Predictors of urinary or fecal incontinence in dogs with thoracolumbar acute non-compressive nucleus pulposus extrusion.J Vet Intern Med. 2019 Nov; 33(6):2693-2700.JV
Urinary (UI) and fecal (FI) incontinence occur in up to 7.5% and 32% of dogs, respectively, after thoracolumbar acute noncompressive nucleus pulposus extrusion (ANNPE).
To investigate clinical, diagnostic, and therapeutic predictors of UI and FI in dogs with ANNPE affecting the T3-L3 spinal cord segments.
Hundred and eighty-seven dogs with T3-L3 ANNPE diagnosed based on clinical and MRI findings.
Multicenter retrospective study. Data were obtained from medical records and telephone questionnaires and analyzed by logistic regression.
UI and FI were reported in 17 (9.1%) and 44 (23.5%) dogs, respectively. Paraplegic dogs were 3 times (95% CI = 1.25, 10.87) more likely to develop UI (P = .018) and 4 times (95% CI = 1.94, 12.56) more likely to develop FI (P = .001) compared to nonparaplegic dogs. Dogs with an intramedullary hyperintensity greater than 40% of the cross-sectional area of the spinal cord at the same level on transverse T2-weighted MRI images were 4 times more likely to develop UI (95% CI = 1.04, 21.72; P = .045) and FI (95% CI = 1.56, 10.39; P = .004) compared to dogs with smaller lesions. FI was 3 times (95% CI = 1.41, 7.93) more likely in dogs that were not treated with nonsteroidal anti-inflammatory drugs (NSAIDs) after diagnosis compared to dogs administered NSAIDs (P = .006) and 2 times (95% CI = 1.12, 5.98) more likely in dogs presented with clinical signs compatible with spinal shock compared to dogs without (P = .026).
CONCLUSION AND CLINICAL IMPORTANCE
The identification of clinical, diagnostic, and therapeutic predictors of UI and FI in dogs with T3-L3 ANNPE can help to approach these autonomic dysfunctions occurring after spinal cord injury.