Diagnosing the cause of incontinence in patients

Identifying the underlying cause of a patient's incontinence can be difficult in general practice, which is why Natalie Marks, DVM, CVJ, CCFP, Elite FFCP-V, offered some guidance in an interview with dvm360.

During the interview, Marks discussed her lecture “UrINe or UrOUT–Common Cases Involving Micturition Management,” which she presented at the Fetch dvm360 Conference in Atlantic City, New Jersey. Marks explained that when determining the cause of incontinence, starting with a thorough history and a physical exam is important. According to Marks, neurogenic incontinence is often accompanied by proprioception loss, hind limb paresis, pain, decreased reflexes, and more, which can provide insight into where to look.

Below is a partial transcript

Natalie Marks, DVM, CVJ, CCFP, Elite FFCP-V: So when we have a patient who is incontinent, in general practice, it can be challenging at times to determine the ultimate, primary cause behind that. So often, what we do is, of course, start with a history and really good physical exam, because if we have neurogenic incontinence, often we have a clue from the physical exam itself—we have conscious proprioception loss, we have paresis in the hind end, we have pain, we have decreased reflexes, we may even have paralysis—and often that gives us a clue of where to look, and in those cases…referral, advanced imaging, and follow up treatment is done more at a specialty center.