Dog Incontinence Treatment

Dog incontinence treatment options vary, depending on what's causing your dog's urinary problems.

Dog lying on stone floor

Sometimes the loss of bladder control is the whole problem, other times it's just a symptom of another underlying issue.

It's also an involuntary behavior (in other words, your poor dog has no control over the leaky plumbing!).

The good news is that there are ways to help make an incontinent dog more comfortable, and to minimize the mess while treatment options are underway.

If Fido or Fifi is constantly dribbling urine, wets the bed at night, or seems to need to pee every 30 seconds, help is at hand!

The Right Treatment For Dog Incontinence 

There are lots of different reasons why your puppy or dog is having trouble controlling her bladder. 

Puppies can have immature nervous systems; older dogs can lose muscle tone which affects all parts of their bodies; several common dog illnesses and conditions can have incontinence a symptom..... figuring out what is at the root of your dog's problem is the key to treating her/him effectively.

Treating Your Dog's Urinary Tract Infection

Bladder infections are a fairly common cause of incontinence in dogs. They happen most often in female dogs due to their shorter urethras.

The only real cure for dog bladder infection is a course of the correct, and specific, antibiotics.

Infections are caused by bacteria which can flourish in the bladder for a number of diffferent reasons. 

Luckily most bladder infections in dogs are pretty easy to treat, especially if they're diagnosed early.

The correct antibiotic is usually efficient in eliminating bacteria. Bladder stones, which are just one cause of UTI's in dogs can sometimes be treated with dietary changes, or surgical options are available.

To find out everything you need to know about treating dog bladder infections, CLICK HERE.

There are also natural products which can help ease symptoms, or can be effective in preventing cystitis from developing by keeping the urinary tract functioning properly, but personally I wouldn't rely on them to cure an active infection.

If your pup/dog has recurrent UTI's, Petwellbeing Urinary Gold contains natural ingredients that help to regulate the ph balance of her bladder and strengthen her immune system.

PetAlive UTI-Free is designed to relieve and soothe the symptoms of a urinary tract infection as well boosting immune function and preventing future recurrences.

PetAlive Better Bladder Control Granules (also available in spray form) is a homeopathic product which strengthens weak sphincter muscles and improves bladder control to put an end to dribbling. It can be a great choice for older dogs.

Treating Incontinence In Dogs After Spay Surgery

With somewhere between 5% and 20% of dogs experiencing some degree of incontinence (ranging from minor and temporary to more severe and long-lasting), hormone-responsive incontinence is a definite issue.

Adult dog in wire crate

Sometimes localized swelling or 'trauma' from  surgery, or the effects of anesthesia or strong pain-killers, can cause your dog to lose control of her bladder for a few hours, or a few days after surgery. This is temporary and your girl should be back to normal soon.

In other cases the change in hormone levels (drop in estrogen) can be behind the sudden leaky faucet. This can happen immediately after surgery or weeks, months or even years later.

If your dog has problems with bladder control after being spayed, and they don't resolve themselves within a few days, then this is something to consider.

Luckily the treatment for spay-related incontinence is usually easy, and effective.

A medication that tightens the sphincter muscles (between the bladder and ureter) might be used. There are several to choose from including Propalin and Proin which contains the active ingredient Phenylpropanolamine (aka PPA), a form of decongestant.

The drug Imipramine is also sometimes prescribed by veterinarian to treat incontinence, either by itself or alongside other medications. 

Estrogen supplements or replacements are often effective too.

In 2011 the FDA approved a drug called 'Incurin' which contains the natural estrogen hormone estriadol.

Dog Incontinence Treatment - Incurin

Incurin is a fairly new drug, and so extended studies on side effects aren't available. Generally these are considered to be mild and include loss of appetite, excessive water consumption and swollen vulva area.

However, some owners have noticed significant behavioral changes in their dogs while taking Incurin.

Although some behavior change isn't unexpected (given that this drug is a hormone replacement), they shouldn't be severe.

Extreme friendliness toward other dogs (to the point of being obnoxious), or heightened aggressiveness or anxiety, are not normal and I'd recommend discussing any sign of these with your own veterinarian.

If you check out the Facebook Comments section at the very bottom of this page you'll find visitors have posted about their dogs experiences with Incurin.

I think they're worth reading.

Diethylstilbestrol (aka DES a synthetic estrogen) is also used, and sometimes a combination of PPA and DES is recommended.

Which drug is prescribed/recommended depends on the individual circumstances and the severity of the problem. It's your vet's call.

For male dogs with hormone-related incontinence sometimes testosterone injections can relieve the symptoms.

But, this might cause a rise in other male behaviors such as scent-marking that are common in un-neutered dogs.

Alternative and natural treatments can help in some cases. Herbal blends and supplements, acupuncture and homeopathic options have all had positive results in some dogs.

Incontinence Caused By Physical Defects

If your pup or dog has some type of malformation or defect in her urinary tract that is causing her loss of bladder control, then surgery is her best option.

Ectopic Ureter (a congenital defect where the ureter doesn't carry urine to the bladder) can often be corrected surgically, but it isn't a 'sure thing'.

