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. doi: 10.1111/jvim.15626. Epub 2019 Oct 31.

Abstract

Background: 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).

Hypotheses/objectives: To investigate clinical, diagnostic, and therapeutic predictors of UI and FI in dogs with ANNPE affecting the T3-L3 spinal cord segments.

Animals: Hundred and eighty-seven dogs with T3-L3 ANNPE diagnosed based on clinical and MRI findings.

Methods: Multicenter retrospective study. Data were obtained from medical records and telephone questionnaires and analyzed by logistic regression.

Results: 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.

Keywords: high-velocity intervertebral disc extrusion; neurogenic bowel dysfunction; nonsteroidal anti-inflammatory drugs; spinal cord injury; spinal shock; traumatic intervertebral disc extrusion.

MeSH terms

  • Animals
  • Biomarkers
  • Dog Diseases / etiology
  • Dog Diseases / pathology*
  • Dogs
  • Fecal Incontinence / etiology
  • Fecal Incontinence / veterinary*
  • Female
  • Intervertebral Disc Displacement / pathology
  • Intervertebral Disc Displacement / veterinary*
  • Male
  • Nucleus Pulposus / pathology*
  • Retrospective Studies
  • Spinal Cord Compression / pathology
  • Spinal Cord Compression / veterinary*
  • Urinary Incontinence / etiology
  • Urinary Incontinence / veterinary*

Substances

  • Biomarkers