Urinary Incontinence Flashcards Preview

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Flashcards in Urinary Incontinence Deck (68):
1

What is dysuria?

Painful urination

2

What is stranguria?

Strained urination

3

What is pollakiuria?

Frequent urination of small amounts

4

What is polyuria?

Urination of large amounts

5

What is incontinence?

Involuntary release of urine through the urethra

6

____ ml/mg/day of urine is considered polyuric in a dog/

50 ml/kg/day

7

What are 3 clinical signs of incontinence?

1. Wet bed

2. Licking vulva/penis

3. Dribbling while walking

8

With which of the following would the animal position (squat): incontinence or polyuria?

Polyuria

9

True or False: Incontinence and polyuria can occur simultaneously.

TRUE

10

What are the 3 nerves involved in micturition?

1. Hypogastric

2. Pudendal

3. Pelvic

11

What are the 3 muscles involved in micturition?

1. Detrusor

2. Internal urethral sphincter

3. External urethral sphincter

12

Which is smooth muscle, the internal urethral sphincter or the external urethral sphincter?

Internal urethral sphincter

13

Which is striated muscle, the internal urethral sphincter or the external urethral sphincter?

External urethral sphincter

14

What are the 2 phases of micturition?

1. Filling

2. Voiding

15

What type of neurological control is filling under?

Sympathetic control

16

What type of neurological control is voiding under?

Parasympathetic control

17

What is the main neurotransmitter in filling?

Norepinephrine

18

What is the main neurotransmitter in voiding?

Acetylcholine

19

From which vertebra does the hypogastric nerve come in the dog?

L1-L4

20

From which vertebra does the hypogastric nerve come in the cat?

L2-L5

21

What effect does the hypogastric nerve have on the detrusor muscle?

Relaxation

22

What receptors in the detrusor muscle are targeted by the hypogastric nerve?

Beta-adrenergic receptors

23

What effect does the hypogastric nerve have on the internal urethral sphincter?

Contraction

24

What receptors in the internal urethral sphincter are targeted by the hypogastric nerve?

Alpha 1-adrenergic receptors

25

Is the hypogastric nerve under sympathetic or parasympathetic control?

Sympathetic

26

Is the hypogastric nerve involved in bladder filling or voiding?

Filling

27

The filling phase is also under voluntary control. What nerve is involved here?

Pudendal nerve

28

From which vertebra does the pudendal nerve come?

S1-S2

29

What is the pudendal nerve's effect on the external urethral sphincter?

Contraction

30

Which receptors does the pudendal nerve effect at the level of the external urethral sphincter?

Nicotinic receptors

31

The pelvic nerve is involved in the voiding phase. From which vertebra does this nerve come?

S1-S3

32

The pelvic nerve stimulates what receptors?

Muscarinic

33

What is the pelvic nerve's effect on the internal urethral sphincter?

Relaxation

34

What is the pelvic nerve's effect on the detrusor muscle?

Contraction

35

Are ectopic ureters more common females or males?

Females

36

What are the 3 most common breeds predisposed to ectopic ureters?

1. Siberian husky

2. Labrador retriever

3. Golden retriever

37

Are most ectopic ureter cases unilateral or bilateral?

Bilateral

38

Are most ectopic ureters extramural or intramural?

Intramural

39

What are 4 abnormalities associated with ectopic ureters?

1. UTIs

2. Hydronephrosis

3. Hydroureter

4. Vestibulovaginal septal remnants

40

What is the GOLD STANDARD for diagnosing ectopic ureters?

Cystoscopy

41

What surgical procedure is used to treat extramural ectopic ureters?

Neoureterocystostomy

42

What surgical procedure is used to treat intramural ectopic ureters?

Neoureterotomy

43

Which can be treated cystoscopically with laser ablation: intramural or extramural ectopic ureter?

Intramural ectopic ureter

44

With treatment of ectopic ureters, which tends to have the better outcome, males or females?

Males

45

What is detrusor instability?

Involuntary bladder contractions at low bladder volumes

46

What is the concept in treating detrusor instability?

Enhancing bladder relaxation

47

What type of drug would you use to enhance bladder relaxation?

Anti-cholinergic

48

What are 2 side effects of anti-cholinergic drugs?

1. GI signs

2. Ptyalism

49

What are 2 anticholinergic drug options for treating detrusor instability?

1. Dicyclomine

2. Oxybutinin

50

What are 2 tricyclic antidepressants that also work in treating detrusor instability?

1. Imipramine

2. Amitryptaline

51

What does USMI stand for?

Urethral sphincter mechanism incompetence

52

What is the definition of a urethral sphincter mechanism incompetence?

Weak urethral pressure resulting in incontinence

53

What is the most common cause of incontinence in dogs?

Urethral sphincter mechanism incompetence

54

USMI is seen in what percentage of spayed females?

5-20%

55

Which breeds are predisposed to USMI, small breeds or large breeds?

Large breeds

56

Which 4 breeds, specifically, are predisposed to USMI?

1. German shepherd

2. Doberman

3. Rottweilers

4. Boxers

57

Clinical signs associated with USMI most commonly occur within ___ months of spaying.

3

58

What is the GOLD STANDARD for diagnosing USMI?

Urethral pressure profilometry

59

What are your 2 general medical options for treating USMI?

1. Estrogen analoques

2. Alpha-adrenergics

60

What are the 2 alpha-adrenergic options for treating USMI?

1. PPA - phenylpropanolamine

2. Ephedrine/pseudoephedrine

61

What are the adverse effects associated with alpha-adrenergics?

1. Hypertension

2. Tachycardia

3. Excitement

62

Estrogens are another treatment option for USMI. What are the 3 mechanisms of action of estrogens?

1. Increased urethral vasculature

2. Hypertrophy of urethral epithelium

3. Increased sensitivity of alpha1-adrenergic receptors

63

What is the efficacy rate of Prion (PPA - phenylpropanolamine)?

85%

64

What is the efficacy rate of estrogens in treating USMI?

18-65%

65

What are the adverse effects associated with estrogen use?

1. Estrus

2. Alopecia

3. Bone marrow suppression

66

Endoscopic collagen injections are another treatment option for USMI. How long does the collagen last?

17-21 months

67

What is a colposuspension?

Where the vagina is affixed to the prepubic tendon, causing lengthening and compression of the urethra.

68

What is a cystourethropexy?

Anchoring the urethra to the ventral abdominal wall.