Page 209 - Problem-Based Feline Medicine

12 – THE INCONTINENT CAT 201

Treatment Diagnosis

Bladder neck reconstructive surgery may be considered Physical examination reveals urine leakage from the
in cats with urethral hypoplasia. umbilical region.
Alpha-adrenergic agonists, such as phenyl-
propanolamine (1.5–2.2 mg/kg PO 8–12 h) and Differential diagnosis
ephedrine (2–4 mg/cat PO 8–12 h) may be used to
Exstrophy of the bladder. The bladder wall and abdom-
alleviate the incontinence. Once the incontinence is
inal wall are not fully formed and are joined, with leak-
controlled, the dosage can be reduced and/or the
age of urine to the exterior.
frequency lengthened.
High doses of oral estrogen therapy were reportedly Treatment
effective in two cats that developed urinary incontinence
following ovariectomy. However, at such doses nympho- Surgical correction and antimicrobial therapy for sec-
mania and toxic bone marrow effects may occur. ondary infection.
Testosterone propionate (5–10 mg intramuscularly),
given to three neutered male cats suspected of repro- Prognosis
ductive hormone-responsive incontinence, gave vari-
Good.
able success.
SPINAL DYSRAPHISM
Prognosis
Response to drug therapy in severely affected animals Classical signs
is often poor.
● Young cat.
● Dribbling urine.
PATENT URACHUS ● Distended urinary bladder.
● ± Hindquarter abnormalities.
Classical signs

● Immature cat. Pathogenesis
● Dribbling urine from the umbilicus.
Incomplete closure of the neural tube during early
● Omphalitis.
prenatal development leads to malformation of the
● Ventral dermatitis.
sacral spinal cord segments and disruption of nerve
pathways responsible for micturition, resulting in loss
Pathogenesis of detrusor responsiveness and urethral sphincter
control.
Patent (persistent) urachus occurs when the entire ura-
chus between the urinary bladder and the umbilicus Sacrocaudal dysgenesis in Manx cats is due to a semi-
remains functionally patent after birth. lethal, autosomal dominant gene.

Clinical signs Clinical signs
Kittens show urine leakage from the umbilicus. Signs occur in young cats (< 6 months of age).
A patent urachus is often associated with omphalitis Severity of the clinical signs vary and may include
(inflammation of the umbilicus), ventral dermatitis abnormalities of urination, defecation and hindlimb
and signs of urinary tract infection. gait.