Urinary Incontinence

One of the more unpleasant conditions that pets may develop is urinary incontinence. This means that involuntary passage or leakage of urine occurs. It’s a relatively common problem in dogs, but uncommon in cats.

Usually, you’ll first notice a wet spot when the animal gets up from lying down. This is because when the bladder gets full up to the level of the urethra (the tubular passage through which urine passes), the uretrha acts kind of like the overflow drain in the bathtub: when the water gets to that level, it’s automatically drained.

It’s a serious issue when a pet begins to leak urine. It’s not fun for the family to deal with, and it is physically and emotionally distressing to the pet. Pets don’t want to urinate in the house or on their bed, but they can’t control it. Cats in particular can become anxious or stressed, because they are usually quite fussy about their cleanliness. Moreover, prolonged contact with urine can also scald and burn the skin, similar to a diaper rash.

The problem gets worse for the pet with general hind end weakness, who can’t move away from the wet spot.

Urinary incontinence is a significant problem that warrants a trip to your veterinarian, who will do a full exam and take a thorough history. Be prepared to discuss the age when the problem started; whether there has been an increase in drinking and/or an increased volume of urine; what circumstances cause urine leakage (lying down, excitement, etc.); and whether there may have been trauma to the hindquarters. A urinalysis, urine culture, blood tests, and an abdominal ultrasound may be indicated.

Urethral Sphincter Mechanism Incompetence (USMI)

USMI, or “weak bladder sphincter,” is the most common cause of incontinence in 80% of female dogs, and almost 60% of all affected dogs.

A sphincter is a circular muscle that surrounds an opening. Examples include the pyloric sphincter, which regulates the movement of food from the stomach to the small intestine (poor sphincter tone there causes GERD (gastric-esophageal reflux disorder); and the anus, which controls defecation. Sphincters that are under voluntary control are normally held in a constricted, or closed position.

Emptying the bladder is a voluntary process in which the urethral (bladder) sphincter relaxes due to signals from the brain. Then urine can flow out of the bladder, down the urethra, and outside.

A weak urethral sphincter is the most common cause of incontinence. Since estrogen plays a role in sphincter muscle tone, payed females are most susceptible. However, male dogs and intact female dogs may still be affected. Most dogs who develop incontinence are more than 6 years old.

Factors that influence the development of sphincter incompetence are:

  • Age
  • Spaying
  • Obesity
  • Holding urine for long periods of time, which may damage the muscles and nerves of the bladder.

Large (>45 pounds) and giant breed dogs are more prone to developing urinary incontinence than small dogs. Certain breeds are predisposed to develop the condition: Old English Sheepdogs, Irish Setters, Rottweilers, Dobermans, Boxers, German Shepherd Dogs,  and Weimeraners.

Breeds that are prone to degenerative myelopathy, a generalized weakness of the muscles of the hind end, are also more likely to develop incontinence, including some of those same breeds (German Shepherd Dogs, Old English Sheepdogs, and Weimaraners), Corgis, and some other large breeds, such as Great Pyrenees, Labrador Retrievers, Belgian Sheepdogs, Chesapeake Bay Retrievers, and Rhodesian Ridgebacks.

Bladder-Related Causes

Infection of the urinary tract infection (UTI) can occasionally cause incontinence, especially if there are bladder stones as well. However, the animal will usually have other symptoms, such as frequent urination, urinating in unusual places, straining or pain during urination, or blood in the urine. UTIs are a common cause of incontinence in adult dogs (especially females), geriatric dogs and cats, and diabetic pets. Antibiotics and/or anti-inflammatories may be used to relieve the dog’s discomfort. Chronic inflammation can damage the bladder and impair sphincter function.

The bladder’s normal defenses against infection, such as frequent urination and adequate exercise, may be overwhelmed in certain situations. For example, forcing a dog to hold its urine all day while the guardian is away at work or school can allow bacteria to multiply.

Blockages due to inflammatory cells, mucus, and other debris; bladder stone(s); bladder tumor; enlarged prostate; or other anatomical defect may cause incontinence, especially if the animal cannot completely empty the bladder. Excessive pressure in the bladder may force urine to seep around the blockage and by-pass the sphincter. Untreated, this can lead to kidney damage.

In cats, dry food is a major contributor to bladder inflammation, crystals and stones.

Total blockage of urine flow can rapidly turn fatal. If urine production is reduced or absent, seek veterinary care immediately.

Increased Water Consumption

Increased drinking may be due to diseases such as hypothyroidism (in dogs), hyperthyroidism (in cats), diabetes, kidney disease, adrenal disease, liver disease, and many other causes. The pet may just not be able to hold it, or get to the yard or litterbox in time. Your veterinarian can best diagnose and treat the problem.

Congenital Defects in the Urinary System

Birth defects may cause urine dribbling, or an apparent inability to be house-trained. Such defects include ectopic ureter (abnormal attachment of the tubes carrying urine from the kidneys to bladder); absent or malformed ureter(s); recessed/juvenile vulva; vulvovaginal stenosis; and excessive perivulvar skin folds (this may also occur in obese adult dogs).

Nerve, Brain, or Spinal Cord Disorders

Cognitive decline (senility) is an issue for some aging pets; the animal may not be receiving the signals that the bladder is full; or may not be able to take action in time. Additionally, joint stiffness and discomfort may tempt the pet to wait until it’s too late.

Dogs with spinal cord disease, including degenerative myelopathy, may develop urinary incontinence. Chiropractic and acupuncture can be quite helpful in these cases. Homeopathy may also be useful, especially in cases of nerve damage or spinal injury.

Dogs who have had their tails docked may be at higher risk of incontinence, due to potential injury of the nerves that control the sphincter and other muscles in the hindquarters. The problem may show up when the dog is older, or when it develops a secondary problem.

Treatment of Urinary Incontinence

There are many potential treatments for urinary incontinence. Conventional pharmaceuticals are often used, and may be necessary for a short time until other therapies have time to kick in. Natural or alternative treatments may be able to resolve the problem long-term. For instance, supplements containing wild yam supply phytoestrogens that mimic the dog’s native estrogen, and may help in spayed females.

In the meantime, use waterproof coverings for bedding and furniture. You may also want to consider diapers for your pet until you find a more permanent solution..

For a list of holistic veterinarians by state, please visit the American Holistic Veterinary Medicine Association Referral List.

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