Peer-reviewed veterinary case report
Managing bladder problems in pets with spinal cord injuries
By Hu, H Z et al.·Published in Journal of veterinary internal medicine·2016·Department of Veterinary Clinical Sciences·View original on PubMed →
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Original publication title: Pathophysiology, Clinical Importance, and Management of Neurogenic Lower Urinary Tract Dysfunction Caused by Suprasacral Spinal Cord Injury.
Plain-English summary
Managing ongoing problems with urination in pets that have had serious spinal cord injuries can be quite difficult. When the injury occurs in the upper part of the spinal cord, it disrupts normal bladder control, which can lead to issues like leaking urine and trouble emptying the bladder completely. This can affect your pet's quality of life and overall health. The research discusses various treatment options aimed at stopping urine leakage, protecting the kidneys, and preventing urinary tract infections. Overall, these treatments aim to improve the situation for pets suffering from these urinary issues due to spinal injuries.
Abstract
Management of persistent lower urinary tract dysfunction resulting from severe thoracolumbar spinal cord injury can be challenging. Severe suprasacral spinal cord injury releases the spinal cord segmental micturition reflex from supraspinal modulation and increases nerve growth factor concentration in the bladder wall, lumbosacral spinal cord, and dorsal root ganglion, which subsequently activates hypermechanosensitive C-fiber bladder wall afferents. Hyperexcitability of bladder afferents and detrusor overactivity can cause urine leaking during the storage phase. During urine voiding, the loss of supraspinal control that normally coordinates detrusor contraction with sphincter relaxation can lead to spinal cord segmental reflex-mediated simultaneous detrusor and sphincter contractions or detrusor-sphincter dyssynergia, resulting in inefficient urine voiding and high residual volume. These disease-associated changes can impact on the quality of life and life expectancy of spinal-injured animals. Here, we discuss the pathophysiology and management considerations of lower urinary tract dysfunction as the result of severe, acute, suprasacral spinal cord injury. In addition, drawing from experimental, preclinical, and clinical medicine, we introduce some treatment options for neurogenic lower urinary tract dysfunction that are designed to: (1) prevent urine leakage arising because of detrusor overactivity during bladder filling, (2) preserve upper urinary tract integrity and function by reducing intravesical pressure and subsequent vesicoureteral reflux, and (3) prevent urinary tract and systemic complications by treating and preventing urinary tract infections.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/27527382/