Urinary incontinence is a common presenting complaint primarily affecting dogs and occasionally cats. The most common cause of urinary incontinence is urethral sphincter mechanism incompetence (USMI), which typically affects spayed female dogs and occasionally male dogs. Other causes include disorders such as urine retention and bladder outflow obstruction, which are more common in male dogs.
Therapeutic objectives include treating signs of incontinence-related disorders such as storage disorders (eg, USMI, ectopic ureter, overactive bladder) and emptying disorders (eg, detrusor-urethral dyssynergia, functional obstruction, urethrospasm, detrusor atony, neurogenic upper motor neuron bladder). Goals for treating storage disorders include increasing urethral sphincter smooth and striated muscle tone, increasing bladder compliance, and decreasing intravesicular pressures during filling and storage. Goals for treating emptying disorders include decreasing urethral sphincter smooth and striated muscle tone, increasing detrusor contraction, and reducing postvoid residual volume.
Following are therapeutic targets for the various causes of incontinence.