Incontinence in Dogs

Urinary Incontinence in Dogs: Causes, Symptoms, and Treatment

Urinary incontinence in dogs is the inability to have a continuous urinary flow. Urinary incontinence is characterized by the dog peeing uncontrollably with periodic signs of pain and discomfort. 

The causes of urinary incontinence are related to injury or disease of the urogenital system, such as urolithiasis, urethral obstruction, chronic kidney disease, pyelonephritis, prostatitis, urinary tract infection, ectopic urethras, neoplasms, and lack of urethral sphincter tone leading to senior dog incontinence

Symptoms of dog incontinence include urine dribbling, discontinuous urination, minimal urine output, whining or whimpering when peeing, peeing while sleeping or resting, and abdominal pain. 

The treatment for dog urinary incontinence varies depending on the underlying cause. Treatment options involve antibiotics, prescription diets, or surgical correction.

What is urinary incontinence in dogs?

Urinary incontinence in dogs is the inability to control urine output. A dog with urinary incontinence pees uncontrollably even while asleep or resting. The urine freely leaks or dribbles out without the dog noticing. 

Some dogs suffer abdominal pain due to urine buildup that is unevenly expressed from the bladder. Urinary incontinence is a sign of urogenital disease that affects the exit of urine from the body.

How common is urinary incontinence in dogs?

Urinary incontinence in dogs is common. The condition occurs in “over 20% of all spayed female dogs and up to 30% of large-breed dogs'' according to VCA Animal Hospitals. Medium to large breeds females that are middle-aged to senior are most commonly affected. 

Ectopic ureters, defects in the tubes that carry urine from the kidney to the bladder, are common in puppies. The condition leads to a urinary tract infection (UTI) in some dogs. UTI in dogs occurs in approximately 27% of all small breeds and is one of the most common urogenital conditions in dogs. 

What types of dogs are more likely to have urinary incontinence?

The types of dogs more likely to have urinary incontinence are listed below.

  • German Shepherds: German Shepherds are large-breed dogs that reach up to 90 pounds and are 26 inches in height. The breed is predisposed to urinary tract infections and chronic kidney disease, which cause urinary incontinence. 
  • Rottweilers: Rottweilers are massive dogs weighing 135 pounds and are 27 inches in height. The breed is included in the list of dogs with an increase in urinary incontinence, according to the North American Veterinary Community. 
  • Doberman: Dobermans are large breeds of dogs that reach 100 pounds and 28 inches in height. Over 20% of female dogs with urinary incontinence are Dobermans, based on research by the University of London's RVC database.
  • Irish Setter: Irish setters are medium-to-large breeds of dogs that weigh up to 70 pounds and have a height of 27 inches. Over 30% of female dogs with urinary incontinence are Irish Setters, according to the RVC database of the University of London.
  • Weimaraners: Weimaraners are a large breed with a weight of 90 pounds and a height of 27 inches. Weimaraners are included in the list of dogs with an increase in urinary incontinence, according to the North American Veterinary Community. 

What age do dogs usually develop urinary incontinence?

Dogs usually develop urinary incontinence between the ages of 5 and 12. Incontinence occurs at any age, but middle-aged to senior dogs are most commonly affected. Puppies are affected by ectopic ureters, which are anatomical defects in the passage of urine from the kidney to the bladder. Senior dogs experience age-related changes due to the lack of muscle tone of the urethral sphincter, which leads to urinary incontinence. 

Are certain breeds more susceptible to urinary incontinence?

Yes, certain breeds are more susceptible to urinary incontinence. A genetic component to the condition makes some breeds more likely to develop it. In the many databases taken from the United States and the United Kingdom, certain dog breeds are recorded to be most affected by the condition. Breeds such as Bearded Collie, Boxer, Collie, Dalmatian, Doberman Pinscher, English Springer Spaniel, German Shepherd Dog, Irish Setter, Old English Sheepdog, Rottweiler, and Weimaraner are among the most commonly reported dogs with urinary incontinence issues. 

What are the causes of urinary incontinence in dogs?

The causes of urinary incontinence in dogs are listed below.

  • Ectopic Ureter (EU): An ectopic ureter is a condition caused by an anatomical birth defect that affects the ureters. The ureters are the tubes that connect the kidneys to the urinary bladder. Ectopic ureters are not attached to their normal location in the bladder, causing urinary incontinence. The condition is most evident in puppies under a year old. 
  • Urinary Tract Infection (UTI): UTIs are one of the most common urological diseases in dogs. A UTI is caused by factors such as diet, breed disposition, and underlying diseases like diabetes, kidney disease, and Cushing's disease. Females get UTIs more than males due to their wider urethras, but it occurs in males. 
  • Chronic Kidney Disease (CKD): CKD is a progressive and long-term disease of the kidneys that causes inadequate filtration of waste products in the blood. The condition is linked to age-related changes, cancer, autoimmune disease, and metabolic disease. CKD affects bladder control and causes urinary incontinence.
  • Prostatitis: Prostatitis is the inflammation of the prostate, an accessory gland surrounding the penile urethra. Pet owners asking, “What causes urinary incontinence in dogs?” must know that prostatitis compresses the penile urethra, leading to urinary incontinence. The dog develops symptoms of pain upon urination and stranguria.
  • Uroliths: Stones inside the urinary bladder or urethra result in urinary incontinence by interfering with the urine pathway. Bladder stones cause cystitis and pain upon urination as the bladder contracts and comes into contact with the stone. Male dogs are susceptible to urethral obstruction secondary to urethral obstruction since the male urethra is much narrower than the female urethra.

