Leaks, dribbles urine

75 Leaks, dribbles urine



INTRODUCTION


Leaking or dribbling urine is a passive action and urine is found where the animal has been sitting or lying and may occur as the animal walks about. It occurs with:


• Weak external sphincter due to a pudendal nerve lesion or sacral cord lesion (S1–3)

• Weak bladder neck and smooth muscle of the urethra (internal sphincter) due to a lesion of the hypogastric nerve or lumbar cord (cat: L2–5, dog: L1–4).

• Urine retention with overflow due to LMN or UMN bladder paralysis

• 32% of dogs that had recovered pain perception and ambulation following a grade 5 IVDD-induced T3–L3 spinal cord injury had urinary incontinence, infrequently dribbling urine in the house. All had mild faecal incontinence.


SIGNALMENT


A 9-year-old neutered male Maine coon cat.



CASE PRESENTING SIGNS


Tail paralysis, faecal and urinary incontinence and a bilateral plantigrade stance.



CASE HISTORY


A low tail carriage and an abnormal hindlimb stance described as ‘rabbit-like’ developed suddenly 2 weeks prior to presentation. Faecal and urinary incontinence commenced with urine and faeces leaking or dropping out where the cat lay or as the cat moved about the house. The owner did not think the cat was in pain as the appetite remained normal and the pet had not become reclusive.



CLINICAL EXAMINATION


The cat was alert and ambulatory. A bilateral plantigrade stance of the hindlimbs was present with the left slight worse than the right hindlimb. The tail hung flaccidly and lacked all voluntary movement (Fig. 75.1). Anal tone was significantly reduced. The cat did not detect noxious stimulation of the tail or the anus (Fig. 75.2). The bladder was enlarged and there was little resistance to expression. Faeces could be digitally removed from the conscious cat. The withdrawal reflex was present in all limbs and seemed normal. The patellar reflex was 2–3+ bilaterally. No spinal pain was detected.


image

Figure 75.1 Plantigrade stance, flaccid tail.

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Sep 3, 2016 | Posted by in SMALL ANIMAL | Comments Off on Leaks, dribbles urine
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