If your vet suspects this is a problem for your pup, first he'll use a physical exam, urine analysis and most likely X-rays, ultrasound or a CT scan to make an accurate diagnosis (and to see exactly how the ureter is placed and where it empties).

Studies show that approximately half of these surgeries will be a complete success. 

For the other half, the dog's incontinence will usually be improved, but not necessarily completely removed. 

In those cases medication can often help clear up remaining symptoms.

Dog Incontinence Due to Neurological, Spinal Problems

Your dog's nervous system is controlled by a set of impulses and signals that set out from his brain and then travel through his body via his spinal column and nerves.

Veterinarian examining sick dog

This means that any injuries or disease of the brain, spine or nervous system can cause problems in any other part of the body, including bladder/bowel control.

In these situations it's not the incontinence that needs to be fixed so much as the injury or disease that's causing the incontinence.

Because there are so many different possibilities such as brain or spinal tumors, degenerative diseases, injuries, inflammation and so on, there's no way to give you one treatment option.

If your dog's incontinence is also accompanied by other symptoms such as weakness or lameness in the rear, loss of co-ordination or balance, seizures, difficulty with bowel movements and so on, then it's worth considering neurological issues being at the root of his problem.

You'll need your vet to give him a thorough check-up and take it from there.

Incontinence As A Symptom Of Other Diseases

As with the incontinence that is a result of a neurological or spinal problem, it can also show up as a symptom in a whole host of other illnesses and diseases.

Loss of bladder control or excessive urination can be caused by:

  • Diabetes
  • Cushing's Disease
  • Addison's Disease
  • Kidney
  • Liver problems
  • Tumors
  • Diseases of the urinary tract
  • Prostate problems

......and more.

The key to which disease/condition is at the root of the problem is usually the other symptoms that you're seeing. 

Excessive thirst, hair loss, weight loss (or weight gain), changes in appetite, fatigue, diarrhea, vomiting, panting/pacing or signs of stress or pain, and so on are all symptoms that you should pay attention to.

If your dog has problems controlling her/his urine, and other symptoms of illness (or just seems 'off' to you in some way), it's definitely worth having your veterinarian take a closer look and find out what's at the root of the problem.

Once you treat the underlying health condition, her bladder control will return.

The Stress & Anxiety Link To Dog Incontinence

Losing bladder control (and sometimes bowel control too) can be a symptom of psychological problems as well as physical ones.

A puppy or dog who is seriously stressed or in a state of high-anxiety can get so upset that their emotions literally overtake their physical self-control and the result can be a puddle (or worse).

Scared Sheltie puppy looking anxious

Submissive urination is a prime example, and it's NOT a house-training issue or a physical limitation, it's a behavioral one.

It's an involuntary behavior and your pup/dog can't help it if she piddles at the feet of a stranger, or when she meets a dog she doesn't know, or hears the vacuum cleaner, or......

Getting cross with her will only make the situation worse. If you click on the link in the earlier paragraph you can learn how to handle submissive urination in a way that will help her overcome her 'issues'.

True separation anxiety is another thing that can make your pup lose control of her bodily functions.

If she gets hysterical when left alone, the level of her fear can make her behave in a 'wild' way. Howling, scratching, throwing herself around, even peeing and/or pooping uncontrollably.

You need to find a way to reduce her anxiety and fear, then the other behaviors will also resolve themselves.

Incontinence In Older Dogs

Senior dogs are more likely to develop health problems which can have incontinence as a symptom, this is a normal part of aging and the deterioration of their body's functions.

As they get older they also lose muscle tone and the sphincter muscle isn't exempt from this, so urine can leak out when it's not supposed to.

But, just because a dog is older, that doesn't mean that his incontinence can't be treated, or at the very least managed.

Senior dog in comfortable dog bed

Dog Incontinence Treatment - A Veterinarian's View

There is no “one size fits all” treatment for incontinence.  Treatment will be most effective when a proper diagnostic workup is performed.

Urethral sphincter mechanism incontinence (USMI) is most common in spayed female dogs due to hormonal imbalances. This happens when the muscle which keeps urine in the bladder becomes weakened.

There is no specific test for USMI---we diagnose it by ruling out other urinary problems.  Dogs with USMI typically have no other symptoms and urine tests are normal. 

The primary treatments for USMI are Proin (phenylpropanolamine) and Incurin (estradiol).  Some dogs respond better to one medication over another.  Proin tightens the sphincter muscle. It is usually given 2 times daily. It is generally safe, but dogs who are overly sensitive to it may have signs of restlessness, high blood pressure, fast heart rate or stomach upset. 

Proin comes in a chewable tablet and some dogs really like the taste—make sure to keep the bottle out of reach of curious dogs! The side effects are much more serious in cases of toxicity or overdosage. 

If your dog’s incontinence doesn’t resolve on Proin, I usually recommend Incurin, an estrogen replacement medication. In the past, DES (diethylstilbestrol) was prescribed, but safety issues in humans drastically reduced its availability.  DES also has some risky side effects in dogs, such as bone marrow suppression.

