Incontinence

Overview

Urinary incontinence is the loss of voluntary control over urination. This occurs most commonly in middle-aged to old neutered female dogs. Medium to large breed females are most often affected. This occurs rarely in males.

Causes

By far, the most common reason for incontinence is lack of reproductive hormones, i.e. neutered females. However, ectopic ureters, nerve damage, intervertebral disc disease, urinary tract infections, urinary cancer, and abnormal confirmation of the vulva can cause incontinence. Prostate disease in males can cause leakage.

Symptoms

For hormone-responsive incontinence, most females start urinating in their sleep. They appear unaware of the behavior and are usually normal otherwise. Some patients will dribble urine as they walk or have urine scalding lesions on the inner thighs or vulva. If there is a primary disease causing the incontinence (nerve damage, urinary tract infection ), there are additional signs associated with those syndromes.   

Treatment

Patients tend to do very well on replacement hormone therapy such as diethylstilbestrol or on phenylpropanolamine. While this is more common in neutered females, the age the female is neutered does not appear to affect whether or not she will develop incontinence. Obesity does seem to increase a female’s risk of developing this condition.It is imperative to rule out urinary infections, stones, or other reasons of incontinence before assuming the pet has hormone-responsive disease. If the patient is young, ectopic ureter is much more likely and needs to be ruled out by an internal medicine specialist. An ultrasound may be indicated if a urinalysis is abnormal.