How can you recognise incontinence in your dog?

A dog with incontinence may regularly leave wet patches where they sleep. You may sometimes see drops of urine coming from the urethra while the dog is walking or lying down. The fur around the genitals may also remain damp. Contact with urine can irritate the skin, causing redness, an unpleasant smell or excessive licking. Many dogs with reduced sphincter function can urinate normally when taken outside. The urine leakage mainly occurs when they are relaxed.

What causes incontinence in dogs?

Urinary incontinence can have several causes. It is therefore important to establish why a dog is losing urine.

Reduced sphincter function

A common cause is reduced function of the urethral sphincter. This sphincter keeps urine in the bladder until the dog urinates. If the sphincter does not close properly, urine may leak involuntarily. This is also known as urinary sphincter mechanism incompetence. This form of incontinence is particularly common in spayed female dogs, but it can also affect other dogs.

Bladder infection or other urinary tract problems

A bladder infection can cause a dog to suddenly urinate small amounts more frequently, experience urgency or have accidents indoors. This is sometimes confused with incontinence. Bladder stones, urinary tract abnormalities and other bladder problems can also disrupt normal urination.

Congenital abnormalities

A congenital abnormality may be present in young dogs that have leaked urine since puppyhood. An ectopic ureter is one example. In this condition, a ureter does not enter the bladder in the normal place, allowing urine to leak past the usual closure mechanism. This condition is seen relatively often in young female dogs.

Neurological problems

The nerves that control the bladder and sphincter play an important role in holding and passing urine. Damage to these nerves, for example due to a spinal cord disorder or injury, can lead to incontinence or difficulty emptying the bladder completely.

Age and other conditions

In older dogs, changes in muscle function, mobility and health can contribute to urinary problems. However, age alone is not a diagnosis. Conditions such as kidney disease, diabetes mellitus and Cushing’s disease can cause a dog to produce much more urine. As a result, the dog may be unable to hold it for as long. This is not always true incontinence, but it may resemble or worsen existing incontinence. Cognitive decline can also lead to inappropriate urination in older dogs.

Incontinence after spaying in dogs

A well-known form of incontinence is urine leakage in female dogs after spaying. During spaying, the ovaries are removed, which significantly changes the production of certain sex hormones. These hormonal changes can affect the urethral closure mechanism. Among other changes, oestrogen levels fall after the operation. Levels of other hormones, including LH and FSH, also change. Changes in sphincter sensitivity, connective tissue and anatomy probably play a role as well.

Incontinence after spaying is therefore not caused solely by an oestrogen deficiency. It is a condition in which several factors contribute to reduced closure of the urethra. Urine leakage may begin shortly after spaying, but it can also develop months or years later.

Which dogs are more likely to develop incontinence after spaying?

Incontinence after spaying is seen relatively often in medium-sized and large female dogs. Boxers, Dobermanns, Rottweilers and certain other larger dog breeds have an increased risk. A higher body weight may also play a role. This does not mean that every spayed female dog becomes incontinent. Most dogs do not develop urinary incontinence after spaying.

How is incontinence in dogs diagnosed?

If your dog loses urine involuntarily, it is advisable to consult a vet. The vet will ask when the urine leakage occurs, how much urine the dog loses and whether there are any other symptoms, such as drinking more, urinating more frequently or difficulty urinating.

A urine test can help identify a bladder infection or other urinary tract problems. Additional blood tests may sometimes be needed. If an anatomical abnormality, bladder stones or another underlying condition is suspected, diagnostic imaging such as an ultrasound scan may be useful. An appropriate treatment can only be selected once the cause is clear.

How is incontinence in dogs treated?

Treatment depends on the cause of the urine leakage. If a bladder infection is present, the underlying infection is treated. A procedure may sometimes be required for a congenital abnormality.

If the urethral sphincter is not functioning adequately, several medications are available:

Propalin

Propalin contains the active ingredient phenylpropanolamine. This substance stimulates certain receptors in the urethral sphincter, increasing the closure pressure and potentially reducing involuntary urine leakage.

Propalin is mainly used for incontinence caused by reduced sphincter function in female dogs. It is only available with a veterinary prescription. As phenylpropanolamine can affect blood pressure and heart function, among other things, the vet will assess whether it is suitable for the dog.

Enurace

Enurace contains ephedrine. This substance can also increase tension in the urethral sphincter.

Enurace is used for urinary incontinence caused by reduced sphincter function in female dogs after spaying. Ephedrine can affect the heart rate, blood pressure and nervous system, among other things. It is therefore important for the vet to assess the dog’s health and supervise the treatment.

