Bladder and Bowel Management in Dogs With Spinal Cord Injury

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Abstract

Spinal cord injury in companion dogs can lead to urinary and fecal incontinence or retention, depending on the severity, and localization of the lesion along the canine nervous system. The bladder and gastrointestinal dysfunction caused by lesions of the autonomic system can be difficult to recognize, interpret and are easily overlooked. Nevertheless, it is crucial to maintain a high degree of awareness of the impact of micturition and defecation disturbances on the animal's condition, welfare and on the owner. The management of these disabilities is all the more challenging that the autonomic nervous system physiology is a complex topic. In this review, we propose to briefly remind the reader the physiology of micturition and defecation in dogs. We then present the bladder and gastrointestinal clinical signs associated with sacral lesions (i.e., the L7-S3 spinal cord segments and nerves) and supra-sacral lesions (i.e., cranial to the L7 spinal cord segment), largely in the context of intervertebral disc herniation. We summarize what is known about the natural recovery of urinary and fecal continence in dogs after spinal cord injury. In particular we review the incidence of urinary tract infection after injury. We finally explore the past and recent literature describing management of urinary and fecal dysfunction in the acute and chronic phase of spinal cord injury. This comprises medical therapies but importantly a number of surgical options, some known for decades such as sacral nerve stimulation, that might spark some interest in the field of spinal cord injury in companion dogs.

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The standardisation of terminology in lower urinary tract function: report from the standardisation sub-committee of the International Continence Society

Magnus Fall, Paul Abrams, Linda Cardozo … (2003)

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Targeting recovery: priorities of the spinal cord-injured population.

Kim D Anderson (2004)

In the United States alone, there are more than 200,000 individuals living with a chronic spinal cord injury (SCI). Healthcare for these individuals creates a significant economic burden for the country, not to mention the physiological, psychological, and social suffering these people endure everyday. Regaining partial function can lead to greater independence, thereby improving quality of life. To ascertain what functions are most important to the SCI population, in regard to enhancing quality of life, a novel survey was performed in which subjects were asked to rank seven functions in order of importance to their quality of life. The survey was distributed via email, postal mail, the internet, interview, and word of mouth to the SCI community at large. A total of 681 responses were completed. Regaining arm and hand function was most important to quadriplegics, while regaining sexual function was the highest priority for paraplegics. Improving bladder and bowel function was of shared importance to both injury groups. A longitudinal analysis revealed only slight differences between individuals injured 3 years. The majority of participants indicated that exercise was important to functional recovery, yet more than half either did not have access to exercise or did not have access to a trained therapist to oversee that exercise. In order to improve the relevance of research in this area, the concerns of the SCI population must be better known and taken into account. This approach is consistent with and emphasized by the new NIH roadmap to discovery.

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Dysbiosis of Gut Microbiota With Reduced Trimethylamine‐N‐Oxide Level in Patients With Large‐Artery Atherosclerotic Stroke or Transient Ischemic Attack

Jia jing Yin, Shuo‐Xi Liao, Yan-Yan He … (2015)

Background Gut microbiota has been suggested to play a role in almost all major diseases including cardio‐ and cerebrovascular diseases. A possible mechanism is the transformation of dietary choline and l‐carnitine into trimethylamine by gut bacteria. This metabolite is further oxidized into trimethylamine‐N‐oxide (TMAO) in liver and promotes atherogenesis. Nevertheless, little is known about gut microbial diversity and blood TMAO levels in stroke patients. Methods and Results We performed a case‐control study of patients with large‐artery atherosclerotic ischemic stroke and transient ischemic attack. TMAO was determined with liquid chromatography tandem mass spectrometry. Gut microbiome was profiled using Illumina sequencing of the 16S rRNA V4 tag. Within the asymptomatic control group, participants with and without carotid atherosclerotic plaques showed similar levels of TMAO without a significant difference in gut microbiota; however, the gut microbiome of stroke and transient ischemic attack patients was clearly different from that of the asymptomatic group. Stroke and transient ischemic attack patients had more opportunistic pathogens, such as Enterobacter, Megasphaera, Oscillibacter, and Desulfovibrio, and fewer commensal or beneficial genera including Bacteroides, Prevotella, and Faecalibacterium. This dysbiosis was correlated with the severity of the disease. The TMAO level in the stroke and transient ischemic attack patients was significantly lower, rather than higher, than that of the asymptomatic group. Conclusions Participants with asymptomatic atherosclerosis did not exhibit an obvious change in gut microbiota and blood TMAO levels; however, stroke and transient ischemic attack patients showed significant dysbiosis of the gut microbiota, and their blood TMAO levels were decreased.

