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Peter Holt. Published by Vet Professionals, 2011, paperback, 48 pages, Price: £9.99 (print), £7.70 (PDF) ISBN: 978-0-9556913-9-3

Canine urinary incontinence is seen commonly in general veterinary practice, and can be challenging and frustrating for both the dog owner and the veterinarian to manage. Although rarely due to a life-threatening condition, urinary incontinence is a common reason for owners to request euthanasia of their pet.

Understanding Canine Urinary Incontinence was written primarily for owners of incontinent dogs. The author, Professor Peter Holt, devoted almost thirty years of his career to investigating the causes, diagnosis and treatment of urinary incontinence in small animals. This is evident throughout the book which is a comprehensive and compassionate review of common and uncommon causes of urinary incontinence in male and female dogs.

It is divided into five chapters, the first providing a brief insight into the emotional impact of canine urinary incontinence. The second and longest section details the causes and work-up of congenital and acquired urinary incontinence. The principles behind different treatments are outlined with their pros and cons discussed in detail.

Section three provides two case examples illustrating the management of incontinence due to an ectopic ureter and urethral sphincter mechanism incompetence (USMI) respectively. These give the reader an insight into the potential successes and complications of treatment with the benefit of long-term follow up. This section is highly readable and could easily be expanded in future editions.

Section four provides a series of questions aimed at providing a comprehensive history. As well as an important guide for owners, this is a useful prompt for veterinarians.

Section five provides a sensitive, detailed guide to euthanasia of dogs, as well as an extensive list of further reading.

The level of explanation is pitched at the educated dog owner. The information is not ‘dumbed down’. Medical terms are used liberally throughout, but all are coloured and defined in an extensive glossary. Information is set out under subheadings so readers can select that which is most relevant to their own dog.

What makes this book more helpful than information available to owners online is the inclusion of the author's experience, which is vast in this area. Professor Holt has the ability to put things into perspective, such as the risk of developing urinary incontinence after neutering.

The book is illustrated throughout with colour photographs and diagrams which are helpful in explaining the pathophysiology of urinary incontinence and the rationale for different treatments. For example, the principles behind colposuspension to treat USMI and ectopic ureter transplantation for juvenile incontinence are illustrated by way of beautifully simple, well-captioned diagrams. Images of diagnostic tests, including plain and contrast radiography, give owners an idea what their veterinarian might be seeking to rule in or out.

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This book provides accurate and extensive information about complications and treatment failure which will aid owners and their veterinarians in making informed decisions. It would be especially helpful in counselling owners about potential surgical treatment of congenital and acquired conditions leading to urinary incontinence, and owners whose dogs are embarking on medical therapy for USMI.

As a practitioner one source of frustration in managing canine urinary incontinence is the often unrealistic expectation on the part of owners that all cases can be cured and an outcome short of that – particularly after the owner invests in specialist surgery – constitutes failure. It is comforting to have an independent source, written by an expert at this level, which helps manage those expectations.

Aside from being a wonderful resource for owners who may be struggling to understand their dog's condition, this book is an excellent resource for veterinarians, nurses and veterinary students. It provides an accessible, thorough review of the topic and can be read from cover-to-cover in a single sitting.

Anne Fawcett

Anne Fawcett is a small animal general practitioner based at Sydney Animal Hospitals Inner West. She is a lecturer at the University of Sydney and contributes to a variety of publications including The Veterinarian Magazine and The Sydney Morning Herald.