Exactly how people deal with urinary incontinence in their dogs never ceases to amaze me. They put up with puddles and a bed-wetting habit in the mistaken belief that it’s part of the aging process and must be tolerated.
It’s wrong on 2 counts:
- Yes, urinary incontinence is treatable.
- No, not all dogs who have urinary accidents are truly incontinent.
Covering Up the Problem
Let’s take Blackie, for example. She is a delightful older dog who once was a stray. Her family fostered this fuzzy cross-breed but fell in love with her sweet face and big brown eyes and couldn’t give her up.
Years later, Blackie started having accidents in the house. Her family preferred to cover up Blackie’s problem rather than risk being told it meant “the end.” However, things came to a head when a vacation was booked, which meant Blackie had to stay with friends.
Unwilling to put her friend through the hassle of coping with Blackie’s weak waterworks, the family eventually sought help for the problem.
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I became suspicious that all was not as it seemed. For one thing, many of Blackie’s puddles were near the door — a strong hint that she knew she needed to urinate. This is significant because a dog with true urinary incontinence “leaks” and tends to wet her bed and furniture when she is lying down and deeply relaxed.
After discussion with Blackie’s family, we decided to run blood tests. This started a detective trail that led to a diagnosis of Cushing’s disease.
We treated Blackie to control this condition, and she regained full control of her bladder. This is a long-winded way of saying that sometimes the pet has a health problem that results in a weak bladder. Treat the underlying condition and the dog returns to normal.
The most common health problems are:
- Diabetes mellitus (sugar diabetes)
- Cushing’s disease
- Kidney disease
- Liver disease
- Prostate problems
Of course, some older dogs do have true urinary incontinence. The signs include damp patches on the dog’s bed and leaving wetness where she sits. Usually the dog does not squat or strain to pass urine, and the accidents are the result of leakage.
Why It Happens
To understand why this happens, let’s look at the plumbing.
The kidneys produce urine, which is stored in the stretchy area we call the bladder. Urine is voided via a muscular tube called the urethra. In a resting state, the muscles of the urethra “squash” the tube, much like putting your foot on a hosepipe, which means urine cannot flow. These muscles are toned by estrogen, and a dog with low estrogen levels may have poor urethral tone.
This means that when pressure rises in the bladder (when it is full or the dog sits and presses on her tummy), or when deeply relaxed (the urethra relaxes even more), the dog leaks urine.
Sometimes there is also a weakness or lack of tone in the valve, or sphincter, that guards the bladder exit. Two treatment options — stilbestrol supplements and phenylpropanolamine drops — tone up the urethra and bladder sphincter, giving the dog back her bladder control.
In this video, Dr. Karen Becker discusses different types of incontinence and causes:
Diagnosis and Treatment
Although it might be tempting for the veterinarian to reach straight for medication, the wise clinician runs tests first. This is because if another problem is present, such as a urine infection, bladder stones or even kidney cancer, the presenting signs are the same as urinary incontinence but the treatment is very different.
The money spent on running urine cultures, blood tests and imaging the bladder is a good investment, because it can identify a problem (such as a bacterial infection in the urine), which is treatable and does not need long-term medication.
If you have an older dog who has urinary accidents, get her (or indeed him — male dogs can suffer problems related to their prostate) checked out by your vet.
It will help if you bring a sample of the urine and make the following observations:
- Where are the majority of the puddles found?
- Is your pet uncomfortable passing urine?
- Is your pet drinking more lately?
Remember, you don’t have to put up with this problem, which is also undignified for the dog. By not seeking help, you could be ignoring an important health problem. If all is well, she might just need a once-a-day pill to get back to dry nights.
This pet health content was written by a veterinarian, Dr. Pippa Elliott, BVMS, MRCVS. It was last reviewed Feb. 27, 2015.