Cool Case Marzipan

Marzipan and Dr. Erin Rockhill share a moment

Marzipan and Dr. Erin Rockhill share a moment

Poor Marzipan has always suffered from incontinence from around the age of 6 months. To her good fortune, she grew up in the home of Dr. Erin Rockhill, a veterinarian at Belle Mead Animal Hospital. Dr. Rockhill has a big heart for Marzipan, and has always done everything she could give her the best quality of life. That included using a drug named Proin designed to reduce urine leakage. “I knew the urine leaks weren’t her fault,” said, Dr. Rockhill, “so we started her on Proin. As time went on, we had to keep increasing the dose until we maxed it out. Eventually, we added a second drug, but she was still having trouble.”

It was at this time that Dr. Rockhill reached out to Dr. Kimberly Hammer, an Internal Medicine specialist at NorthStar VETS. “I remembered Dr. Hammer doing an interesting case a few years ago for a dog with a bladder issue, so I asked her what could be done for Marzipan.” recalled Dr. Rockhill. “She told me about a new procedure where they inject collagen into the sphincter muscles in the urethra to plump them up and help prevent urine from dribbling through. I trusted Dr. Hammer to do the procedure, and after researching it for myself, decided to explore this option further with her.”

“Marzipan, a 7-year-old Doberman Pinscher, is affected by one of the most common urinary tract diseases in female dogs: urinary incontinence,” explained Dr. Hammer. “Urinary incontinence is when the sphincter that connects the bladder to the urethra is weak. This results in urine leakage when she is not urinating. The amount that leaks can be variable: sometimes a few drops at night, sometimes a constant drip all over the house. It is most commonly seen in female spayed dogs and there may be some connection to the loss of hormones (mainly estrogen) when a female dog is spayed,” Dr. Hammer continued. “We have many options with respect to treating urinary incontinence including drugs to help tighten the sphincter and procedures that tighten the sphincter. In Marzipan, we performed collagen injections into the sphincter to help tighten it up.”

Dr. Rockhill had Marzipan checked out by Veterinary Cardiologist, Dr. Karen Meltzer, at NorthStar VETS. “I dropped her off for an echocardiogram,” explained Dr. Rockhill, “to make sure her heart was good and Dr. Hammer checked Marzipan to rule out any structural issues before moving forward.”

Marzipan2Dr. Hammer performed collagen injections into Marzipan’s urethra. This was done cystoscopically (a camera was passed through the vulva into the urethra with no incisions made). Collagen was injected into the tissue at the smooth muscle sphincter. “If you’ve ever seen a celebrity after getting collagen into their lips to make the lips look fuller,” said Dr. Hammer, “then you can picture what we did for Marzipan.” The procedure was a success and Marzipan when home the same day. “Everyone treated us well,” said Dr. Rockhill, “I’ve been coming to NorthStar VETS recently with my cat, Mango, so I’ve gotten to know a lot of the team there.”

Back at home, Dr. Rockhill exclaimed, “Things are going well! I know it’s not a permanent fix, but it’s really helped Marzipan a lot. Over time, the collagen will get reabsorbed into Marzipan’s body, allowing more urine to slip through the sphincter. As that happens, we’ll add Proin again to maximize our time, then consider a second collagen injection in the future. I’m hoping we get at least 18 months from this.”

“I named Marzipan after a cartoon character, not the dessert topping,” revealed Dr. Rockhill, “I just loved the name. We got her as a puppy at three months of age and she has been my dog ever since. Even with her issues, we’ve made every accommodation for her. Our furniture has cloth covering so we can clean up after her. I love her no matter what, but it’s great that we were able to improve her quality of life through this procedure!”

Learn more about the Internal Medicine service at NorthStar VETS.

Kimberly Hammer, DVM, DACVIMKimberly Hammer, DVM, DACVIM
Dr. Hammer received her veterinary degree from the University of Pennsylvania School of Veterinary Medicine in 2000. She spent a year at Mississippi State University College of Veterinary Medicine for a small animal internship and returned to the University of Pennsylvania for a two-year residency in small animal internal medicine. She earned board certification from the American College of Veterinary Internal Medicine in 2004. She has a special interest in interventional radiology/endoscopy and minimally invasive procedures. Her other interests include endocrinology, gastroenterology and hematology. She currently serves as the medical adviser for the NorthStar VETS blood bank. She joined the NorthStar VETS team in September 2007.

Outside of work she enjoys hiking, mountain biking, going to music concerts and reading.

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