trelstar and Urinary-Incontinence

In 2009 Suprelorin® was released in Switzerland for the temporary suppression of fertility in male dogs. However, in practice it has also been used to treat other conditions in male dogs and in bitches. These include treatment of benign hyperplasia of the prostate, the induction or suppression of oestrus and treatment for the side effects of gonadectomy. Also in feline reproductive medicine GnRH-agonists gain increased importance. These areas of application are listed here in terms of treatment success and possible adverse effects after treatment of which owners have to be informed beforehand.

Topics: Animals; Cat Diseases; Cats; Dog Diseases; Dogs; Enzyme Inhibitors; Estrus; Female; Fertility; Male; Ovariectomy; Prostatic Hyperplasia; Triptorelin Pamoate; Urinary Incontinence

A 2-year-old female ovariectomised Norwegian Forest cat with a history of post-spaying urinary incontinence was diagnosed with acquired urinary sphincter mechanism incompetence (USMI) after complete clinical and laboratory examination. Although there is no literature regarding the treatment of post-spaying USMI in cats, deslorelin acetate is successful in the treatment of post-spaying USMI in dogs. Deslorelin acetate implants have been shown previously to be effective for contraception and oestrus suppression in queens, and suppression of reproductive function in tomcats. Therefore, deslorelin acetate implant treatment was chosen for treatment of post-spaying USMI in this queen. Follow-up examinations were performed on days 8, 15 and 30 after deslorelin implant insertion. Urinary continence was restored about 25 days after implantation and maintained for at least 15 months, without treatment-related negative effects. In the present case report, the post-spaying urinary incontinence related to the acquired USMI was successfully treated with a deslorelin acetate implant. In addition, safe implantation was easy in cats and the single injection resulted in long-lasting efficacy. Further studies are needed to confirm the usefulness of deslorelin acetate treatment for post-spaying USMI in queens and to better delineate the duration of efficacy.

Topics: Animals; Cats; Drug Implants; Enzyme Inhibitors; Female; Hysterectomy; Ovariectomy; Triptorelin Pamoate; Urinary Incontinence

After removal of the ovaries approximately 20% of dogs develop urinary incontinence. Removal of the gonads results in estrogen deficiency and chronic elevation in the production and secretion of FSH and LH. The gonadotrophins may directly or indirectly, adversely affect the sphincter function of the urethra. Estrogen replacement therapy and treatment with sympathomimetics, such as ephedrine or phenylpropanolamine (PPA), are effective only in some of the affected dogs, and many of these subsequently become nonresponsive. Since the role of the elevated gonadotrophins has not been elucidated, we used depot preparations of GnRH analogues to down-regulate gonadotrophins once or twice in 13 ovariectomized (ovx), incontinent dogs, which were either refractory to alpha-adrenergics (n=11) or in which alpha-adrenergics were contraindicated (n=2). Dogs were treated with leuprolide, deslorelin, buserelin or triptorelin. In 7 dogs treatments with GnRH analogues alone (n=11) resulted in continence for 50-738 days (mean 247). In all dogs except one, where GnRH treatments did not resolve the incontinence completely, additional treatment with phenylpropanolamine was successful. With additional treatment of phenylpropanolamine complete continence was restored for 21-367 days (mean 159). All treatments caused long-term reduction of circulating FSH and LH concentrations to very low or undetectable levels. No adverse effects of treatments were observed.

Topics: Animals; Buserelin; Dog Diseases; Dogs; Female; Follicle Stimulating Hormone; Gonadotropin-Releasing Hormone; Leuprolide; Luteinizing Hormone; Ovariectomy; Phenylpropanolamine; Sympathomimetics; Triptorelin Pamoate; Urinary Incontinence

Fourteen patients with large uterine fibroids and urinary symptoms were treated with monthly injections of [D-Trp6]-luteinizing hormone-releasing hormone microcapsules. The average uterine size before treatment was 728 ml; it dropped to 323 ml (a drop of 55%) after treatment. Urinary symptoms of diurnal frequency disappeared in 11 of 12 patients (p less than 0.005) after the reduction of uterine size. Urgency decreased in 11 of 13 (p less than 0.005) and nocturia in eight of 10 (p less than 0.02). No differences were found before and after treatment in the symptoms of urge incontinence and stress incontinence in the cystometric and urethral pressure profile measurements. Urinary symptoms of frequency, urgency, and nocturia may be caused by the direct pressure exerted on the bladder by the enlarged uterus. Symptoms of urge incontinence and stress incontinence deserve a more specific treatment as they are not related to uterine size.

Topics: Adult; Antineoplastic Agents; Female; Fibroma; Gonadotropin-Releasing Hormone; Humans; Luteolytic Agents; Middle Aged; Triptorelin Pamoate; Urinary Bladder; Urinary Incontinence; Urinary Incontinence, Stress; Urination Disorders; Uterine Neoplasms