ultrasound
cystoscopy
contrast radiography
urethral pressure profile

Question 9

what are some causes of urethral incompetence?

Answer 9

puppy piddler
pelvic bladder

Question 10

what are some treatment options for urethral incompetence?

Answer 10

nonmedical management
colposuspension
imbrication techniques
collagen injections
hydraulic occlude
vetfoam urethral bulking agent- gelatin based

Question 11

what are some causes of urge incontinence?

Answer 11

neurogenic
inflamed or irritated bladder
main differential diagnosis is cystitis

Question 12

what is the definition of ectopic ureters?

Answer 12

ureteral opening in any area other than the normal position in the trigone of the bladder

Question 13

who is ectopic ureters most common in?

Answer 13

female large breed dogs
young dogs

Question 14

what are the clinical signs of ectopic ureters?

Answer 14

urinary incontinence most common
less than one year of age typically
uncommonly diagnosed in male dogs: longer urethra

Question 15

what breeds are predisposed to ectopic ureters?

Answer 15

golden retrievers
labrador retrievers
siberian huskies
newfoundlands
english bulldogs

Question 16

what are some causes of urinary incontinence other than ectopic ureters?

Answer 16

stones
vaginal tumors
recessed, infantile, or deep set vulva

Question 17

what should you ask when getting a history for urinary incontinence?

Answer 17

age of onset
sexual status of animal
age of neutering
current medications
history of trauma or previous urinary tract disorders

Question 18

what makes up the storage phase of micturition?

Answer 18

bladder: low resistance and high capacity
urethra: high resistance barrier

Question 19

what are some neurogenic disorders?

Answer 19

lower motor neuron: atonic bladder
upper motor neuron: automatic bladder
detrusor-urethral dyssynergia

Question 20

what are some disorders of voiding?

Answer 20

urethral sphincter mechanism incompetence
ectopic ureters
detrusor instability

Question 21

what are some disorders of storage?

Answer 21

functional outflow obstruction
mechanical outflow obstruction
atonic bladder

Question 22

what are some causes of lower motor neuron lesions?

Answer 22

trauma or surgery in pelvic region
lesion below L5

Question 23

what do lower motor neuron lesions cause?

Answer 23

sphincter and detrusor hyporeflexia

Question 24

in upper motor neuron lesions, the urethral sphincter shows _______________

Answer 24

hyper-excitability

Question 25

what happens in reflex dyssnergia?

Answer 25

active contraction of detrusor without relaxation of the internal or external urethral sphincters

Question 26

what can an outflow obstruction lead to?

Answer 26

paradoxic incontinence

Question 27

is an outflow obstruction easy to catheterize?

Answer 27

no

Question 28

who is urethral sphincter mechanism incompetence most common in?

Answer 28

middle aged or older neutered or spayed dogs

Question 29

what is the most common cause of detrusor hyperreflexia/instability (urge incontinence)?

Answer 29

bacterial UTI

Question 30

what is urethral sphincter mechanism incompetence a common cause of?

Answer 30

acquired urinary incontinence

Question 31

what is normal urethral pressure for urethral pressure profilometry?

Answer 31

exceeds intravesical pressure during all phases of bladder filling

Question 32

when should you perform a urethral pressure profilometry?

Answer 32

when animal fails medical management

Question 33

what are the indications for a urethral pressure profilometry?

Answer 33

urethral sphincter mechanism incompetence suspected increased urethral tone reflex dyssnergia ureteral ectopia

Question 34

what are some causes of stress incontinence/urethral incompetance?

Answer 34

urethral smooth muscle incompetence or urethral malposition

Question 35

what is detrusor atony from overdistension?

Answer 35

separation of tight junctions of the detrusor muscle

Question 36

what are the clinical signs of detrusor atony?

Answer 36

dribbling urine large distended bladder stranguria/dysuria

Question 37

where are the locations for ectopic ureters?

Answer 37

bladder urethral junction various locations along urethra rarely within vestibule

Question 38

what breeds are more likely to get ectopic ureters?

Answer 38

golden retriever labrado retriever siberian husky newfoundland english bull dog

Question 39

how can you diagnose ectopic ureterss?

Answer 39

abdominal ultrasound cystoscopy excretory urography fluoroscopic urethrography urethral pressure profile CT

Question 40

who can have a recessed, infantile, or deep set vulva?

Answer 40

conformational predisposition overweight dogs dogs spayed young

Question 41

what specific things should you look at with a dog with a micturition disorder?

Answer 41

evaluate perineum palpation of bladder to assess size rectal exam digital vaginal exam observe dog urinate neurologic exam

Question 42

what should you do during a neurologic exam for a dog with a micturition disorder?

Answer 42

perineal reflex bulbospongiosus reflex