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Care Guide

About Care Guides[x] These care guides are written to help your clients understand common conditions, tests, and procedures, as well as to provide basic information about pet care. They are based on the most up-to-date, documented information, recommendations, and guidelines available in the United States at the time of writing. Pharmaceutical product licensing, availability, and usage recommendations are based on US product information. Use the Download Handout button to generate a PDF for printing or e-mailing to your clients.

Urinary Incontinence

    • Urinary incontinence is an inability to store urine in the bladder until voluntary urination occurs, or the loss of voluntary urinary control.
    • It is important to distinguish urine leakage/incontinence from other types of abnormal urination.
    • Depending on the cause, urinary incontinence may be treatable. In other cases, pet owners must decide if they can manage a pet with continued incontinence.

    What Is Urinary Incontinence?

    Urinary incontinence is generally defined as the inability to voluntarily control urination. Instead of the bladder being able to store urine until voluntary urination occurs, urine can escape the bladder prematurely. The condition can occur in cats and dogs, but it is much more common in dogs.

    What Causes Urinary Incontinence?

    After urine is produced, it is stored in the bladder until release (through the urethra) during urination. The urethral sphincter is a tiny, circular muscle that constricts to hold urine in the bladder and relaxes to allow the release of urine during urination. Conditions that damage or alter the nerve supply to the urethral sphincter or associated structures can lead to incontinence. Examples include arthritis or tumors; fractures involving vertebrae in the middle and lower back or pelvic area; and trauma to the nerves in this area.

    Cats that have experienced urethral obstruction (being “blocked”) may have temporary urinary incontinence secondary to extreme bladder distention (stretching). Fortunately, this complication is generally temporary and responsive to medication.

    Certain congenital malformations of the urinary tract can contribute to incontinence. When this occurs in young puppies, owners may mistakenly believe the dog is simply being difficult to housebreak. When in doubt, ask your veterinarian for advice if your puppy seems to urinate abnormally or seems difficult to housebreak.

    A relatively common type of urinary incontinence occurs in spayed female dogs. Most affected dogs are middle-aged or older and of a medium-sized or large breed. The problem is hormonal in nature and usually responds to medication.

    What Are the Clinical Signs?

    The most common clinical sign of urinary incontinence is dribbling urine. This can occur continuously or intermittently. Some affected pets may posture normally (some dogs squat; others lift the rear leg) and urinate, but then dribble urine when they walk away. They may also have episodes of apparently normal urination, but leak urine at other times or develop a bad odor from urine being present on their fur. Sometimes, dogs with incontinence urinate while sleeping, leaving a wet spot when they wake up.

    It is important to distinguish urine leakage from other types of abnormal urination. If you find a puddle of urine on the floor, the dog could have had a urinary accident, but it does not necessarily mean incontinence. Pets with bladder infections, bladder tumors, or bladder stones can have a type of incontinence called “urge incontinence.” These pets tend to void small amounts of urine frequently because of bladder inflammation, discomfort, or reduced capacity.

    In contrast, pets with diabetes, kidney disease, or Cushing’s disease may drink more water than usual, which forces them to urinate more often. These pets are not incontinent; they simply have a need to urinate more frequently. Similarly, a pet with a behavioral problem such as submissive urination, or an elderly dog with cognitive dysfunction syndrome (sometimes referred to as “doggie Alzheimer’s disease”) may urinate abnormally or have accidents in the house, but these conditions should also be distinguished from incontinence.

    If your pet is urinating inappropriately, notify your veterinarian. He or she can examine your pet and recommend the appropriate diagnostic tests to help determine the cause.

    How Is Urinary Incontinence Diagnosed?

    A detailed medical history is the first critical part of the diagnostic workup for suspected urinary incontinence. An accurate history helps your veterinarian determine if the pet is truly incontinent or is having a different type of urinary problem.

    In addition to a full physical examination, diagnostic testing may include the following:

    • Urinalysis
    • Urine culture testing
    • Blood work (such as a chemistry panel and complete blood count, or CBC)
    • X-rays
    • Abdominal ultrasound or other specific studies to evaluate the urinary tract

    If a problem with the vertebral column or spinal cord is suspected, additional x-ray studies, magnetic resonance imaging (MRI), computed tomography (CT), or other tests may be recommended. In complicated cases, referral to a neurologist or other specialist may be recommended.

    How Is Urinary Incontinence Treated?

    Depending on the cause, urinary incontinence may be treatable. Some conditions respond to surgery, and others are treatable or manageable with medication.

    In some cases, the problem can’t be corrected, so owners must decide if they can manage a pet with continued incontinence. Caring for a pet under these conditions can be challenging—even for the most devoted pet owner. Keeping the pet as clean and dry as possible is critical to help prevent urine scalding and associated skin infections. Sometimes, special diapers can help keep the environment cleaner, but these must be checked and changed frequently to keep the pet dry. If the pet has trouble walking, additional care is needed to help prevent pressure sores and other complications.

    Many pets with chronic incontinence are at an increased risk for bladder infections, so your veterinarian may recommend performing a urinalysis and urine culture testing periodically to check for evidence of infection.

    Depending on your comfort level with nursing care, your veterinarian may be able to show you how to express your pet’s bladder at home. This allows you to empty the bladder on a schedule, which helps reduce involuntary leakage because the bladder is not required to store large amounts of urine. In short-term situations, an indwelling urinary catheter can be used to help keep the pet dry and reduce the amount of urine being stored in the bladder. This, however, requires more extensive nursing care and is not ideal for a long-term care situation.

    For some pet owners, caring for an incontinent pet may require more physical, emotional, and/or financial commitment than the family can provide. In such cases, humane euthanasia may be a reasonable option for preventing unnecessary suffering and poor quality of life for the pet.