Pegram C, Brodbelt D C, Church D B, Hall J, Owen L, Chang Y-M, O'Neill D G
Pathobiology and Population Science, The Royal Veterinary College, Hatfield, Herts, AL9 7TA, UK.
Clinical Sciences and Services, The Royal Veterinary College, Hatfield, Herts, AL9 7TA, UK.
J Small Anim Pract. 2019 Dec;60(12):723-733. doi: 10.1111/jsap.13072. Epub 2019 Oct 7.
To investigate association between neutering and early-onset urinary incontinence in bitches under primary veterinary care in the UK.
A retrospective cohort study of bitches within VetCompass born between January 1, 2010 and December 31, 2012 that were followed until March 31, 2018. The clinical records were automatically searched and manually validated for incontinence cases. Incidence risk and rate over the study period were calculated. Cox regression modelling separately evaluated the hazard of urinary incontinence and association with neutering: (1) from the date of birth for all bitches, both neutered and entire; and, (2) from the date of neutering for the neutered subset. Other variables considered included breed, bodyweight and veterinary practice group.
Overall, 492 bitches were identified with early-onset urinary incontinence from a total of 72,971 included in the study period. Incidence risk was 0.68% (95% confidence intervals 0.62 to 0.74), while incidence rate increased with age. After accounting for confounding factors, increased hazard of early-onset urinary incontinence was identified in: (1) neutered bitches, with the effect increasing with age; and, (2) bitches neutered before 6 months, within the first 2 years following neutering. In both models, increased hazard was additionally associated with increasing bodyweight and breed.
Neutering itself and early-age neutering (<6 months) are major risk factors for early-onset urinary incontinence. These results should be taken into account in making evidence-based recommendations on neutering and its timing.
调查在英国接受初级兽医护理的母犬绝育与早发性尿失禁之间的关联。
对2010年1月1日至2012年12月31日在VetCompass出生并随访至2018年3月31日的母犬进行回顾性队列研究。自动搜索临床记录并人工验证尿失禁病例。计算研究期间的发病风险和发病率。Cox回归模型分别评估尿失禁的风险及其与绝育的关联:(1)从所有母犬(包括已绝育和未绝育)的出生日期开始;(2)从已绝育母犬的绝育日期开始。考虑的其他变量包括品种、体重和兽医执业组。
总体而言,在研究期间纳入的72971只母犬中,有492只被确定患有早发性尿失禁。发病风险为0.68%(95%置信区间0.62至0.74),发病率随年龄增长而增加。在考虑混杂因素后,发现早发性尿失禁风险增加的情况如下:(1)已绝育母犬,其影响随年龄增加;(2)在6个月前绝育的母犬,在绝育后的头2年内。在两个模型中,风险增加还与体重增加和品种有关。
绝育本身以及早期绝育(<6个月)是早发性尿失禁的主要风险因素。在制定关于绝育及其时机的循证建议时应考虑这些结果。