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This is most commonly treated through drug therapies, which work in most cases. However, in some cases, surgical intervention is more appropriate. A keyhole, or endoscopic, procedure has been developed which injects collagen into the urethra to help closure. This is a simple and minimally invasive procedure, and has a 75% success rate.
Urinary incontinence is embarrassing not only to the owner but to the affected dog itself. Because many bitches only become incontinent after surgery it was some time before spaying was considered to be the cause. The onset of incontinence varies from immediately to ten years after surgery, with an average interval of 2.9 years. Urinary incontinence manifest itself mainly during sleep. It is generally accepted that the underlying cause is an insufficient closure of the urethra.
Diagnosis
Spaying is the most common cause of incontinence, but it is important to rule out other possible causes. Therefore, if an animal is incontinent, it should be thoroughly examined by a vet in order to determine the cause. Possible other causes of incontinence are: neurological disease, bacterial cystitis, urinary tract malformation, or tumours or polyps in the bladder. In order to rule out these causes, a thorough physical examination is necessary, as well as a detailed history and information on daily water intake.
Treatment
The most common treatment for urinary incontinence in spayed bitches is through use of drugs. The most effective are a class called alpha-adrenergic drugs (Ephedrine or Phenylpropanolamine), which result in continence in 74% of cases and improvement in 24% of incontinent patients. If the animals does not respond to these drugs, or they are contraindicated, oestrogens may be given as an alternative.
If these therapies fail, surgery may be considered. The endoscopic procedure, developed by Dr. Arnold at the University of Zurich, injects collagen into the urethra to help close the sphincter. The technique is based on similar operations to cure incontinence in humans, pioneered in the 1980s. The procedure takes about 40 minutes and is completely successful in 75% of cases.
The procedure was performed for the first time in the UK by Dr Arnold in 1999 at the Godiva Referrals Veterinary Clinic in Coventry on Jemma, a four-year old dalmation, at the invitation of Jemma’s owner, Charles Cadogan. Although Dr. Arnold performs about 40 such procedures a year in Switzerland, it is not yet being offered as a treatment in the UK.
For more information about Jemma and her operation, see www.jemmathedog.co.uk.
(extracted, with permission from the author, from “Urinary incontinence in spayed bitches” in two parts, by Dr. Susi Arnold. The full paper originally appeared in Scheiz. Arch. Tierheil 1997, issue 139, pp 271-276 and 319-324)
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