Introduction
Urinary incontinence is a common condition in female dogs characterized by involuntary urine leakage. It occurs when a dog loses control of its bladder, leading to unwanted dribbling or leaking of urine typically while resting or sleeping. Urinary incontinence is more prevalent in neutered/spayed females and older dogs. According to a study by Forsee et al. published in Journal of the American Veterinary Medical Association, the prevalence of acquired urinary incontinence in pet dogs is approximately 5.12%.
While urinary incontinence in dogs rarely leads to life-threatening complications, it can greatly impact a dog’s quality of life and requires veterinary attention and treatment. This article provides an overview of the causes, diagnosis, and treatment options for urinary incontinence in female dogs.
Causes of Incontinence
There are several potential causes of urinary incontinence in female dogs:
Hormonal Issues
Decreased estrogen levels that occur after spaying can weaken the urethral sphincter and lead to incontinence. This is referred to as hormone-responsive or spay incontinence and is the most common cause of incontinence in dogs (1).
Urinary Tract Infections
UTIs irritate the bladder and urethra, causing increased urination and accidents. They are more common in female dogs due to their shorter urethras (2).
Spinal Issues
Injuries, herniated discs, or other spinal problems can damage nerves that control bladder function and lead to incontinence or inability to fully empty the bladder (3).
Other Medical Conditions
Diseases affecting the kidneys, bladder, or urethra may also contribute to incontinence. Examples include bladder stones, anatomical defects, cancer, bladder inflammation, and bladder weakness (1, 2).
(1) https://vcahospitals.com/know-your-pet/urethral-incontinence-in-dogs
(2) https://hospital.vetmed.wsu.edu/2021/10/26/urinary-incontinence-in-dogs/
(3) https://www.webmd.com/pets/dogs/urinary-incontinence-dogs
Diagnosing Incontinence
To diagnose urinary incontinence in female dogs, the veterinarian will first perform a complete physical exam and take a full medical history. This allows the vet to rule out other conditions like urinary tract infections, bladder stones, anatomical defects, or neurological issues that could be causing the incontinence (Veterinary Teaching Hospital).
The vet will also analyze a urine sample through urinalysis. This checks for signs of infection as well as other abnormalities involving the kidneys, bladder, or urethra (VCA Hospitals).
Imaging tests like X-rays or ultrasound allow the vet to visualize the bladder and urethra. This can identify anatomical problems, bladder stones, tumors, or other issues leading to incontinence (VCA Hospitals).
Treatment Options
There are several treatment options for urinary incontinence in female dogs:
Hormone Therapy
One of the most common treatments is hormone therapy. Estrogen supplementation can help strengthen the urethral sphincter in spayed female dogs. Synthetic estrogens such as estriol and diethylstilbestrol are commonly prescribed, but natural estrogens may also be used (WebMD). According to the AKC Canine Health Foundation, researchers have also explored using regenerative medicine, such as stem cells, to regenerate the urethral sphincter and treat incontinence.
Antibiotics
Antibiotics may be prescribed if urinary tract infection is causing or contributing to the incontinence. Common antibiotics used include cephalexin, amoxicillin-clavulanate, trimethoprim-sulfa, and enrofloxacin (VetFolio).
Surgery
Surgeries like colposuspension or urethropexy can provide a more permanent solution by supporting or tightening the urethra. However, these come with risks like any major surgery. Less invasive options like bulking agents can also be injected to tighten the urethra.
Lifestyle Changes
Making changes like limiting water intake closer to bedtime, assisting the dog to urinate more frequently, using belly bands, and cleaning accidents promptly can help manage incontinence symptoms.
Medications
There are several medications commonly prescribed for urinary incontinence in female dogs. The most common are:
- DES (diethylstilbestrol) – This synthetic estrogen was frequently prescribed in the past but is now rarely used due to potential side effects like bone marrow suppression and increased risk of reproductive tract cancer 1.
- PPA (phenylpropanolamine) – This sympathomimetic amine constricts smooth muscles like the urethra and bladder neck to prevent urine leakage. The brand name Proin is commonly prescribed 2.
- Estriol – This natural estrogen may be used alone or with PPA. It thickens the lining of the urethra to aid continence. However, long-term use can increase health risks so it is not commonly prescribed 3.
