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Incontinence in dogs

Health & Wellbeing

Urinary incontinence in dogs isn’t going to put your dog’s life in danger, and many dogs with UI can live a normal and happy life. However, finding little leaks around the home can obviously be frustrating for pet parents, and put a strain on the human-hound relationship. But what is incontinence in dogs, and can it be cured or prevented?

Incontinence in dogs

What is incontinence in dogs?

Urinary incontinence in dogs, sometimes shortened to UI, is simply the involuntary leakage of urine from your dog’s bladder. These leaks usually happen when a dog is sleeping or in a state of relaxation, as more pressure is put on the bladder while they’re lying down.

The fact incontinence is involuntary means that your dog has no control over the condition, so behavioural correction will not fix it. As frustrating as it may be, you must remember that your dog can’t help it, so telling them off won’t change anything and will only distress them.

If your dog is having accidents in the house and you see them squatting and peeing, or leg-lifting and weeing, then this is a conscious act and not considered urinary incontinence. There are some behavioural issues that may cause your dog to appear incontinent. For example, some dogs will wee when they’re excited. But again, this is not considered urinary incontinence.

Urinary incontinence in dogs can be caused by a number of different things, from infections to hormonal imbalance, advancing age or even being overweight. If you find your dog is leaking a little bit of wee, you should book them in to see the vet and find out what’s causing the problem and how to fix it.

Female dogs are more likely to suffer from incontinence in their lifetime, with 3% of all bitches being affected. Meanwhile, less than 1% of male dogs will develop UI.

What causes incontinence in dogs?

There are a number of different causes for incontinence in dogs, and they can trigger slightly different types of urine leakage whether it’s caused by changes to their urge to pee, an overfilling or overflowing bladder, or a physical abnormality inside their urinary system.

Common causes of urine incontinence in dogs are:

  • UTIs or other infections in the bladder
  • Bladder stones
  • Prostate problems (these only affect intact male dogs.)
  • Increased thirst
  • Back injury or trauma
  • Neurological issues
  • Obesity
  • Low hormones
  • Physical abnormality

How do these cause incontinence?

Infections and bladder stones

Urine tract infections are one of the most common causes of irritation and inflammation in the bladder, which can cause urine to leak out.

Bladder stones could cause a blockage and as pressure increases in the bladder as it becomes more full, the pressure will force some urine out around the blockage. (Think about what happens if you put your thumb over the end of a hose!). It’s much less common, but a tumour growing inside the urethra can also cause a blockage and incontinence.

Unneutered male dogs may develop problems that cause inflammation to their prostate, which can put pressure on their urethra and colon and cause problems in their urination.

Increased thirst and weight

Your dog might be urinating more simply because they are drinking much more. With an increase in fluids, the bladder is fuller and your dog can’t always help a little leaking out. Increased thirst itself can be symptomatic of other medical conditions such as Cushing’s Disease or diabetes.

Regardless of whether you have a male or female dog, obesity can increase their risk of urinary incontinence because the extra weight on their body will put additional pressure on their organs including their bladder.

Injury or physical abnormality

An injury or trauma to your dog’s back can also trigger incontinence. This is because the spinal cord carries the nerves that communicate between the bladder, bowel and the brain, controlling their function. A back injury could disrupt these nerves and cause incontinence, but other issues like tumour growth on the spine could also impact your dog’s neurological function and cause incontinence.

Physical abnormalities can also cause UI in dogs. The most common of these abnormalities is Ectopic Ureters, which is a physical defect present from birth where a dog’s urine tubes that connect the kidneys to the bladder aren’t in the normal position and can cause incontinence.

Hormonal imbalance

Studies suggest there is a link between spaying and neutering a dog and an increased risk of developing incontinence. However, how serious this risk may be is still under much debate.

UI in spayed female dogs is much more common and it’s caused by the lack of oestrogen in their body. Their low oestrogen supply weakens the muscles of the sphincter on their urethra, meaning it cannot close as tightly as it should and allows some urine to leak out.

When the sphincter can’t close properly, it’s called Urethral Sphincter Mechanism Incompetence (USMI) and is not always caused by a lack of sex hormones. For example, a dog’s urethral sphincter will sometimes weaken as they age.

However, old dogs will naturally stop producing sex hormones too and can suffer from a similar problem. When a female dog develops UI due to a lack of oestrogen, it is known as Oestrogen-Responsive Urinary Incontinence (ORUI).

In male dogs, a lack of testosterone can have a similar effect on the tone of the sphincter and cause incontinence, but it is much rarer. Additionally, neutering means there will be no chance of prostate problems in your dog, which can sometimes cause incontinence.

Are some dogs more at risk of incontinence?

Two of the biggest risk factors for incontinence in dogs are their age and body weight.