Incurin

Incurin contains oestriol, an oestrogen.

This medication is used for hormone-dependent urinary incontinence caused by reduced sphincter function in spayed female dogs. Oestriol affects the sensitivity and function of the urethral closure mechanism, which may reduce urine leakage. Incurin is also a prescription veterinary medicine. The vet determines the correct dosage and assesses any side effects.

What if medication does not help enough?

If medication does not have a sufficient effect on the incontinence, various surgical treatments are available to reduce urine leakage. The most suitable procedure depends on the cause of the incontinence and the dog’s individual situation.

• Urethral bulking injections: During an endoscopic examination of the urethra, known as urethroscopy, an elastic material is injected beneath the mucous membrane at several locations. This narrows the passage through the urethra, allowing a poorly functioning sphincter to retain urine more easily.
• Colposuspension: During this operation, the vagina is pulled forwards and secured to the abdominal wall. This changes the position of the bladder neck and urethra, which may improve urethral closure. A similar operation for male dogs is called vasopexy, in which the vas deferens are secured to the abdominal wall. These procedures can be performed through conventional abdominal surgery or keyhole surgery.
• Artificial sphincter: During this treatment, an inflatable silicone cuff is surgically placed around the urethra. After a recovery period of approximately six weeks, the cuff is gradually filled with a physiological saline solution. This progressively increases the pressure on the urethra, with the aim of reducing urine leakage without obstructing normal urination.

These treatments are performed by specialist vets. Not every procedure is suitable for every dog, and complete restoration of continence cannot be guaranteed. The vet can assess which options are available if medication does not help enough.

Can supplements help with incontinence in dogs?

In addition to medication, supplements are available that are intended to support bladder function or hormonal balance.

It is important to know that the effectiveness of supplements for true sphincter incontinence has been studied much less thoroughly than that of authorised veterinary medicines. Supplements can therefore play an additional role at most. They are not a substitute for examination or necessary treatment by a vet.

Sensipharm Inconti Stop Dogs

Sensipharm Inconti Stop Dogs is a complementary feed containing a combination of herbal extracts and plant-based ingredients. The product has been developed to support bladder function in dogs. Its ingredients include cuscuta, dioscorea, rubus and cornus. Discuss its use with your vet, especially if your dog is also receiving medication or has other health problems.

Nutrilabs Östrofer and phytoestrogens

Nutrilabs Östrofer is a complementary feed developed to support hormonal balance in female dogs. It contains red clover and soya beans, among other ingredients. These plants naturally contain substances known as phytoestrogens. Phytoestrogens are plant-based substances that can interact with oestrogen receptors in the body. However, their action is not the same as that of the body’s own hormone oestrogen or the medicine oestriol.

As hormonal changes can play a role in incontinence after spaying, phytoestrogens are sometimes used in supportive supplements for female dogs. However, there is insufficient robust clinical research in dogs to conclude that phytoestrogens effectively treat incontinence after spaying. It has also not been demonstrated that Nutrilabs Östrofer has the same effect as Incurin. Consult your vet before giving a supplement containing phytoestrogens, especially if your dog is already receiving hormonal medication.

What can you do yourself for an incontinent dog?

Alongside any treatment, you can help your dog remain comfortable and clean at home. Take your dog outside regularly so that the bladder does not remain full for an unnecessarily long time. An additional opportunity to urinate before bedtime can be particularly helpful. You should also provide an easy-to-clean sleeping area. A waterproof protective layer or washable incontinence mat can help keep the dog’s bed clean and dry.

If the fur around the genitals becomes wet, you can gently clean and dry it thoroughly to prevent skin irritation. For some dogs, a female dog nappy or incontinence pants may temporarily help. Change these regularly to prevent skin problems.

Do not restrict the amount of drinking water available in an attempt to prevent urine leakage. A dog must always have access to sufficient fresh drinking water. It is also important not to punish your dog for urine leakage. With true incontinence, the dog has no control over it.

When should you take an incontinent dog to the vet?

Have your dog examined if they regularly lose urine unconsciously, suddenly begin urinating indoors or clearly need to urinate more frequently. A veterinary visit is also important if there is blood in the urine, pain during urination, excessive drinking or changes in behaviour.

Is your dog unable to urinate, or do they repeatedly strain without passing any urine? Contact a vet immediately. A urinary tract blockage can be life-threatening.

Do you have any questions about incontinence in dogs? Please contact veterinarian@vetsend.co.uk.