In my experience, Incurin is very well-tolerated.  At the doses needed for incontinence, serious side effects are rare.  A very small percentage of dogs may have hormonal side effects such as vulvar swelling or mammary development. Every dog is started on a daily dose of Incurin which is gradually reduced every 7 days.  Some dogs can get by with only 1-2 doses per week! 

There are some dogs that require a combination of both Proin and Incurin.  Because they work differently, it safe to give them together. There are no cures for USMI, so treatment with either medication usually lifelong.  

Other treatment options have been explored for dogs with severe USMI that are resistant to medical treatment.  Various surgeries that alter the conformation of the urinary tract have proved minimally successful. Collagen injections administered around the urethra can help resist urine leakage. 

While initially effective for most dogs, the injections often need to be repeated over time.  These are usually last-resort measures for the most severely affected dogs. 

For other causes of incontinence, you need to treat the underlying disease and the leakage resolves. 

Urinary tract infections should be treated with appropriate antibiotics, often based on urine culture/sensitivity test results.  This test tells us what antibiotic will be best for the specific infection present.  Bladder stones often need to be surgically removed, but can sometimes be dissolved with special prescription diets. 

Some diseases cause ‘overflow’ incontinence because they dilute the urine. The bladder cannot physically hold the amount of urine present and leaks as a result. 

Diabetes, kidney disease, and adrenal disease are the most common examples. Some medications can cause increased urine production as well. Bloodwork, urine testing, and other specialized tests are required to diagnose these conditions.

Because dogs with these conditions lose a lot of water through their urine, it is extremely important that they are able to drink plenty of water to maintain proper hydration.  Please do NOT restrict water in the hopes of decreasing incontinence!! Once the condition is properly managed, the incontinence should resolve.  

Due to their anatomy, male dogs rarely develop incontinence. 

When infection, bladder stones, prostate problems, and underlying internal diseases are ruled out, we try Proin therapy to increase urethral muscle tone.  Unfortunately, male dogs do not always respond to Proin as reliably as female dogs.  

Older dogs or dogs with severe irreversible nerve damage can develop incontinence that is not always responsive to medical therapies. 

In these cases, we need to manage the condition with supportive nursing care including diapers and absorbent pads. Change diapers often and keep your pet’s skin clean to prevent urine scald, which can be painful and lead to infections. 

For female dogs, it is beneficial to use medicated wipes around their vulvar region to prevent infections from ascending up to their bladder.  

Fecal incontinence is rare and generally only seen in dogs with severe neurologic disease, tails docked too short, or advanced senility. 

There are no treatments for fecal incontinence itself, but to help manage the problem I usually recommend a low-residue diet to reduce fecal volume, doggy diapers, and good sanitary measures. 

Author: Megan Teiber, DVM

Managing Incontinence In Dogs

Obviously it's most important to treat whatever is causing your dog to have trouble with her bladder control.

It's also important to try to help relieve the discomfort and keep your home from being constantly damp.

  • Doggie diapers for girls and belly bands for boys can be a Godsend if you have a dog who is constantly dribbling urine. There are disposable and washable options and most dogs tolerate them well.

  • Find a water-resistant dog bed, and put rubber or plastic-backed blankets (you can make these yourself) on furniture or beds.

  • If you have a small-breed dog, consider adding pee-pads or a doggie litterbox to each room so that your dog doesn't have far to go if she gets a sudden urge to pee.

Some additional side-effects of dog incontinence can be 'scalding' (basically when the acid in urine burns the skin), inflammation and infection.

You can relieve discomfort caused by urinary incontinence by:

  • Keeping your pets skin clean and dry can go a long way towards reducing these issues. 

  • Use baby wipes (unscented), medicated wipes, or unscented soap and water to keep the tummy area clean. Use just plain lukewarm water for the vulva or tip of the penis if necessary.

  • If the skin is just irritated, a little vaseline petroleum jelly or aloe vera gel can be soothing. 

    Remember that your dog is likely to be licking this area, a  lot, so don't use anything that might be toxic (including diaper rash cream that contains zinc)

But if there's a lot of redness, swelling or the area feels hot, chances are there's some infection there and you'll need to get antibiotics and/or anti-inflammatory medications from your vet.

The best dog urine cleaning products

A good urine and odor remover is worth having on hand to clean up dribbles and puddles.

Also, a good supply of patience and a lot of love is necessary.

Remember, your dog can't help dribbling or flooding, there's something wrong and she's relying on you to help her get better.

Don't limit her water intake (unless your vet recommends it as part of her treatment) in an effort to reduce the amount of pee she produces. 

This is more likely to lead to dehydration or a UTI which will just make the situation worse, not better.

There are natural supplements which can help improve your dog's bladder health and function (but they're not a cure of incontinence). 

Occasionally, incontinence can be caused by a sensitivity or allergy to a dog food ingredient or is linked to medication or supplement.

Grains can be one of the problems in dog food, and switching to a grain-free diet or preparing your dog's food at home can sometimes help.

All the information and advice on this page has been approved by
Veterinarian, Dr. Megan Teiber, DVM

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