By Diana Bocco
Incontinence in dogs can be a symptom of many different conditions, so getting to the cause is essential, says Dr. Jeffrey Levy, doctor of veterinary medicine and a certified veterinary acupuncturist. To understand the underlying cause, your vet will ask you a lot of questions and perform a complete physical exam. In addition, the vet might order a fecal examination and tests on your pet’s urine to check for signs of urinary tract infection and other abnormalities, as well as blood work to rule out conditions like diabetes, kidney failure, and Cushing’s disease, Levy says. Imaging such as X-rays or an ultrasound may also be needed.
Senior Dogs and Incontinence
Incontinence in dogs often starts as the animal enters middle age and beyond—and this is somewhat dependent on the size and breed of the dog, according to Dr. Michael D. Lucroy, an Indianapolis-based veterinary medical oncologist and director of the Clinical Studies Center at MedVet Medical & Cancer Centers for Pets. “For example, a 5-year-old Great Dane is middle aged, whereas a similar aged small terrier would still be considered a young dog,” Lucroy says.
While urinary incontinence can affect any breed, there are some breeds that are more likely to develop this condition, including Dobermans, Old English Sheepdogs, and Cocker Spaniels, according to Lucroy. “We really don’t understand why certain breeds are at higher risk,” Lucroy says. In addition, females, particularly spayed females, are more likely to develop urinary incontinence. “In spayed females, the urinary incontinence is often the result of the lack of estrogen,” Lucroy explains.
On the other hand, larger breed dogs such as Labrador Retrievers and Golden Retrievers are more likely to develop fecal incontinence due to an increased prevalence of musculoskeletal and neurologic disease, according to Dr. Joseph Linwood Jernigan, president and chief medical officer at the Animal Hospital in Summerfield, North Carolina.
Underlying Causes of Incontinence in Dogs
Because there can be so many different underlying causes for incontinence, Levy says it's important that pet owners tell their vets about any symptoms they notice. Signs associated with urinary incontinence may include drinking excessively, free flowing or halting urine, blood in the urine, pain, dribbling while moving around, leakage when settled in bed, and urinating in large amounts. “Each of these could signal a different cause and require a different treatment,” Levy says. “For example, arthritis may prevent a dog from crouching sufficiently to empty the bladder fully, and injuries or degeneration of the spinal column can cause nerves to be compressed, resulting in incontinence.”
Any medication that increases urine production can also potentially cause urinary incontinence, according to Lucroy. “Commonly used medications in dogs that increase urine output include prednisone, triamcinolone, dexamethasone, furosemide, spironolactone, and phenobarbital,” he says.
The most common cause of fecal incontinence is lower vertebral disease (conditions affecting the lower back), according to Jernigan. “These are all aging-related diseases and may be overly represented in obese patients,” Jernigan says. “NSAID therapy and weight reduction would be a first line of treatment and if not responsive, consider further diagnostics such as MRI to rule out upper motor neuron disease.”
Treatment and Correction of Incontinence in Dogs
The two most commonly used drugs to manage urinary incontinence in dogs are phenylpropanolamine (a drug that helps strengthen the contraction of the urinary sphincter) and diethylstilbestrol (DES), which is a hormone replacement therapy, Lucroy explains. “Generally, these drugs do not cure the incontinence and are used long-term to manage the problem,” he says.
Urinary incontinence may also be treated with surgery. “Surgery may benefit dogs that have developed urinary incontinence secondary to a spinal cord injury due to a ruptured intervertebral disc,” Lucroy says. “If urinary incontinence is due to the presence of stones in the bladder, then surgery is also appropriate.”
Management for Dogs with Incontinence
First the good news: about 90 percent of dogs with urinary incontinence will respond to medical management, according to Lucroy. If treatment is not successful, Lucroy says there are a few things that pet parents can do to make the problem manageable at home.
“These include more frequent walks (especially first thing when their dog awakens in the morning and last thing before bedtime), using ample washable bedding (with waterproof pads below to protect flooring or furniture), and using doggy diapers,” says Lucroy. “It is also important to pay close attention to the skin around the vulva, on the abdomen, and legs that might get wet from urine, as chronic moisture and contact with urine can be very irritating to the skin and may predispose to skin infections.”
It is also important to discuss changing medications that cause incontinence or water restriction with your veterinarian before making any adjustments at home. “If the medication is prescribed for a short time, then using a diaper and more frequent walks may be sufficient to manage the incontinence,” Lucroy explains. “If this is a chronic medication (such as furosemide for congestive heart failure), then discussing alternative drugs or dosing schedules with your veterinarian may be appropriate if the incontinence is challenging to manage.”
Jernigan also recommends that pet parents can use plastic sheets or sheets of absorbable material underneath their dog to capture fecal or urinary accidents. “Always consider your pet’s physical and emotional needs when dealing with incontinence,” Levy adds. “Housetrained dogs often feel embarrassed when they are ‘bad,’ so take your pet out often, and consider doing some pee-pad training.” If that isn't enough, Levy recommends trying dog diapers.