Neurogenic urinary retention in cats following severe cluster seizures

Abstract

Case series summary Four cats that presented with severe cluster seizures developed neurogenic urinary retention in the postictal phase. None of the cats had previous seizures. Micturition was reported as normal in all cats for 3 or more years before seizure onset. All cats required a continuous rate infusion of propofol to control the seizure activity. In all cats manual bladder expression was performed every 8 h until recovery of normal micturition. One cat was started on phenoxybenzamine to reduce internal urethral sphincter tone. All cats recovered normal micturition within 4 weeks of the last cluster of seizures. Relevance and novel information Transient neurogenic urinary retention has not previously been reported in cats or dogs following severe cluster seizures. Urinary retention should be considered a potential postictal deficit, requiring prompt recognition and treatment to avoid urinary tract infection and detrusor muscle atony.

Case Report: Ventriculoperitoneal Shunting and Radiation Therapy Treatment in a Cat With a Suspected Choroid Plexus Tumor and Hypertensive Hydrocephalus

“…In people, urinary tract retention has been described secondary to structural disorders in the frontal lobe, posterior fossa, hypothalamus, basal nuclei, paraventricular white matter, internal capsule, cerebellum, brainstem and thalamus ( 16 – 19 ). In cats, severe cluster seizures have also been associated with neurogenic urinary retention ( 20 ). In our case, the urinary signs resolved when the raised ICP was treated.…”

Neurogenic Bladder in Dogs, Cats and Humans: A Comparative Review of Neurological Diseases

“…Since these areas are considered suprapontine centres of micturition, it is believed that the incontinence associated with seizures in these patients is due to the involvement of these same centres. During the perictal and postictal periods, as a consequence of seizure activity, transient urinary retention (up to 48 h) has already been described in humans [ 63 , 64 ] and cats [ 65 ] in case-series studies. The post ictal state (PS) is considered an abnormal condition occurring between the end of an epileptic seizure and the return to baseline condition in a variable time, sometimes a few hours and up to days [ 66 ].…”

“…The difference in the recovery of normal micturition in humans and cats is probably due manual bladder expression in affected cats. It was supposed that manual bladder expression may delay the recovery of normal micturition, wrongly overestimating the duration of urinary retention [ 65 ].…”