In female dogs at least, it has been found that dogs that weigh above average for their breed are almost twice as likely to develop incontinence and therefore obesity is a significant risk factor in a dog becoming incontinent.

Overweight animals are not the only ones at risk, as large and giant breeds of dog are much more likely to develop UI compared to small breeds, even if they are within the normal weight range for their breed.

One study found that bitches weighing more than 10kg are 1.9 times more likely to develop incontinence, while bitches over 30kg are 3 times more likely to develop urinary incontinence.

Meanwhile, advancing age is another big risk factor of incontinence in dogs. Female dogs between 9 and 12 years old are 3.86 times more likely to develop incontinence. Although older dogs are more likely to become incontinent, it’s still not inevitable or normal and they will need to see the vet.

A little-known risk factor of incontinence is tail docking. Although it is illegal to dock tails in the UK, the practice is still continued on a case by case basis for individual dogs such as working dogs, or those in medical need.

Spaying seems to increase the risk of incontinence in dogs, but the evidence needs much more investigation. There is conflict in findings regarding the age of spay and the risk of incontinence, with some studies saying there’s no link between spaying and UI, others which find that bitches spayed earlier are less likely to develop UI, and other studies saying the contrary and that spaying at an early age will increase the risk of developing incontinence. It’s believed that spaying will make a female dog 2 to 3 times more likely to become incontinent, so the risk is no greater than if your dog happened to be old or large.

As well as factors like obesity, age, and spaying, certain breeds of dog are simply more likely to suffer from incontinence. Breeds such as the Boxer, Bull Mastiff, Dobermann, Weimeraner, and the Fox Terrier have been named in some studies as being predisposed to urinary incontinence.

Incontinence in dogs

High-risk breeds such as these are far more likely to suffer from UI, with up to 15% of the entire breed being affected, which is about 5 times more than the dog population on average.

Symptoms of incontinence in dogs

The most obvious symptom of incontinence in your dog is finding puddles of pee around your home. Other signs of incontinence in dogs are:

  • Puddles of urine where your dog has been sleeping.
  • Red, irritated skin around the genitals.
  • Yellow-stained fur around the genitals and down the back legs.
  • Damp or wet legs.
  • Persistent urine odour on your dog or in their bed.
  • Increased grooming and licking of the genitals and back end.
  • Dribbling urine while walking.

Peeing normally and just weeing more often or urinating during the night is not always a sign of incontinence. Instead, they can be caused by increased thirst and urination which are often symptomatic of other health conditions.

If your dog has started having accidents in the house, or is weeing normally but with changes to the places, times, and frequency of urination it could be a sign of something untoward. In these cases, it is still a good idea to take your dog to be examined by the vet to find the cause of their toileting troubles and treat it.

Diagnosing incontinence in dogs

Your vet will begin by conducting a physical examination of your dog, which will include feeling how large their bladder is and how easy it is to express. They will also study a sample of your dog’s urine to check for any signs of a UTI that could be causing their urine leakage.

Blood tests may be taken to rule out any underlying conditions such as diabetes that could be causing incontinence or increased urination in your dog.

If the cause of your dog’s incontinence is still not known, your vet might use an ultrasound to examine your dog’s bladder and check there is no trauma or tumour in the bladder wall that could be causing their urine leakage.

The vet can also perform an X-ray or an ultrasound to take a look inside your dog’s bladder and urethra and see if there is anything inside them such as bladder stones or a tumour that could be causing UI.

How to prevent incontinence in dogs

You cannot prevent incontinence in dogs, not least because there are so many different things that could cause it. However, you can lower your dog’s risks of developing incontinence by controlling several lifestyle factors.

For example, obesity will significantly increase your dog’s risk of developing UI so providing regular exercise and a healthy diet to maintain a normal body weight will help to minimise the chances of your dog developing incontinence.

Although spaying and neutering can slightly increase your dog’s chances of developing a UI, most vets do not recommend keeping your dog intact to avoid UI. This is because the vast majority of spayed and neutered dogs live normal, happy, healthy lives. Not to mention, because UI does not dramatically impact the dog’s wellbeing, the benefits of spaying usually far outweigh the risks.

And although female dogs are more affected by incontinence and spayed bitches are more likely to become incontinent, the chance of your pooch developing UI are still very small overall.

Spaying is important in preventing unwanted pregnancy as well as a number of serious health problems including life-threatening pyometra which will affect 1 in 4 intact bitches. Spaying also significantly reducing the risk of mammary cancer and in spays where the ovaries are removed, the chance of your dog developing ovarian cancer is removed too. In male dogs, neutering stops unwanted matings, and prevents prostate problems including cancer - these issues can often cause incontinence.

You can find out more about spaying or neutering your puppy in our guide.

