Incontinence in older dogs: Causes, tips & how to help

Urinary incontinence in dogs, especially older dogs can be upsetting for both pets and their owners. A once house-proud dog may have lost the ability to control their bladder, and start to urinate indoors, through no fault of their own. 

But, did you know, urinary incontinence is a common issue in senior dogs. Research indicates that urinary incontinence affects as many as 1 in 30 female spayed dogs. 

Lets explore what causes incontinence in dogs, its treatment and understand how do you live with an incontinent dog to support them as best you can. 

What is dog incontinence? 

Urinary incontinence in dogs is an inability to retain urine in their bladder. This is related to lack of hormones, weakened bladder sphincter muscles or age related muscle loss. 

Incontinence is involuntary and a distinguishing sign is finding a urine soaked bed after rest or sleeping. 

Canine incontinence in older dogs is different from inappropriate elimination. Inappropriate elimination is a behavioural issue whereby a dog will choose to urinate indoors. The difference is that a dog with inappropriate elimination can choose where to urinate and when, and can often stop their urine stream if needed. An incontinent dog has reduced control over the bladder and will leak urine when the bladder becomes full or stretched. 

What causes incontinence in dogs?

There are a few different reasons for urinary incontinence in dogs, and some conditions that can appear very similar to urinary incontinence.

Age related changes 

When dogs age, their hormone levels - oestrogen for females and testosterone for males naturally decline. These hormones are important for urinary control, and lower levels can lead to incontinence. 

USMI 

Urethral sphincter mechanism incompetence is an age related change whereby the muscles of the urethra weaken, leading to urinary incontinence. Medication or surgery can usually help with USMI causes of incontinence. 

UTIs 

Urinary tract infections can mimic urinary incontinence. A dog with a UTI will urinate frequently and this may look similar to incontinence. A vet can tell the difference between a UTI and true incontinence through urinalysis.  

Neutering

A dog can become incontinent after neutering. This is because the ovaries produce oestrogen which acts on the urethra to aid urinary control. When the ovaries are removed, the hormone levels drop, and some dogs can become incontinent. Are you thinking about neutering your dog? Read our blog on whether neutering a dog calms them down.

Neurological issues 

Nerves are important in urinary control. If there is nerve damage from previous trauma, or degenerative disease such as arthritis, this can affect the neuron's ability to control the bladder, leading to incontinence in dogs. 

Obesity 

If your dog is overweight it can worsen their urinary incontinence. This is because the extra adipose (or fat) tissue creates physical pressure on the bladder as it fills. Weakened sphincter muscles are not able to close the urethra adequately, and so your dog is more likely to leak urine when they are overweight. 

Arthritis and mobility 

Arthritis may not directly cause incontinence, but it can affect the degree at which your dog struggles with incontinence. When a dog has arthritis or mobility issues, it can be more challenging to get up to go outside to urinate when the urge arises. 

A dog with arthritis can feel low level pain, and this means crouching to urinate can be uncomfortable. In response to this, some dogs will not fully empty their bladder when outside, as it hurts to crouch for a long period of time. This leads to part emptying of the bladder, and increased chance of urinary leakage as a result. 

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Signs your dog may be incontinent 

Signs of incontinence in dogs are: 

• Bed wetting
• Dribbling urine when walking
• Licking at the genital areas
• Red or irritated skin around the genital areas 

Some of the signs above can be related to other urinary issues such as infection, or behavioural issues. A veterinarian will do a physical exam, then test urine and blood to find the reason for your dog's incontinence. 

How to treat incontinence in dogs 

Many cases of incontinence can be well managed with replacement hormone therapy. This is a lifelong medication that replaces the hormone (oestrogen) needed to tighten the urethral sphincter to stop urine leakage. 

Another treatment is phenylpropanolamine. This medication acts on smooth muscle receptors in the urethra allowing them to tighten and control urine leakage. This medication is not as long lasting as hormone replacement and may need to be given multiple times a day for good effect. 

If medications are unsuccessful there are surgical treatment options, but these are used as a last resort after trying a combination of medical and home management treatment. 

At home support can make a big difference when considering how to treat an incontinent dog. 

Regular toilet breaks allow your pet to maintain dignity and reduce risks of developing secondary urinary tract infections. Bathing or sponging their back end when they have had an accident will reduce the risk of urine scalding and sores. 

Weight loss, acupuncture and physiotherapy can all help in treating an incontinent dog's co-morbidities. An overweight dog with incontinence is more likely to get urine scalding from the extra tissue folds that develop around the genitals. Weight loss removes this extra tissue and reduces urine pooling in skin folds. 

Tips for living with an incontinent dog 

As incontinence is a lifelong condition, having a few tips on dealing with old dog incontinence can make the condition much more manageable. As a vet, I advise my pet owners on the following: 

• Incontinence sheets, or ‘puppy pads’ placed over bedding, or areas your dog likes to lie.
• Regular toilet breaks or a dog flap if you have a smaller breed dog
• Using pet sitters if leaving your dog for a prolonged period of time during the day
• Nappies if travelling for long distances
• Weight loss to reduce skin sores
• Managing any other health concerns such as osteoarthritis 

Urinary incontinence in dogs is a very treatable and common problem that your vet will have a wealth of experience managing. Never feel embarrassed or unsure to approach your vet about discussing more delicate health concerns in your dog- the treatment options we have work very well, and your dog will be much happier after starting treatment. 

When to see a vet 

Not all cases of urine leakage are actually urine incontinence in dogs. There are other conditions that present urinary signs. If you notice any of the signs below, a vet check is needed, and you should take a urine sample with you. 

Signs of a urinary issue: 

• Frequent urination
• Urination with blood, or clots
• Brown, green or red urine streams
• Straining to urinate
• Not able to urinate at all for 24 hours
• Licking frequently at genitals
• Purulent (white, cream or green) discharge from genital areas
• Reduced appetite or energy levels 

Summary 

Urinary incontinence in dogs is a treatable condition. The long term results of medication combined with home management allow dogs to live happy and comfortable lives with very small changes to their lifestyles. 

What can appear to be an embarrassing hygiene issue affects almost a third of the spayed female dog population, so please know you are not alone in wondering how to live with an incontinent dog. Reach out to your vet for a check up, and you will be pleasantly surprised at how effective treatment can be.