Page 235 - Problem-Based Feline Medicine

14 – THE CAT WITH INAPPROPRIATE URINATION 227

and radiology including contrast studies and ultra-
INCONTINENCE (INCLUDING
sonography of the lower urinary tract.
HORMONALLY RESPONSIVE
Many congenital anomalies are possible, but congenital INCONTINENCE)
anomalies are uncommon in cats.
● Patent urachus and ectopic ureters are the most Classical signs
common congenital anomalies.
● Unconscious urination usually occurs when
● Other anomalies include, but are not limited to:
asleep.
– Bladder agenesis.
● Cats with congenital disease may
– Bladder duplication.
continuously pass small drops of urine
– Vaginal defects such as septal defects.
whether awake or asleep.
– Urethral dysgenesis.
– Urethral strictures.
See main reference on page 193 for details (The
– Bladder and urethral diverticulae.
Incontinent Cat) on incontinence.
MENINGIOMA Clinical signs

Classical signs Incontinence may be due to an underlying congenital or
acquired anatomic problem.
● Inappropriate urination.
● Neurological deficits (altered mentation, Incontinence is urination that is uncontrolled or uncon-
abnormal proprioception or spinal sciously done.
reflexes). ● Unconscious urination usually occurs when
asleep.
See main reference on page 914 for details on menin- ● Cats with congenital disease may continuously
gioma. pass small drops of urine whether awake or
asleep.

Clinical signs Pollakiuria, dysuria and stranguria may also occur if a
secondary bacterial urinary tract infection occurs.
Meningiomas may be associated with urinary incon-
Urinalysis is usually normal unless a secondary bacterial
tinence and inappropriate urination.
urinary tract infection is present.
Inappropriate urination is usually due to incontinence
related to a spinal cord meningioma but may be asso-
Diagnosis
ciated with cerebral meningioma.
Diagnosis is usually made on the basis of historical and
Other neurologic deficits, such as proprioceptive deficits
physical examination findings.
or abnormal spinal reflexes, may or may not be present.
Incontinence must be differentiated from consciously
Typically occurs in old cats > 10 years.
controlled inappropriate urination as might be
observed with bacterial urinary tract infection, urolithi-
Diagnosis asis, bladder or urethral neoplasia or other causes of
lower urinary tract disease.
Diagnosis is difficult.
● With lower urinary tract disease, cats
● Meningiomas involving spinal cord may require
appear to have urgency or discomfort when
myelography for diagnosis.
urinating.
● Meningiomas that occur intracranially require com-
– Hematuria and/or pyuria with or without crystal-
puterized tomography or magnetic resonance imag-
luria is usually present.
ing for diagnosis.
– Laboratory and radiological evaluation may be
Laboratory evaluation is normal. abnormal.