Disorders of micturition in small animal patients: clinical significance, etiologies, and management strategies.

OBJECTIVES

To review the physiology of micturition, the pathophysiology of micturition disorders, and current pharmacological agents used to treat these disorders. To discuss different urinary catheterization techniques, along with the risks of catheter-associated urinary tract infections attributed with these techniques.

ETIOLOGY: Many critically ill veterinary patients are at risk of developing a number of neurological and non neurological micturition-related disorders.

DIAGNOSIS: Micturition disorders can be diagnosed based on physical examination findings, urinary voiding contrast studies, urethral pressure profiles, and diagnostic testing such as urinalysis and urine cultures.

THERAPY: Therapy can be either pharmacological, involvement of urinary catheterization, surgical, or a combination of all the above. The goal of the treatment is to correct the underlying causes resulting in the micturition-related disorder, and if possible, allow the patient to regain their normal physiological micturition behavior.

PROGNOSIS: Depending on the underlying disease process and duration of the micturition disorder, the prognosis can be variable. In many instances, near-normal or normal function can return, but in severe cases, the patient may not regain its normal, appropriate micturition response.