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24 Cards in this Set

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What 3 components of the body are needed for urinary continence?
1) Internal and external sphincters
2) Intact spinal cord L7-S3
3) Brain & cerebellum
What animals usually have a hypotonic urethra (sphincter incompetence)?
Adult female spayed dogs
*Sphincter incompetence is most common cause of incontinence in dogs
What are 2 types of drugs that increase urethra tone?
Alpha-adrenergic agonists (sympathetic causes constriction)
Reproductive hormones
What are 2 drugs that are alpha adrenergic agonists?
1) Phenylpropanolamine
2) Phenylephrine
What is the mechanism of action of phenylpropanolamine?
Direct stimulation of alpha-adrenergic receptors
Excellent results in > 85% of cases
Is phenylpropanolamine used in males or females?
Both
What is the problem with using phenylephrine to increase urethral tone?
Effect is less predictable
What are 5 adverse effects of alpha-adrenergic agonists?
1) Anorexia
2) Weight loss
3) Hyperexcitability
4) Tachycardia
5) *Hypertension
What are 2 reproductive hormones used to increase urethral tone?
1) Diethylstilbesterol
2) Testosterone
What is the mechanism of action of diethylstilbesterol? Success rate?
Sensitization and up-regulation of alpha receptors
-Success rate 60-70%
What reproductive hormone is used to increase urethral tone in females? Males?
Females -Diethylstilbesterol
Males-testosterone
What are 3 side effects of diethylstilbesterol?
1) Alopecia
2) Signs of estrus
3) Bone marrow suppression
How is testosterone administered to increase urethral tone? Is it used very often?
IM only
-Rarely used bc of side effects like increased male behavior-aggression, marking
What drug is used to treat a hypertonic urethra by decreasing smooth muscle tone?
alpha-adrenergic antagonists
-Phenoxybenazamine
What is the mechanism of action of phenoxybenzamine?
Irreversibly inactivates alpha-receptors --> decreases smooth muscle tone
Why is phenoxybenzamine less predictable in cats?
Because in cats striated muscle predominates the urethra and phenoxybenzamine decreases smooth muscle tone
What are 3 side effects of phenoxybenzamine?
1) Hypotension
2) Reflex tachycardia
3) GI upset
What drug can be used to treat a hypertonic urethra by decreasing striated muscle tone?
Diazepam
When do you give diazepam for a hypertonic urethra?
Short acting, should give it 15-30 minutes before urinating
-Short term usage
What are 4 side effects of diazepam?
1) Sedation
2) Weakness
3) Paradoxical excitement
4) Hepatotoxicity (cats)
What are 2 causes of a hypotonic bladder?
1) Neurologic diseases
2) Overdistension of the bladder
What drugs are used to treat a hypotonic bladder?
Cholinergic agent-bethanecol
-Unreliable, but only choice so worth a shot!
What should you start an animal on before putting them on a cholinergic agent for a hypotonic bladder?
Give alpha-blockers first
-Full effect in 1-2 days
What are 5 side effects of bethanecol?
1) Salivation
2) Defecation
3) Abdominal cramps
4) Vomiting
5) Diarrhea
*Too much vago activation (parasympathetic)