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Contributors

Nicolas Granger: URI : http://loop.frontiersin.org/people/1030532/overview

Natasha J. Olby: URI : http://loop.frontiersin.org/people/808262/overview

Yvette S. Nout-Lomas: URI : http://loop.frontiersin.org/people/1090587/overview

Journal

Journal ID (nlm-ta): Front Vet Sci

Journal ID (iso-abbrev): Front Vet Sci

Journal ID (publisher-id): Front. Vet. Sci.

Title: Frontiers in Veterinary Science

Publisher: Frontiers Media S.A.

ISSN (Electronic): 2297-1769

Publication date (Electronic): 11 November 2020

Publication date Collection: 2020

Volume: 7

Electronic Location Identifier: 583342

Affiliations

Author Affiliations: Department of Veterinary Clinical Sciences, The Ohio State University College of Veterinary Medicine, Columbus, OH, United States; Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States; Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, United States; Department of Veterinary Clinical Sciences, Purdue University College of Veterinary Medicine, West Lafayette, IN, United States; College of veterinary Medicine, Texas A&M University, College Station, TX, United States; Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, United States; Department of Clinical Sciences, Colorado State University, Fort Collins, CO, United States; Department of Clinical Science and Services, Royal Veterinary College, Hertfordshire, United Kingdom; The Royal Veterinary College, University of London, Hertfordshire, United Kingdom; CVS Referrals, Bristol Veterinary Specialists at Highcroft, Bristol, United Kingdom; Faculty of Veterinary Medicine, Institute of Veterinary Pathology, Leipzig University, Leipzig, Germany; Division of Clinical Neurology, Department for Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland; Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany/Europe; Department of Veterinary Medicine and Surgery, MU Veterinary Health Center, University of Missouri, Columbia, MO, United States; Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany/Europe

[1] ¹The Royal Veterinary College, University of London , Hertfordshire, United Kingdom

[2] ²CVS Referrals, Bristol Veterinary Specialists at Highcroft , Bristol, United Kingdom

[3] ³Department of Clinical Sciences, North Carolina State University College of Veterinary Medicine , Raleigh, NC, United States

[4] ⁴Department of Clinical Sciences, Colorado State University , Fort Collins, CO, United States

Author notes

Edited by: Andrea Fischer, Ludwig Maximilian University of Munich, Germany

Reviewed by: Gualtiero Gandini, University of Bologna, Italy; Theresa Elizabeth Pancotto, Virginia Tech, United States

*Correspondence: Nicolas Granger nicolasgranger@ 123456rvc.ac.uk

This article was submitted to Veterinary Neurology and Neurosurgery, a section of the journal Frontiers in Veterinary Science

Article

DOI: 10.3389/fvets.2020.583342

PMC ID: 7686579

SO-VID: 01dffa2e-1c71-4bb3-8c1a-551085baa571

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This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

History

Date received : 14 July 2020

Date accepted : 22 October 2020

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Figures: 3, Tables: 3, Equations: 0, References: 109, Pages: 19, Words: 15591

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Bladder and Bowel Management in Dogs With Spinal Cord Injury

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Most cited references 109

The standardisation of terminology in lower urinary tract function: report from the standardisation sub-committee of the International Continence Society

Targeting recovery: priorities of the spinal cord-injured population.

Dysbiosis of Gut Microbiota With Reduced Trimethylamine‐N‐Oxide Level in Patients With Large‐Artery Atherosclerotic Stroke or Transient Ischemic Attack

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