Can urinary infections lead to incontinence?

Yes, urinary infections can lead to incontinence. An untreated UTI leads to more complications, such as kidney disease or urolithiasis, which affect urination. Dogs with UTI feel a painful or burning sensation during urination, which leads to stranguria or incontinence. Persistent UTIs are a risk factor for urolithiasis, which causes urethral obstruction and acute kidney injury. 

Are there neurological causes for urinary incontinence in dogs?

Yes, there are neurological causes for urinary incontinence in dogs. Neurogenic bladder (neurogenic bladder) is a disease in dogs that impairs the lower urinary tract due to neurological disease. The disease occurs when the nerves that carry messages back and forth between the bladder and the spinal cord have become impaired. Common causes of NB in dogs are spinal injuries and neoplasias of the nervous system. 

Can bladder stones cause urinary incontinence in dogs?

Yes, bladder stones cause urinary incontinence in dogs. Bladder stones are causes of cystitis, persistent UTI, and urethral obstruction, which are able to turn into acute kidney injury. Acute kidney injury leads to renal azotemia that becomes life-threatening if left untreated. 

Bladder stones cause urethral obstruction that interferes with urine passage. Urethral obstruction secondary to urolithiasis is more prevalent in male dogs since the male urethras are much narrower than females. Dogs with bladder stones have dribbling, intermittent, painful, and blood-tinged urination. 

What are the symptoms of urinary incontinence in dogs?

The symptoms of urinary incontinence in dogs are listed below.

  • Decreased Urine Output: Urinary incontinence affects the amount of urine expelled from the body. Owners notice a below-average volume and frequency of urination. The lack of urine output is a symptom of underlying problems.
  • Urine Leaking: Urine leaking is when urine seemingly emerges, even if the dog is unaware. The dog can’t hold in pee all of a sudden as it starts leaking out while sleeping, walking, or sitting down. A female dog leaking urine while resting is highly indicative of urinary incontinence, though it is possible in males as well. 
  • Intermittent Urine Flow: Normal urinary output in dogs is a steady and continuous stream that gets slower as the bladder empties. Dogs with urinary incontinence have a discontinuous stream of urine that stops mid-stream and continues after a few seconds, with less urine output than usual. 
  • Painful urination: Urinary incontinence due to underlying diseases such as UTI of uroliths is painful and uncomfortable to pass. Dogs start to whine or cry during urination and exert more effort in peeing. 
  • Lethargy: Dogs with urinary incontinence have associated pain and discomfort from a lack of proper bladder relief. The dog has decreased energy levels and becomes lethargic due to constant discomfort. 

How is urinary incontinence diagnosed in dogs?

Urinary incontinence in dogs is diagnosed using history and laboratory examinations. The veterinarian notes the onset, frequency, and quality of urination. 

Hematological exams such as a complete blood count and blood chemistry are performed to evaluate the presence and extent of suspected infection. Kidney function is assessed by creatinine, BUN, and SDMA values to check for signs of renal insufficiency. 

Radiology is necessary for dogs with stranguria or hematuria, along with incontinence, as these symptoms indicate urinary stones. Some stones are not visible on X-rays, so an X-ray and ultrasound are done to assess the structure of the kidneys, bladder, and urethra. 

What are the treatments for urinary incontinence in dogs?

The treatments for urinary incontinence in dogs are listed below.

  • Cystotomy: Cystotomy is the best treatment option for dogs with bladder or urethral stones. The procedure involves surgically creating an incision on the bladder to retrieve the stone/stones. Incontinence resolves once all stones are removed and the bladder heals. 
  • Urethrostomy: A urethrostomy is the best treatment for dogs with persistent and numerous uroliths inside the urinary tract. The procedure involves surgically creating a patent opening at the penile urethra, a wider opening for stones to pass naturally. 
  • Antibiotics: Prescription antibiotics are highly effective against urinary tract infections (UTIs). Dog incontinence medication for UTIs includes Amoxicillin Clavulanate, trimethoprim Sulfa, and Enrofloxacin. The incontinence resolves once the pathogenic bacteria are eliminated. 
  • Castration: Castration is the best treatment for prostatitis in male dogs. Castration eliminates the production of testosterone, which exacerbates prostatic inflammation. The prostate returns to its normal size within one month after surgery.
  • Supportive Therapy: Dogs with chronic and progressive urogenital diseases are treated symptomatically. Prescription diets help reduce the occurrence of UTIs and uroliths. The veterinarian advises supplements and home remedies for dog incontinence to support urogenital health. 

