Urinary Incontinence in Dogs

What can I do for my female dog, Bianca, who has become incontinent in the past year or so? She is 14 and was spayed when she was about a year.

If your dog has true urinary incontinence, she is not aware that she is urinating when she has an accident and therefore will usually do it in her sleep and wake up soiled with urine. It is important to distinguish this from behavioral accidents that occur when awake and usually in the same location or situation repeatedly. Incontinent dogs will have urine loss in many different locations.

If the problem appears behavioral, you would need to work with your dog via training techniques. Bianca, who is older and was spayed at a young age, most likely has a physical problem.

The causes of incontinence include:

CYSTITIS: A bladder infection which can be diagnosed by bringing a urine sample to your veterinarian. (You should always rule this out first.)

URETHRAL INCOMPETENCE OR "SPAY INCONTINENCE": A loss of control in neutered male and female dogs, commonly seen in older pets.

BLADDER HYPOCONTRACTILITY: A change in the ability of the bladder muscle to squeeze out the urine, usually due to nerve damage.

ANATOMIC ABNORMALITIES: Birth defects, such as ectopic ureters or pelvic bladders, where the actual flow of urine is altered internally. These would normally be seen in a young pet, not a dog of Bianca's age.

Depending on the cause of Bianca's incontinence (which you can determine by having her urine examined and a physical exam performed by your veterinarian), there may be medications that can help her situation.

Dogs with spay incontinence are best treated with a drug used in the human world for congestion, a compound called phenylpropanolamine. It needs to be given twice a day in most cases, and it works by tightening the urinary sphincter, thereby increasing control. This is a very safe drug and the only side effects I have seen have been restlessness and nervousness. These are easily corrected by skipping a dose and starting over at half the original amount. I have had great success using this drug for my patients with spay incontinence.

Another drug used for this condition is a form of estrogen for female dogs and a form of testosterone for male dogs. These work because the muscle tone of the male and female urinary tracts is directly affected by sex hormones, so if we replace the hormones taken away by neutering, we can restore normal functioning to the urination process. There is higher risk in using these drugs. For the females, estrogen pills need be given daily for a week and then 2-3 times a week for life. There is risk of creating bone marrow suppression (which could result in a severe anemia), so these patients need close monitoring. The male hormone is usually given by injection and must be done 2-3 times a week. I try to avoid using these hormones with my patients.

Until you figure out how to deal with Bianca's problem, I would recommend placing a large baby diaper or adult incontinence pad on her overnight so that at least she can remain dry and your home clean. Good luck, and most importantly, don't get angry with her--she probably can't help soiling and is undoubtedly as upset as you are.

Dr. Peter Kross, DVM, has had his own veterinary practice, the Rivergate Veterinary Clinic in New York City, since 1989. He lives in Manhattan with his three white boxers, Buchanan, Wilhelmina and Laila.