Falceto M V, Caccamo R, Garrido A M, Pisu M C, Tejedor M T, Trerotoli P, Nicoli S, Zagarella P, Lippi I, García-Pedraza E, Rambaldi J, Kirilova D, Mitjana O
Department of Animal Pathology, Agroalimentary Institute of Aragon-IA2, Universidad de Zaragoza-CITA, Zaragoza, Spain.
Dipartimento di Scienze Veterinarie, Universitá di Torino, Torino, Italy.
Front Vet Sci. 2024 Jul 17;11:1360288. doi: 10.3389/fvets.2024.1360288. eCollection 2024.
Urinary incontinence (UI) consists of involuntary leakage of urine during the storage phase of urination.
An anonymous survey was given to Spanish and Italian veterinarians about canine UI treated cases, diagnosis, treatment, follow-up, and professional interest.
Most veterinarians treated ≤3 cases/quarter, resulting in the percentage of incontinence males being lower than that of females (1-4% vs 0-24%). The percentage of spayed incontinent females was lower in Spain (0-24%) than in Italy (75-100%). Most diagnoses were based on a diagnostic algorithm (Spain: 88.7%; Italy: 65.3%); patient report and history, blood work, urinalysis and abdominal ultrasound. Urethral/bladder pressure measurement was unusual (Spain: 0.2%; Italy: 2.4%). In Spain, radiology with contrast medium and CT urography (26.3% and 34.4%, respectively) were more frequent than in Italy (11.6% and 22.7%, respectively). When suspecting urethral sphincter mechanism incompetence pharmacological trial (Spain: 93.2%; Italy: 78.9%). The first-choice medical treatment was Phenylpropanolamine, followed by Ephedrine and Deslorelin. When pharmacotherapy failed, the most frequent option was drug change, followed by increased drug dosage/frequency of administration, surgical therapy and colposuspension. A review was completed after the first week of treatment followed by periodic reviews. Most of the respondents participated in continuing education only if UI occurred in their everyday practice (Spain: 63.0%; Italy: 55.4%) and about 30% responders did it regardless of the number of UI cases treated (Spain: 30.5%; Italy: 37.4%).
Some recommendations in clinical practice were made. UI can be underestimated by owners; therefore, a complete history should be obtained by veterinarians. Veterinarians should carefully evaluate if spaying is advisable considering it could increase UI risk. A step-by-step approach is recommended and a specific diagnostic-therapeutic algorithm for UI in dogs is provided. Conservative approaches (regular exercise, weight loss in overweight dogs and observing an "incontinence diary" to identify abnormal patterns of urination) are advisable.
尿失禁（UI）是指在排尿储存阶段尿液不自主漏出。
针对西班牙和意大利的兽医进行了一项匿名调查，内容涉及犬类尿失禁的治疗病例、诊断、治疗、随访及专业兴趣。
大多数兽医每季度治疗≤3例病例，导致失禁雄性犬的比例低于雌性犬（1 - 4%对0 - 24%）。绝育后失禁的雌性犬比例在西班牙（0 - 24%）低于意大利（75 - 100%）。大多数诊断基于诊断算法（西班牙：88.7%；意大利：65.3%）；患者报告与病史、血液检查、尿液分析及腹部超声。尿道/膀胱压力测量不常见（西班牙：0.2%；意大利：2.4%）。在西班牙，使用造影剂的放射学检查和CT尿路造影（分别为26.3%和34.4%）比在意大利（分别为11.6%和22.7%）更频繁。怀疑尿道括约肌机制功能不全时进行药物试验（西班牙：93.2%；意大利：78.9%）。首选药物治疗是苯丙醇胺，其次是麻黄碱和地洛瑞林。药物治疗失败时，最常见的选择是更换药物，其次是增加药物剂量/给药频率、手术治疗和阴道悬吊术。治疗第一周后进行复查，随后定期复查。大多数受访者仅在日常实践中遇到尿失禁病例时才参加继续教育（西班牙：63.0%；意大利：55.4%），约30%的受访者无论治疗的尿失禁病例数量如何都会参加（西班牙：30.5%；意大利：37.4%）。
提出了临床实践中的一些建议。主人可能低估尿失禁情况；因此，兽医应获取完整病史。考虑到绝育可能增加尿失禁风险，兽医应仔细评估是否建议进行绝育。建议采用逐步方法，并提供了犬类尿失禁的特定诊断 - 治疗算法。保守方法（定期运动、超重犬减重以及观察“失禁日记”以识别异常排尿模式）是可取的。
