Time requirement and effect on owners of home-based management of dogs with severe chronic spinal cord injury

Freeman, Paul; Holmes, Mark A.; Jeffery, Nick; Granger, Nicolas

doi:10.1016/j.jveb.2013.06.001

Cited by 15 publications

(26 citation statements)

References 15 publications

(17 reference statements)

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“…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 . However, the rectal transducer can produce misleading results if placed inappropriately such as contacting rectal wall or in feces . Additionally, the rectal transducer can trigger, usually transient, detrusor contraction and subsequent voiding, defecation, and excessive pelvic limb and tail movement in T3–L3 spinal‐injured pet dogs, likely because of the unsuppressed segmental afferent stimulation.…”

Section: Cystometric Evaluation Of Neurogenic Lower Urinary Tract Dysmentioning

confidence: 99%

“…However, the rectal transducer can produce misleading results if placed inappropriately such as contacting rectal wall or in feces. [67][68][69][70] Additionally, the rectal transducer can trigger, usually transient, detrusor contraction and subsequent voiding, defecation, and excessive pelvic limb and tail movement in T3-L3 spinal-injured pet dogs, likely because of the unsuppressed segmental afferent stimulation.…”

Section: Cystometric Evaluation Of Neurogenic Lower Urinary Tract Dysmentioning

confidence: 99%

“…Clients need to be informed as early as possible as to the degree of likely neurogenic lower urinary tract dysfunction and associated prognosis because home-based management can be challenging and time-consuming, requiring a median of 3 hours per week and up to 16 hours per week for a chronically paraplegic dog. 68 Immediately after severe acute spinal cord injury, animals can experience a period of spinal shock that is characterized by the transient absence or depression of spinal reflexes caudal to the lesion. 36 During this period, the urinary bladder passively distends but the detrusor cannot contract; 33 thus, assisted bladder voiding is often required to prevent bladder overdistension and urinary tract infection.…”

Section: Management Considerationsmentioning

confidence: 99%

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

Granger

Jeffery

2016

Veterinary Internal Medicne

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Management of persistent lower urinary tract dysfunction resulting from severe thoracolumbar spinal cord injury can be challenging. Severe suprasacral spinal cord injury releases the spinal cord segmental micturition reflex from supraspinal modulation and increases nerve growth factor concentration in the bladder wall, lumbosacral spinal cord, and dorsal root ganglion, which subsequently activates hypermechanosensitive C‐fiber bladder wall afferents. Hyperexcitability of bladder afferents and detrusor overactivity can cause urine leaking during the storage phase. During urine voiding, the loss of supraspinal control that normally coordinates detrusor contraction with sphincter relaxation can lead to spinal cord segmental reflex‐mediated simultaneous detrusor and sphincter contractions or detrusor‐sphincter dyssynergia, resulting in inefficient urine voiding and high residual volume. These disease‐associated changes can impact on the quality of life and life expectancy of spinal‐injured animals. Here, we discuss the pathophysiology and management considerations of lower urinary tract dysfunction as the result of severe, acute, suprasacral spinal cord injury. In addition, drawing from experimental, preclinical, and clinical medicine, we introduce some treatment options for neurogenic lower urinary tract dysfunction that are designed to: (1) prevent urine leakage arising because of detrusor overactivity during bladder filling, (2) preserve upper urinary tract integrity and function by reducing intravesical pressure and subsequent vesicoureteral reflux, and (3) prevent urinary tract and systemic complications by treating and preventing urinary tract infections.

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Section: Cystometric Evaluation Of Neurogenic Lower Urinary Tract Dysmentioning

confidence: 99%

Section: Cystometric Evaluation Of Neurogenic Lower Urinary Tract Dysmentioning

confidence: 99%

Section: Management Considerationsmentioning

confidence: 99%

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

Granger

Jeffery

2016

Veterinary Internal Medicne

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“…A prevenção das lesões secundárias é fundamental para a recuperação do paciente neurológico (Sharp & Wheeler 2005a) e embora os tutores tenham sido orientados quanto ao manejo, prevenção e tratamento das complicações, pode haver dificuldade em compreendê-las ou segui-las corretamente. O manejo do paciente com problema neurológico pode ser muito trabalhoso (Sharp & Wheeler 2005a), podendo haver muita sobrecarga física e mental sobre o cuidador (Freeman et al 2013).…”

Section: Discussionunclassified

“…Alguns estudos avaliaram a qualidade de vida dos animais com lesões medulares (Levine et al 2008) ou o tempo gasto pelos tutores para cuidar desses pacientes (Freeman et al 2013), entretanto, existem poucos trabalhos avaliando a ocorrência das complicações em cães e gatos com problemas neurológicos. O objetivo do presente estudo foi avaliar nessas espécies a frequência do aparecimento de complicações, a epidemiologia, localização da lesão e etiologia, avaliando ainda a evolução do quadro e o tempo de sobrevida.…”

Section: Introductionunclassified

Complicações observadas em cães e gatos com doenças neurológicas

Santoro

Árias

2018

Pesq. Vet. Bras.

