common causes of urinary incontinence in dogs

common causes of urinary incontinence in dogs
Posted by Dr. Kim Smyth on Nov 05 2012

Urinary accidents can occur from time to time, even in the most well-trained dog. But if you notice that your dog’s bed is damp more than it’s dry, urinary incontinence may be to blame.

When trying to understand canine urinary incontinence, it’s important to differentiate it from a break in potty training. If your pet is posturing, or getting into the stance for urination, she is not exhibiting incontinence.

Urinary incontinence generally occurs unbeknownst to your dog, usually while she is relaxing or sleeping. It is very common in older pets, especially female dogs. For instance, your pet is curled up peacefully sleeping on your brand new couch, and when she gets up there’s a puddle of urine where she was sleeping. This is involuntary urination.

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What your vet will want to know

If your dog is experiencing incontinence, be prepared to answer the following questions during your vet appointment:

  1. When did the incontinence begin?
  2. When is the leakage typically observed – during sleep or with activity, before or after urinating outside?
  3. Is your dog drinking more water than normal? Ideally measure how much water she drinks during a 24-hour time period. Normal water intake during 24 hours should be no more than one ounce per pound of the dog’s body weight per day.
  4. Does the act of urination appear normal in terms of time spent squatting, strength of urine stream, and appearance and odor of urine?
  5. Are there any other observed symptoms such as difficulty passing a bowel movement or hind end weakness?
  6. Has there been a recent change in diet or addition of medications or supplements?
  7. Have you ever lived with an incontinent pet? What was the diagnosis and what was the outcome?

Your veterinarian will be able to use this information to help diagnose the cause of your dog’s incontinence.

Forms of urinary incontinence in dogs

The most common form of urinary incontinence is called hormone responsive incontinence. Also known as “urethral sphincter mechanism incompetence,” this type of incontinence occurs in approximately 10% to 20% of spayed female dogs and the occasional male dog, as well as cats of both sexes. Decreased urethral tone, aging and abnormal positioning of the bladder or urethra can all contribute to hormone responsive incontinence.

Adult female, spayed dogs that present for incontinence are generally presumed to have hormone responsive incontinence. But it is important to rule out illness before a definitive diagnosis is made. A complete urinalysis and urine culture should be performed to make sure a urinary tract infection is not present. Dogs that leak urine are prone to urinary tract infections. In addition, full blood work will rule out metabolic diseases that could contribute to incontinence.

Other factors that may be associated with increased risk for hormone-responsive urinary incontinence include:

Breed: Old English Sheepdogs, Doberman Pinchers, German Shepherds, Boxers, Weimaraners, Rottweilers, and Irish Setters are at increased risk because of hereditary breed health conditions.

Size: Large and giant breeds have increased risk and small breed dogs have decreased risk.

Tail docking: This surgical procedure performed on puppies of certain breeds is suspected to increase the risk of incontinence.

Treatments for incontinence in pets

Treating hormone responsive incontinence can be relatively easy.

Many cases will resolve with oral medications. Proin, an FDA-approved chewable tablet, is available by prescription for use in dogs to treat urinary incontinence

Another option for oral medication is estrogen tablets, such as INCURIN®, which is often used for female dogs with incontinence.

Both medications have potential side effects, so talk to your veterinarian about which option is best for your pet.

What else causes canine incontinence?  

Incontinence caused by increased thirst

Dogs who drink more water produce more urine. This translates into a bladder that becomes maximally distended, particularly during the night when a dog spends many hours in a state of sound sleep. This bladder distention can override the urethral sphincter, resulting in urine leakage. The key here is to hone in on the cause of the increased thirst. Correct this issue and the urine leakage typically resolves.

Ectopic ureters

If your young dog is waking up in a puddle, a condition called ectopic ureters may be to blame.

Ureters are the structures that carry urine from the kidney to the bladder, and normal ureters enter the bladder well behind the sphincters that work to hold urine in the bladder. Ectopic ureters enter the bladder in front of the sphincters so that urine cannot be held in the bladder – it constantly flows instead. This is a congenital condition that will be noticeable in puppies, and may require surgical correction which can be greatly aided by pet insurance that covers hereditary and congenital conditions.

Urinary tract infections and bladder stones

Urinary tract infections and bladder stones are often behind incontinence, so the very first thing your veterinarian will probably do is perform a urinalysis. An X-ray may be needed to rule out bladder stones. If an infection is found, antibiotics will be prescribed and once the infection is cleared, the incontinence should clear as well.

Bladder cancer

Unfortunately, bladder cancer can also be the cause of incontinence. Abnormal bladder cells may show up in the urinalysis and your veterinarian will probably want to perform an ultrasound of your pet’s bladder to assess the health.

Urethral sphincter abnormalities

Defects at the level of the urethral sphincter can interfere with its normal function. Such abnormalities can include bladder/urethral stones, prostate gland disease, tumors, and inflammation caused by infection. Resolution of the incontinence is dependent on successful treatment of the underlying disease.

Neurological disease

Normal urine retention and voiding is dependent on a complex set of neurological signals involving the brain, spinal cord, and nerves leading to the bladder and urethral sphincter. Disease within this circuitry can result in urinary incontinence, typically accompanied by other neurological symptoms such as hind leg disuse or weakness and an inability to pass bowel movements normally.

Therapy is dependent on the underlying neurological disease, and your vet will help determine the best course of treatment to address your pet’s needs.

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