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Urinary Incontinence: Equine Urinary Disease Pt. 2 - Coggle Diagram
Urinary Incontinence: Equine Urinary Disease Pt. 2
usually reflects
primary neuro problem
UMN - proximal to sacral nerves
LMN - sacral cord affecting detrusor and urethra
ddx
neurologic
EHV-1 herpes myelitis
cauda equina neuritis
sacral trauma
neoplasia
abscess
non-neuro
calculi
ectopic ureter
neoplasia
estrogen-responsive (rare)
diagnosis
thorough history
duration
trauma
concurrent signs
neuro exam
rectal exam
bladder size
tone
ease of expression
UMN neuro damage
difficult to express
no voluntary micturtion
LMN neuro damage
easy to express
no voluntary micturtion
may dribble when walking
endoscopic exam of urethra/bladder
vaginal exam
US urinary treact
urinalysis + culture
prolonged bladdder distention leads to...
detrusor injury/dysfunction
accumulation of crystals/sludge
increased bacterial infection
treatment
UMN dysfxn
phenoxybenzamine
relaxes urethral sphincter
bethanechol
improves detrusor tone
LMN dysfxn
phenylpropanolamine
helpful in some cases
prognosis
poor for full recovery
long-term management
medication
bladder care
prognosis better if related to acute EHV-1
regain fxn in 1-2w