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RESUMO.-Cães e gatos com problemas neurológicos estão sujeitos a várias sequelas e complicações, em decorrência das deficiências motoras, sensoriais e viscerais. Algumas complicações estão relacionadas a maior mortalidade, principalmente aquelas relacionadas ao trauma vertebromedular. O objetivo do presente estudo foi avaliar nessas espécies a frequência do aparecimento de complicações, a epidemiologia, localização da lesão e etiologia, avaliando ainda a evolução e o tempo de sobrevida. Foram acompanhados 100 cães e gatos com doenças neurológicas trazidos para atendimento no Serviço de Neurologia do Hospital Veterinário da Universidade Estadual de Londrina. Observou-se que 91% dos animais desenvolveram complicações, sendo que as mais frequentes foram atrofia muscular (n=32), retenção urinária (n=24), incontinência urinária (n=24), incontinência fecal (n=17) e feridas de decúbito (n=16). O principal local de lesão associado ao aparecimento das complicações foi medula espinhal (91,3%) e a principal etiologia foi o trauma vertebromedular (37,3%). O tempo mediano e médio de vida estimado foram, respectivamente, dois e sete meses sendo que as principais causas de morte ou eutanásia estavam relacionadas ao trauma vertebromedular, trauma cranioencefálico ou doença inflamatória/infecciosa. O tempo de vida estimado foi menor para animais mais velhos e mais pesados. Embora o índice de sobrevivência dos animais com complicações tenha sido alto, muitos permaneceram com sequelas, indicando que a sobrevivência não significou capacidade funcional normal. Cães e gatos com problemas neurológicos requerem alto grau de atenção do veterinário e de seus tutores, sendo ABSTRACT.-Santoro M.B. & Bahr Arias M.V. 2018. [Complications observed in dogs and cats with neurological diseases]. Complicações observadas em cães e gatos com doenças neurológicas. Pesquisa Veterinária Brasileira 38(6):1159-1171. Dogs and cats with neurological diseases can show several sequelae and complications as a result of motor, sensory and visceral deficiencies. Some complications are an important cause of mortality, mainly complications related to spinal cord injury. The aim of this study was to evaluate in 100 dogs and cats brought to the Neurology Service of Veterinary Hospital from Universidade Estadual de Londrina the frequency of complications, epidemiology, lesion localization and etiology, still assessing the evolution and survival time.It was observed that 91% of the animals developed complications. The most frequent were muscular atrophy (n=32), urinary retention (n=24), urinary incontinence (n=24), fecal incontinence (n=17) and pressure sores (n=16). The main site of injury associated with the onset of complications was spinal cord (91%) and the main cause was the spinal cord trauma (37.3%). The median survival time of animals with complications was two months and the mean was seven months. The main causes of death or euthanasia were related do spinal cord trauma, traumatic brain injury or inflammatory/infectious disease. The estimated lifetime was l...

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A review of the neural control of micturition in dogs and cats: neuroanatomy, neurophysiology and neuroplasticity

et al. 2022

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This article discusses the current knowledge on the role of the neurological structures, especially the cerebellum and the hypothalamus, and compares the information with human medicine. Micturition is a complex voluntary and involuntarily mechanism. Its physiological completion strictly depends on the hierarchical organisation of the central nervous system pathways in the peripheral nervous system. Although the role of the peripheral nervous system and subcortical areas, such as brainstem centres, are well established in veterinary medicine, the role of the cerebellum and hypothalamus have been poorly investigated and understood. Lower urinary tract dysfunction is often associated with neurological diseases that cause neurogenic bladder (NB). The neuroplasticity of the nervous system in the developmental changes of the mechanism of micturition during the prenatal and postnatal periods is also analysed.

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Time requirement and effect on owners of home-based management of dogs with severe chronic spinal cord injury

Cited by 15 publications

References 15 publications

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

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

Complicações observadas em cães e gatos com doenças neurológicas

A review of the neural control of micturition in dogs and cats: neuroanatomy, neurophysiology and neuroplasticity

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