The medication chosen depends on factors like the underlying cause of incontinence, the dog’s health status, and potential side effects. PPA is usually the first choice for urinary incontinence treatment in female dogs today due to its effectiveness and safety profile.
Side Effects
While PPA medications like Proin can be effective for treating incontinence in female dogs, they do have potential side effects to be aware of. According to VCA Animal Hospitals, the most common side effects include vomiting, diarrhea, lack of appetite, increased thirst, restlessness, irritability, and difficulty urinating.
One concerning side effect is increased thirst and urination. As explained by PetMD, PPA medications can actually increase urination frequency because they tighten the bladder neck sphincter, resulting in incomplete bladder emptying. This leads to increased thirst and urinary frequency as the dog tries to empty its bladder fully.
Behavior changes are another potential side effect of PPA medications. According to the Proin for Dogs website, some dogs may experience restlessness, agitation, irritability, and even aggression. These behavior changes seem most likely to occur during the first few weeks of treatment as the dog adjusts to the medication.
Finally, PPA medications can sometimes cause reproductive issues in intact female dogs. As reported by PetMD, PPA can interfere with the estrous cycle, leading to prolonged estrus or pyometra. For this reason, vets usually recommend spaying dogs before starting PPA treatment.
Lifestyle Changes
There are some lifestyle adjustments that can help manage incontinence in senior female dogs. These include:
Scheduled feeding – Feeding your dog at set times rather than free-feeding can help regulate when she needs to urinate. This allows you to anticipate bathroom breaks and assist your dog in getting outside. Source
Limiting water intake – Restricting access to water 2-3 hours before bedtime can help reduce accidents overnight. However, be sure your dog stays well-hydrated during daytime hours. Source
Increased walks – Taking your dog out more frequently, especially first thing in the morning and before bed, allows more opportunities to urinate outdoors. Watch for signals that she needs to go out.
Success Rates
The success rate for treating urinary incontinence in female dogs with medication can vary quite a bit. Studies show that progesterone-based medications like estriol and phenylpropanolamine (PPA) have about a 50-75% success rate in controlling symptoms. However, long-term continence after medical therapy is often lower, with some studies showing only around 50% of female dogs remaining continent after 1 year of medication use [1].
In male dogs, the success rates for medication are even lower. Less than 50% of males respond positively to medical therapy for incontinence. For males, the most effective treatment is often prostatectomy surgery, with higher long-term success rates compared to medication alone [2].
Overall, while medication can help control symptoms in many dogs, lifelong continence is difficult to achieve in all cases. Owners should be prepared for the possibility that medication may not completely resolve leakage long-term. Close monitoring, follow-up vet visits, and additional treatment methods may be needed to improve outcomes over time.
Costs
The costs associated with treating incontinence in female dogs can vary significantly depending on the treatment path. The two main options are medication or surgery.
For medication, prices typically range from $20-130 for a one month supply depending on the specific drug, dosage, and pharmacy. Some common medications like Proin can cost $45-130 per month. Other drugs may be cheaper. Medication needs to be continued regularly, making it an ongoing expense.
Surgery such as an urethral sling has upfront costs ranging from $300-1300 depending on the specific procedure, veterinarian fees, and other factors. It is a one-time cost meant to provide longer-term symptom relief. Additional follow-up vet visits may be needed after surgery as well.
Pet owners should factor in both the continuous costs of medication and potential upfront surgical expenses when budgeting for dog incontinence treatment. The right option depends on the dog’s specific condition, owner’s financial situation, and other lifestyle factors.
Conclusion
Incontinence in female dogs is a common condition that can significantly impact their quality of life. While the underlying cause of incontinence can be challenging to diagnose, there are effective treatment options available to help manage symptoms.
Getting prompt veterinary attention and following recommended treatment plans are key to improving continence and minimizing accidents. This may involve medications, dietary changes, scheduled potty breaks, or even surgery in some cases. With patience and perseverance, it is often possible to successfully manage incontinence and dramatically improve a dog’s comfort and wellbeing.
Treating incontinence is vitally important to female dogs’ health and happiness. By understanding the condition and exploring the available treatment options with a trusted veterinarian, dog owners can help their pets live fuller, less stressful lives.