Are there any surgical options for Urinary Incontinence in Dogs?

Yes, there are surgical options for urinary incontinence in dogs. Dogs with incontinence due to ectopic ureters, uroliths, and prostatitis are able to be corrected with surgical procedures. Ectopic ureters are treated with intra-abdominal surgery, which involves relocation of the misplaced ureters. Uroliths are treated with cystotomy or urethrostomy procedures. Prostatitis is addressed by castration. 

Are there supplements that can help with urinary incontinence?

Yes, there are supplements that can help with urinary incontinence. Probiotics and antioxidants help restore urogenital flora and reduce the occurrence of UTIs in dogs. Vitamins E and C have antioxidant and urinary acidifying properties that help hasten healing from UTIs. Other causes of urinary incontinence require surgical intervention for effective resolution. Supplements help with pain and hasten healing. 

What are the benefits of probiotics for dogs in managing urinary incontinence?

The benefits of probiotics for dogs in managing urinary incontinence is to hasten healing. Urinary incontinence due to UTIs occurs when pathogenic bacteria colonize and cause inflammation in the urogenital system. 

The benefits of probiotics in dogs is the return of beneficial urogenital bacteria to reduce inflammation. A human study evaluating probiotics on female urogenital health showed that “Probiotics do not cause antibiotic resistance and may offer other health benefits due to vaginal re-colonization with Lactobacilli,” according to Gupta et al., in the research entitled “Recurrent Urinary Tract Infections in Women: How Promising is the Use of Probiotics?”, 2007. Other causes of urinary incontinence require surgical intervention for effective resolution.

What is the prognosis for dogs with urinary incontinence?

The prognosis for dogs with urinary incontinence is good to fair with proper management. Early detection is key to managing urinary incontinence in dogs. Many causes of incontinence present similar clinical signs, making prompt treatment essential. Visit a veterinarian when noticing urinary health issues in the dog to get a full assessment. Regular compliance with medication, diet, lifestyle, and regular follow-ups are necessary to prevent bladder problems. 

Can urinary incontinence lead to other health complications in dogs?

Yes, urinary incontinence leads to other health complications in dogs. The inability to properly void the bladder of urine leads to azotemia, or the buildup of metabolic by-products in the body. Prolonged azotemia results in acute kidney injury that affects the renal tissue. The tissue damage leads to a poorer prognosis. Urinary incontinence predisposes the dog to develop recurrent UTIs and urinary stones.

How can urinary incontinence in dogs be managed effectively?

Urinary incontinence in dogs can be managed effectively using the following steps.

  1. Comply with prescriptions. Dogs with urinary incontinence require assessment from a veterinarian. The vet prescribes medication that targets the cause of incontinence. Comply with the frequency and administration of medicines and return for follow-ups when indicated. 
  2. Prepare pee pads. Provide pee pads underneath the dog when resting or sleeping to prevent soiled fur and skin. Be extra patient with dogs that leak urine, and be prepared to clean up after them when they are out. 
  3. Control the dog’s diet. Prescription diets are available for urinary health. Consult a veterinarian about which diet is suitable for the dog’s needs. Avoid giving other food items when the dietary restriction calls for exclusive feeding. 
  4. Provide renal supplements. Urinary care supplements help reduce the likelihood of renal impairment. Supplements with omega fatty acids, vitamins E and C, cranberries, and probiotics restore healthy urogenital flora. 
  5. Avoid prolonged diaper use. Owners put dogs with urinary incontinence in diapers to avoid soiling in some cases. Ensure the diaper is regularly changed and the skin is washed to prevent urine scalding and secondary pyoderma infections. 

Can homemade probiotics help manage urinary incontinence in dogs?

Yes, homemade probiotics can help manage urinary incontinence. Probiotics restore healthy urogenital flora affected by urinary tract infections, contributing to incontinence. Prepare homemade probiotics using high-quality ingredients to ensure their effectiveness and safety. Consult a veterinarian to understand the interactions with ongoing medication or existing health conditions. 

Is there a difference between urine incontinence in dogs and bladder infection in dogs?

Yes, there is a difference between urine incontinence in dogs and bladder infection in dogs. Urinary incontinence is the loss of control during urination. Dogs with urinary incontinence lack control during peeing. The condition is not considered a disease but a sign of an underlying problem. Bladder infection in dogs is a disease caused by an infectious pathogen. The result of bladder infection is urinary incontinence or the loss of bladder control.