Treating incontinence in dogs

Luckily, there are many effective treatments for incontinence in dogs and how your pup is treated will depend on what is causing their incontinence.

If your dog has developed incontinence as a consequence of a UTI, then they will be given a course of antibiotics to clear the infection. Dogs with UI due to bladder stones may be advised on dietary changes that will prevent urine crystals and stones from forming. They may also need to undergo surgery to remove any stones that have formed inside their bladder, but afterwards, their incontinence often clears.

Dogs with a physical defect that’s causing their incontinence, such as ectopic ureters, usually have to undergo surgery to treat the underlying problem. In the case of ectopic ureters, the ureters will be moved into the correct position which might be done as open surgery, or less invasively by using lasers. Most dogs respond well to treatment and become continent, however, there is no guarantee that surgery will always completely clear up UI.

Some dogs improve with surgery but still have some minor incontinence, in these cases, your vet will likely prescribe medication for your dog to manage their incontinence.

If there’s nerve damage that’s causing your dog’s bladder dysfunction, such as overfilling, then there are medications your vet might prescribe in order to regulate their neurological function, helping to relax the nerves and allow your dog to urinate normally.

Medication for incontinence in dogs

There are several different medicines your vet might prescribe to treat your dog’s incontinence. One of which is called Phenylpropanolamine which helps to combat Urethral Sphincter Mechanism Incompetence by stimulating the brain into triggering a tightening of the sphincter.

Your dog will need to take either a tablet or liquid medicine 2 or 3 times a day, but it has a very high response rate, with between 85.7% and 98.1% having satisfactory control of their urination with ongoing treatment.

Because many cases of incontinence are caused by loss of tone to the sphincter due to a lack of oestrogen or testosterone, a spayed or neutered pooch could be given tablets containing synthetic hormones to combat their incontinence.

For female dogs, they will likely be given Estriol which contains oestrogen, and most dogs respond well to this type of treatment. Your dog might become continent again, but a few dogs will still have an occasional dribble, but their level of incontinence will be greatly improved.

Generally, treatment for incontinence in dogs is quite successful and many dogs do become continent again. However, there is always variation in responses to treatment and no guarantee that your dog will be completely dry.

Some dogs might respond reasonably well and see a reduction in leakage, but not a complete fix. It is quite rare, but sometimes dogs will not respond to medication at all and your vet might have to try another.

However as you can see, there are various different treatments available for incontinence in dogs, and the likelihood is that there will be something to help your pooch.

Solutions for incontinence in dogs

As well as medication and surgery to treat the cause of incontinence, there are methods of managing your dog’s little leaks to make you and your pooch more comfortable.

You can purchase diapers meant for dogs that will catch any drips and dribbles and stop any leaks around your home. Just like nappies on a baby, you will need to change your dog’s diaper regularly to keep your pup clean and dry and to prevent urine from sitting against their skin and causing irritation or scalds.

Obviously, you must keep in mind that this method can be quite expensive and create a lot of waste. There are also reusable sanitary pants you can buy for your pup, but you will still need to change these regularly and wash them after each use.

You can purchase waterproof mats or puppy pads to put on their bed and prevent urine leakage from ruining their bed. You could also purchase a waterproof cover or waterproof, machine-washable bed. These won’t stop your dog’s incontinence, but they will make your life as an owner much simpler because you can clean up accidents much more easily. Having puppy pads around can also help if your dog needs to go but can’t make it outside in time.

In terms of improving your dog’s wellbeing and cleanliness, make sure you trim any long fur around their genitals or ask your groomer to give them a sanitary trim. This will help to keep your dog clean and comfortable, as long hair in this area will catch and soak up any leaking urine, which will stain their fur, cause a smell, and could lead to scalding on your dog’s skin.

Washing your dog regularly and keeping them clean will help to prevent any persistent urine odour, even if you just spot-clean their genital area with a damp cloth every day. This will also help to prevent any irritation to their skin caused by increased contact with urine.

Sources
  1. Phenylpropanolamine for Urinary Incontinence Todays Veterinary Practice
  2. The association between acquired urinary sphincter mechanism incompetence in bitches and early spaying: A case-control study Veterinary Journal, 187, (1), Jan 2011, 42-47, doi.org/10.1016/j.tvjl.2009.11.004
  3. Tail docking in dogs British Veterinary Association
  4. Incontinence in bitches: huge breed predispositions shown in VetCompass study Royal Veterinary College, 2017
  5. Neutering bitches trebles the risk of urinary incontinence Royal Veterinary College, 2019
  6. The effect of neutering on the risk of urinary incontinence in bitches – a systematic review Journal of Small Animal Practice, 53, (4), Feb 2012, 198-204, doi.org/10.1111/j.1748-5827.2011.01176.x