Effectiveness of manual bladder expression in paraplegic dogs

Abstract

General rightsThis document is made available in accordance with publisher policies. Please cite only the published version using the reference above. Full terms of use are available: http://www.bristol.ac.uk/pure/about/ebr-terms Conclusions and Clinical RelevanceManual bladder expression is ineffective at completely emptying the bladder of urine but the effectiveness of the procedure is not affected by body weight. It is still likely to be a useful procedure to prevent a build-up in pressure within the bladder. On average ultrasonographic estimation of bladder volume can be a useful predictor of actual bladder volume but is susceptible to wide variations for individual cases and so should be interpreted with a degree of caution.

Pathophysiology, Clinical Importance, and Management of Neurogenic Lower Urinary Tract Dysfunction Caused by Suprasacral Spinal Cord Injury

“…Bladder compliance is a measure of the bladder wall response to stretching during filling and it is defined as the amount of change in intravesical pressure associated with a specific change in intravesical volume or Δ V /Δ P ves . Although 12.5–30 mL/cmH 2 O has been used as the lower end of normal in humans, bladder compliance can vary greatly among both spinal‐intact and spinal‐injured individuals, rendering its interpretation problematic …”

“…Although 12.5-30 mL/ cmH 2 O has been used as the lower end of normal in humans, bladder compliance can vary greatly among both spinal-intact and spinal-injured individuals, rendering its interpretation problematic. 39,[63][64][65][66] Bladder capacity can be measured by comparing the total volume infused with the maximum physiologic storage capacity. Although the generally accepted safe, intravesical pressure threshold is in the vicinity of 40-50 cmH 2 O for humans, [63][64][65][66][67] the physiologic bladder capacity is yet to be determined, although 300-600 mL per patient has been used in most human studies.…”

“…39,[63][64][65][66] Bladder capacity can be measured by comparing the total volume infused with the maximum physiologic storage capacity. Although the generally accepted safe, intravesical pressure threshold is in the vicinity of 40-50 cmH 2 O for humans, [63][64][65][66][67] the physiologic bladder capacity is yet to be determined, although 300-600 mL per patient has been used in most human studies. [63][64][65][66][67] In our cystometry studies, we have used a value of 20 mL/kg for estimating normal bladder capacity in spinal-injured pet dogs derived from a reported value of 18 mL/kg in dogs.…”

“…Although the generally accepted safe, intravesical pressure threshold is in the vicinity of 40-50 cmH 2 O for humans, [63][64][65][66][67] the physiologic bladder capacity is yet to be determined, although 300-600 mL per patient has been used in most human studies. [63][64][65][66][67] In our cystometry studies, we have used a value of 20 mL/kg for estimating normal bladder capacity in spinal-injured pet dogs derived from a reported value of 18 mL/kg in dogs. 13 A rectal transducer placed before infusion will simultaneously measure the abdominal pressure P abd , which can be subtracted from the intravesical pressure P ves to obtain the net detrusor pressure P det , or P ves = P det + P abd .…”

“…Current long‐term urological management of suprasacral spinal‐injured animals is limited to treating urinary tract infections and assisting voiding, mainly by manual bladder expression. However, in paraplegic dogs, manual bladder expression is inefficient because only ~50% of the bladder volume can be emptied, resulting in substantially higher residue volumes of 0.50–33.02 mL/kg in paraplegic dogs compared to the values of 0.2–0.4 mL/kg in normal dogs . Thus, a consensus addressing various aspects of neurogenic lower urinary tract dysfunction, from initial diagnosis to long‐term management, should standardize and improve our current practices.…”