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Urinary Incontinence and Urine Retention

The clinical signs of urinary bladder denervation are variable and depend on the lesion location. Lesions of the sacral segments of the spinal cord produce a flaccid bladder, which distends with a large residual volume.

Spontaneous urine leakage occurs continuously through the paralyzed atonic urethral sphincter. Additional urine flow occurs when the abdominal pressure is increased. Lesions of the brainstem or spinal cord anterior to S1 produce reflex dyssynergia, a disturbance in coordina­tion of micturition, wherein the facilitatory influence of the bladder stretch receptor (afferents) maintains tonic activity on the efferents of the urethral sphincter. The lack of inhibi­tion of these reflexes from the upper motor neuron pathways produces hypertonicity of the urethral sphincters and results in an impediment to urine flow. There is a high intravesicular pressure and a large postvoiding urine volume. The urine escapes paroxysmally only when the intravesicular pressure exceeds the sphincter pressure. After approximately 1 month of denervation, local spinal reflexes between the sacral afferent and efferent neurons develop in the S1 to S5 segments, and incomplete voiding occurs. In these cases the residual volume remains large, and the normal urination posture is not attained.

■ TABLE 8.12

Diseases of the Spinal Cord, Peripheral Nerve, and Motor End Plate of Large Animals border=0> Disease Signs Species Affected Occipitoatlantoaxial malformation Ataxia, spasticity, hyperreflexia, crepitation or pain with neck flexion, head tilt, torticollis, ataxia, visible swelling or asymmetry All species Fractures and dislocations Tetraparesis, tetraplegia, paraparesis, paraplegia, hyperreflexia, stiff neck, recumbency, ataxia, acute death, crepitation, pain, swelling All species Cervical spinal abscesses Tetraparesis, tetraplegia, paraparesis, paraplegia, recumbency, stiff neck, ataxia, sudden death, crepitation, pain, swelling All species Cervical vertebral stenotic myelopathy Tetraparesis, tetraplegia, paraparesis, paraplegia, recumbency, stiff neck, ataxia, strip sweating Horse Spinal tumor (lymphosarcoma, neurofibroma) Tetraparesis, tetraplegia, paraparesis, paraplegia, recumbency, ataxia All species Equine herpesvirus myeloencephalopathy Tetraparesis, tetraplegia, paraparesis, paraplegia, recumbency, ataxia, flaccid anus, flaccid tail, dysuria, distended bladder, impacted rectum, urine scalding Horse Copper deficiency Tetraparesis, tetraplegia, paraparesis, paraplegia, recumbency, ataxia Sheep, goat Cauda equina neuritis Pruritus in perineum, hair loss in perineum, analgesia in perineum, flaccid tail, flaccid anus, paraphimosis, dysuria, facial palsy, head tilt, leaning, nystagmus Horse Ischemic myelopathy (fibrocartilaginous embolism) Paraplegia, tetraplegia, flaccid tail, flaccid anus, areflexia at site of lesion, hyperreflexia distal to site of lesion, ataxia Horse, sheep Postanesthetic myelopathy Paraparesis to paraplegia, ataxia, hypalgesia, scoliosis Horse, cattle Caprine arthritis-encephalitis virus Tetraparesis, tetraplegia, paraparesis, paraplegia, recumbency, ataxia Goat Segmental myelitis Tetraparesis, tetraplegia, paraparesis, paraplegia, recumbency, stiff neck, ataxia, strip sweating, hyporeflexia, areflexia, lower motor neuron deficit, facial nerve paralysis, jaw drop Horse Developmental defects (spina bifida, Arnold-Chiari syndrome, syringomyelia, hemivertebrae, spinal cysts) Paraplegia, paraparesis, tetraplegia, tetraparesis, hypotonia, atonia, neurogenic atrophy, torticollis, scoliosis, kyphoscoliosis, misshapen tail, absence of skin over dorsal midline All species Verminous encephalitis Tetraparesis, tetraplegia, paraparesis, paraplegia, recumbency, ataxia, head tilt, hyporeflexia, areflexia, hyperreflexia, hypertonia, hypotonia All species Tetanus Stiffness, normal reflexes, flashing third eyelid, trismus, bloat, convulsions, coma, raised tailhead All species Botulism Flaccidity, ataxia, dysphagia, hyporeflexia, pupillary dilation, facial hypotonia, flaccid tail, flaccid anus All species Progressive ataxia Ataxia, recumbency Charolais cattle Locoism Ataxia, recumbency, bizarre behavior All species Dying back axonopathies Hypermetria, hyperreflexia, ataxia, flaccid tail, flaccid anus, fecal and urine retention, urine scalding, recumbency All species Elso heel (spastic paresis) Affected pelvic limb is hyperextended and swings in pendulum fashion; tailhead is elevated Cattle Bovine spastic syndrome Episodic hyperextension of the pelvic limb, extension of the limb behind the cattle, head and neck extension Cattle Peripheral nerve injuries Areflexia, hypotonia, hyporeflexia, atonia, anesthesia, analgesia of a specific area of limbs or trunk, inability to support weight, normal function of limbs distal to denervated site All species Ionophore toxicosis (salinomycin, lasalocid, monensin) Tetraparesis, tetraplegia, ataxia, colic, cardiac dysrhythmia, sudden death All species Periodic hyperkalemia (HYPP) Episodic tremors, weakness, spasticity during episodes, recumbency Horse Myotonia congenital Episodic weakness, spasticity during episodes All species Bromide intoxication Weakness, ataxia, stumbling, closed eyelids, drooped head and neck, paraphimosis Horse Coyotillo poisoning Progressive weakness, hypermetria, areflexia Goat Neosporosis Recumbency, ataxia, neurogenic atrophy Calf Cycad palm poisoning Posterior paresis, elevated tailhead, paraparesis, paraplegia Cattle Acquired torticollis Abnormally positioned head and neck All species Sorghum toxicosis Ataxia, paraparesis, paraplegia, rabbit-hopping gait, ataxia, recumbency, weight loss Horse, cattle Stringhalt Normal at rest, involuntary hyperflexion of the hock and stifle Horse Tick paralysis Progressive generalized paresis, ataxia, recumbency, flaccid tail, flaccid anus, weak facial muscles All species

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Source: Smith Bradford P., Van Metre David C., Pusterla Nicola (eds.). Large Animal Internal Medicine. Part 1. 6th edition. — Elsevier,2020. — 2279 p.. 2020

More on the topic Urinary Incontinence and Urine Retention:

  1. Sorghum Toxicity
  2. MANIFESTATIONS OF DISEASE
  3. Smith Bradford P., Van Metre David C., Pusterla Nicola (eds.). Large Animal Internal Medicine. Part 1. 6th edition. — Elsevier,2020. — 2279 p., 2020