New Treatment for Urinary Incontinence
Urinary incontinence is a troubling problem that occurs in more than 20% of spayed female dogs. When the urethral sphincter muscles don’t work properly, the result is uncontrolled urine loss and additional complications such as bladder infections and skin irritation. Standard treatment involves oral medications to help strengthen the sphincter, but not all dogs respond, some dogs have intolerable side effects, and the response can decline over time. Therefore, the search for additional and more advanced treatment options continues. Urethral injection with bulking agents or surgery to alter the shape of the urethra have been studied, but they also come with potential complications and incomplete response.
With funding from AKC Canine Health Foundation (CHF), investigators at North Carolina State University College of Veterinary Medicine explored regenerative medicine as a treatment option for urinary incontinence. Regenerative medicine stimulates the body's own repair mechanisms to heal tissues or organs. Dr. Vaden, the study’s Principal Investigator, has had success restoring urethral function in a laboratory model after injecting skeletal muscle stem cells. It is believed that injecting stem cells results in a complex process that regrows and replaces nerve and muscle cells. The goal of this clinical trial was to see if the treatment worked in dogs with naturally occurring urinary incontinence that did not respond to standard medical management. Results were recently published in the Journal of Veterinary Internal Medicine.1
Regenerative medicine is an option to treat urinary incontinence in female dogs.
Fifteen dogs of eleven different breeds and mixes completed the clinical trial. A muscle biopsy was taken from their triceps muscle and processed in the laboratory to provide a large population of muscle stem cells. A second surgical procedure was then completed to inject these stem cells into the tissue surrounding the urethral sphincter. Dogs were allowed to continue their oral incontinence medications for three months after the procedure, but then medications were stopped to see if the dogs would be continent without them. Response was based on owner questionnaires and objective measurement of urethral pressure.
According to owner questionnaires, urinary continence improved to mostly or always continent in 14 of the 15 dogs. The effect seems to be long-lasting as 11 of the dogs were still continent two years after the procedure. The stem cell treatment was not curative though, as 13 dogs still required oral medications to be continent. Urethral pressure measurements did not show a significant change, but the measurement is technically challenging and not all dogs returned for measurements at the requested times.
This study shows that regenerative medicine is an option to treat urinary incontinence in female dogs. While the procedure was labor-intensive and not curative, there were few complications in the dogs that participated in this clinical trial and most of them did improve. Urinary incontinence has a significant impact on quality of life for affected dogs and their owners. Therefore, CHF and its donors remain committed to finding new and more effective treatments. Learn more about CHF-funded research at akcchf.org/research.
CHF Grant 01844: Treatment of Urinary Incontinence with Multipotent Muscle Cells: A Regenerative Medicine Approach to a Common Canine Health Problem
1. Vaden, S. L., Mathews, K. G., Yoo, J., Williams, J. K., Harris, T., Secoura, P., Robertson, J., Gleason, K. L., Reynolds, H., & Piedrahita, J. (2022). The use of autologous skeletal muscle progenitor cells for adjunctive treatment of presumptive urethral sphincter mechanism incompetence in female dogs. Journal of Veterinary Internal Medicine. https://doi.org/10.1111/jvim.16505
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