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Use of a Percutaneously Controlled Urethral Hydraulic Occluder for Treatment of Refractory Urinary Incontinence in 18 Female Dogs

Authors

  • Rachael L. Currao DVM,

    1. Department of Surgery, Bobst Hospital of The Animal Medical Center, New York, NY
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  • Allyson C. Berent DVM, Diplomate ACVIM,

    Corresponding author
    • Department of Diagnostic Imaging and Interventional Radiology, Bobst Hospital of The Animal Medical Center, New York, NY
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  • Chick Weisse VMD, Diplomate ACVS,

    1. Department of Surgery, Bobst Hospital of The Animal Medical Center, New York, NY
    2. Department of Diagnostic Imaging and Interventional Radiology, Bobst Hospital of The Animal Medical Center, New York, NY
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  • Philip Fox DVM, MS, Diplomate ACVIM & ECVIM (Cardiology), ACVECC

    1. Department of Cardiology, Bobst Hospital of The Animal Medical Center, New York, NY
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  • Study performed at the Bobst Hospital of The Animal Medical Center in New York, NY and the Matthew J. Ryan Veterinary Hospital of the University of Pennsylvania in Philadelphia, PA.

  • Presented in part at the 2011 American College of Veterinary Surgeons Veterinary Symposium November 1–5, 2011, Chicago, IL.

Corresponding Author

Allyson C. Berent, DVM, Diplomate ACVIM, The Animal Medical Center, 510 East 62nd Street, New York, NY 10065

E-mail: allyson.berent@amcny.org

Abstract

Objective

To evaluate the efficacy and safety of a percutaneously controlled urethral hydraulic occluder (HO) device for the treatment of refractory urinary incontinence (RUI) in female dogs with various urogenital anomalies.

Study Design

Case series.

Animals

Female dogs with RUI (n = 18).

Methods

Retrospective evaluation of dogs after a silicone ring (HO) was surgically placed around the proximal urethra. The ring was connected to a subcutaneous injection port with actuating tubing. Residual incontinence was treated with percutaneous infusion of sterile saline into the device to provide extraluminal urethral compression. Dogs were assessed for continence (owner-assessed 10-point continence scale) and complications at standard time points.

Results

All 18 dogs had significantly improved continence scores (P < .001) after HO placement (median and mean score pre-HO = 2.8 and 3.3; post-HO = 10 and 8.9, respectively) with a median follow-up time of 32 months. “Functional” continence (score ≥ 9) was achieved in 67% of dogs after HO placement, though only 13/18 clients were compliant with inflations. Of dogs belonging to compliant owners, 12 (92%) had a functional continence score. Six dogs (33%) did not require inflation to achieve continence. Urethral obstruction occurred as a complication in 3 dogs.

Conclusions

Use of an HO device was an effective long-term treatment for RUI when traditional options failed. The technique was associated with some complications, and these risks should be considered before use.

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