URINARY INCONTINENCE IN DOGS
Urinary incontinence is the involuntary release of urine; that is, the dog is not aware of the need to urinate or act of urinating. It is different from urinary accidents where the pet is aware of urinating (for example, squatting to urinate).
Episodes of urinary incontinence can occur in various situations. The most common incontinent patient, in our experience, is the dog that leaks urine while it is asleep. We also see dogs with incontinence that dribble when they try to perform a particular activity, such as running or jumping on a lap or furniture.
The amount of urine that leaks in each episode is also variable. It is often a medium-sized to large puddle, but less commonly we have had patients that leaked just a few drops each time. The owners of these latter dogs do not typically find any leaked urine; instead, they notice their pet regularly licking its vulva or penis.
There are many possible causes of urinary incontinence, including bladder infections, bladder stones, abnormally increased water consumption, and spinal diseases. The most common cause, by far, is urethral sphincter weakness; in these cases, the muscle sphincter that normally keeps the bladder tightly closed and relaxes only to allow urination loses some its strength, and it can no longer effectively hold the bladder closed all of the time.
Some dogs have multiple causes for their incontinence occuring simultaneously.
Incontinence due to urethral sphincter weakness occurs more often in:
- spayed female dogs
- middle aged and older dogs
- overweight dogs
- dogs with large body stature
- dogs that have had their tails docked
We can usually make a tentative but strong diagnosis of urinary incontinence due to sphincter weakness based on the pets history and physical exam. Some dogs with this type of incontinence have secondary urinary tract infections, so we will often recommend diagnostic testing in addition to the exam. A urine test is often all that is needed, but occasionally xrays, ultrasound exam, and blood profile are very helpful.
Diagnosing urinary incontinence that is due to a problem other than sphincter weakness is more challenging, almost always requires requires the tests mentioned above, and sometimes requires even more specialized testing, such as cystoscopy (exam of the urethra and bladder with an endoscope).
Urinary incontinence due to sphincter weakness cannot be cured. Fortunately, this type of incontinence can almost always be easily controlled with medication. We currently have a few different medications to choose from; each of them is very effective and very safe. When the problem cannot be controlled with medication there are other treatment options, including injections into the urethra to "bulk it up" and surgery to elevate the urethra (in 30 years of practice we have not encountered a patient that required one of these procedures).
Treatment for urinary incontinence due to problems other than sphincter weakness is determined by the specific cause of the problem. For example, incontinence due to bladder stones might be treated by surgical removal of the stones; incontinence due to urinary tract infection might be treated with antibiotics.
Yarmouth Veterinary Center