Urinary incontinence is an inability to control urination. Urination is a complex process that coordinates mental awareness, voluntary and involuntary nerve input, urine storage, and muscle relaxation and contractions. Urinary incontinence occurs when some part of this process fails.
Causes include hormone deficiency (the most common and easily treated form); neurogenic (nerve-function) problems, which require special management; anatomic abnormalities; bladder storage or outflow tract problems; metabolic disorders; kidney failure; bladder stones; urinary tract infections; and prostatic disease.
Risk factors and detection
Urinary incontinence affects dogs of any age and breed, but dogs are more susceptible. Spayed or neutered dogs show greater risk for developing incontinence associated with hormone deficiency, but the benefits of spaying or neutering far outweigh this risk.
Dogs with urinary tract abnormalities may be incontinent from birth. However, incontinence also accompanies such age-related conditions as senility, kidney disease, and cancer. Obesity increases the risk of incontinence in female dogs.
Trauma, especially to the spinal column and pelvis, increases the risk for neurogenic incontinence. And dogs who are at risk for developing bladder stones also are predisposed to storage and outflow tract problems.
Signs of urinary incontinence include:
- ammonia-like odor on bedding
- dribbling urine while asleep or at rest
- urine accidents in the house
- irritated skin around the penis or vulva
- dribbling urine when barking, jumping, or coughing.
If you notice these signs in your dog, call your veterinarian. Your dog’s doctor will ask you to describe the elimination behavior, when the problem started, what medications your dog takes, and whether your dog has a history of urinary tract disorders or trauma. This helps differentiate incontinence from voluntary but inappropriate urine elimination and urine marking. He or she then will perform a complete physical examination, including urinalysis, blood tests, and possibly X-rays and an ultrasound.
Prevention and treatment
Maintaining a healthy urinary tract and avoiding obesity help prevent incontinence. Provide plenty of fresh water every day, feed your dog the right amount of high-quality food, provide adequate exercise, and keep the litterbox clean. Also monitor your dog’s elimination habits so you’ll recognize changes in her routine. Annual examinations help your veterinarian detect and treat underlying medical conditions before they progress.
If your dog develops urinary incontinence, your veterinarian will rule out or treat any underlying problems. For dogs suffering urinary incontinence associated with hormone deficiency, your doctor may prescribe hormone replacement therapy or phenylpropanolamine, a medication that increases urethral pressure and helps keep the urethral sphincter closed. Your veterinarian likely will recommend surgery to correct anatomic abnormalities, remove bladder stones, and treat some prostatic diseases.
Specific types of urinary incontinence respond to medications such as diazepam, phenoxybenzamine, or bethanacol, which will either relax or stimulate muscles to allow urination. If your dog suffers acute spinal cord injury or similar nerve damage, your veterinarian will teach you how to manually empty your dog’s bladder or insert a catheter until the bladder can contract and empty on its own.
Prognosis
Most dogs with hormone deficiencies respond favorably to medical therapy. Your veterinarian can use surgery to treat anatomical malformations, spinal cord trauma, and bladder stones, but there’s no guarantee that the dog will urinate normally again.
Because the nervous system has little capacity for regeneration, dogs with neurogenic incontinence are unlikely to regain normal function. Likewise, incontinence associated with bladder or urethral cancer indicates advanced disease. Talk with your veterinarian about your dog’s unique case.
