Dog - Urinary Incontinence

Incontinence indicates uncontrollable leakage of urine. It can occur when the dog is lying down, often when asleep. It can affect dogs of either sex although bitches, because they have a shorter urethra, are more predisposed. Urinary incontinence is a most distressing and socially unacceptable condition which is by no means rare in dogs.

What are the signs of the condition?

Signs include:

• Dribbling urine, particularly when at rest.
• Bed wetting.
• Smell and dampness on the rear parts of the dog.
• Urine loss when barking etc.
• Frequently licking at vulva/penis

What age would I expect to see it?

Most commonly it is a problem in adult dogs. If it occurs in puppies the cause is usually associated with problems present from birth, i.e. a congenital malformation.

What are the main causes?

In young dogs the cause is often associated with congenital problems affecting the ureters (ectopic ureters). This is frequently mistaken for lack of proper housetraining but in fact the dog has no control over it. Other congenital problems affecting the bladder may also result in the condition.

Paralysis of the bladder, particularly following nerve damage after pelvic fractures or certain types of spinal disease can result in urine leakage.

Occasionally in female dogs there may be problems with the urethral sphincter (valve). This can also occur less commonly in male dogs, particularly neutered males.

Prostatic disease in male dogs can also lead to urination difficulties, usually initially an inability to pass urine followed by incontinence. Other causes include incorrect positioning of the bladder as can occur sometimes in overweight neutered bitches and also severe chronic cystitis. Certain types of bladder cancer can also cause incontinence.

What are the clinical signs?

In many cases affected dogs and bitches will be observed to pass urine normally. In these cases subtle signs such as frequently damp beds, the smell of urine around the hindquarters and continuous licking of the privates are usual signs.

How is it diagnosed?

Effective treatment is obviously dependent upon accurate diagnosis. This can, on occasions, be lengthy and expensive to achieve. The younger the dog the greater is the chance that the condition is congenital. This can occur in both males and females. There also appears to be certain breed predispositions for congenital urinary tract abnormalities.

The most common cause which affects middle aged, neutered bitches, is known as urethral sphincter mechanism incompetence (USMI). This usually involves a lack of muscle tone in the actual urethral sphincter (outflow valve) of the bladder, often linked with a short urethra and some mal-positioning of the bladder neck. Neutered bitches are possibly more prone to this condition since they lack oestrogen which normally plays a role in 'tightening' the bladder sphincter. Tail docking, now an illegal practice for cosmetic purposes was also considered to play a part in the case of very short docks.

Neutered male dogs can also be affected.

How is it diagnosed?

In all cases positive diagnosis involves careful clinical examination, often under sedation or general anaesthesia. radiography (x-ray) and other imaging techniques and laboratory tests involving blood and urine samples, may also be necessary.

How is it treated?

Some of the congenital problems can be treated surgically once they have been positively diagnosed. For the commonest cause, USMI, drugs, surgery or a combination of both may be employed. Surgery, if successful, has an advantage since lifelong medication is then unnecessary.

What is the long term outlook?

Good if the diagnostic work-up has led to a positive diagnosis which can be treated surgically. This includes USMI.

If USMI is controlled with drugs the response is usually good but treatment has to be maintained lifelong otherwise the condition returns.

In other cases the prognosis depends on the nature of the problem. For example in the male dog prostatic problems can often be successfully treated and once stabilised concomitant urinary incontinence frequently improves.