Most dog owners who have acquired a new puppy have been through the “accident” phase. Many of those dog parents ask themselves, “Will he ever stop peeing in the house?” (Learn about house training your puppy.) The good news is that once a healthy puppy is house trained they don’t often revert. Unexpected and inappropriate changes in the toilet habits of a dog should not be considered a slip but rather a tip that something is occurring and making it difficult to control urine flow. Occasionally, a puppy may be born with a congenital defect such as ectopic ureter, which makes them unable to control their urination without medical intervention. These puppies will seem to fail to learn housebreaking skills. Make sure that you discuss any and all abnormalities, concerns, and changes in your pet with your vet.
Talking about incontinence in your dog with your veterinarian
Don’t be shy. Though it can sometimes be a bit awkward, be sure that your pet’s toilet habits are discussed with your veterinarian. The most important step is to discuss the problem of urinary accidents and treat it appropriately.
One of the first things you as a pet parent can do is to carefully observe the problem. If your dog is having "accidents," it would be helpful to tell your veterinarian if the dog is consciously urinating or is “leaking” urine as is seen with urinary incontinence. Some details to share can be obvious:
- What is the timing of the urination?
- Is it happening frequently or only occasionally?
- Is there effort involved?
- Does your pet squat and strain, or do you find puddles of urine where your dog has been sleeping?
- Does the urine have an unusual color or unpleasant odor?
Common causes of urinary incontinence
But what could be causing the incontinence? There are several possible causes, including:
- Urinary tract or bladder infections will often result in frequent and urgent urination. A burning sensation in the bladder and resultant spasms that occur express small amounts of urine frequently. Bladder infections are common in dogs and must be ruled out before any treatment is considered. In these cases, urination is often conscious (not true incontinence), but is difficult to control due to the sense of urgency.
- Ectopic ureters are an uncommon congenital defect in which the urine flows freely from the kidneys without being collected in the bladder. This defect is not common, and is usually identified during puppyhood. Surgery to insert the ureter into the bladder is often curative.
- A neurologic or spinal problem can occasionally result in an inability to empty the bladder or control urine flow. Generally these dogs will have other signs of spinal cord disease that will lead your veterinarian to consider neurologic disease.
- Another infrequent cause of incontinence is called “paradoxical incontinence,” wherein an obstruction actually leads to overflowing small amounts of urine. Problems such as stones or tumors in the urethra can cause partial obstructions that will often result in incontinence.
- Dementia and senile changes causing dogs to forget or be unaware of their urination are possible. There are products available that may increase mental awareness in old dogs. (Learn about cognitive dysfunction syndrome in dogs.)
- Estrogen responsive incontinence is by far the most common cause of urinary incontinence in otherwise healthy dogs. Because it occurs most commonly in older, spayed female dogs it was believed to be an estrogen deficiency. In reality, there is a loss of tone in the detrusor muscle that acts as a valve controlling the emptying of the bladder. In fact it is now often referred to as geriatric incontinence of spayed females. Although primarily a problem in older spayed female dogs, occasionally it occurs in young spayed female dogs and even in male dogs. Affected dogs are generally able to control their urine, but when they lie down to relax to sleep they lose conscious control. In the past, estrogen therapy was the treatment of choice; however, while many dogs will respond well to the estrogen therapy, estrogen is not always safe and other drugs offer a safer way to accomplish the same effect without the side effects of estrogen. Phenylpropanolamine is effective, affordable, and safe. It is available by prescription from your veterinarian.
Don’t live with puddles. If your dog is experiencing incontinence, work with your veterinarian to do a thorough evaluation, often including a blood count and blood chemistries to rule out diabetes and kidney disease.
If you have any questions or concerns, you should always visit or call your veterinarian -- they are your best resource to ensure the health and well-being of your pets.