Urinary Incontinence in Dogs

Written by Small Door's medical experts

Urinary incontinence in dogs is a common condition, but thankfully it’s one of the easiest to successfully treat. If you feel that your dog may be experiencing urine leakage, read on to learn more about what signs to look out for and how this condition may be treated.

In this article:

• What is urinary incontinence in dogs?

• Signs and symptoms of urinary incontinence in dogs

• Causes of urinary incontinence in dogs

• Diagnosing canine urinary incontinence 

• Treatment of urinary incontinence in dogs

• Recovery and management of urinary incontinence in dogs

• Can you prevent urinary incontinence in dogs?

• Summary of urinary incontinence in dogs

Urinary incontinence in dogs is what occurs when a canine experiences an involuntary leakage of urine. When this occurs, the amount of urine leakage may vary anywhere between small dribbles of urine to a larger amount.

It’s more common in female dogs. A study in the Journal of Small Animal Practice found that out of 100,397 female dogs (both spayed and not spayed), 3.14% were diagnosed with incontinence.

According to Merck Animal Health, one out of five spayed female dogs develops urinary incontinence on average about 2.9 years after being spayed, with larger breed dogs much more prone.

What’s the difference between urinary incontinence and inappropriate elimination? 

Inappropriate elimination differs from urinary incontinence. Incontinence is involuntary (meaning that the dog has no control over the urine leakage), whereas inappropriate elimination indicates that the dog does have control over their urination and is aware of where and when they are urinating. Some examples and causes of inappropriate elimination in dogs may include: 

• New puppy/pet beginning house training, or house-training errors

• Behavioral issues (territorial marking in unneutered males, submissive or fear urination, anxiety-based urination)

• No access to a relief area to urinate in

Some of the signs and symptoms of urinary incontinence in dogs may include: 

• Your dog urinates while they’re asleep (you may notice your dog wakes up with wet bedding)

• Visible dribbles of urine in the home (dribbling or larger amounts) when awake or active

• Increased thirst or drinking more water than normal 

• Wet or damp coat of hair around the vulva or prepuce (foreskin that covers the penis) or urine scalding (irritated skin) along the hind end

There are various underlying medical causes that may lead to urinary incontinence in dogs. Some of the most common causes may include:

• Urinary tract infection/UTI (or another urinary medical condition, such as cystitis, bladder stones, or kidney disease)

• Orthopedic issues or muscle weakness, which may cause it to be painful for your pet to squat/posture to urinate (a cruciate ligament tear or arthritis of the hind legs or hips, for example)

• Cognitive decline/dysfunction in senior or geriatric dogs (think of the dog version of Alzheimer’s disease)

• Excessive water consumption (which may be due to another underlying illness, such as diabetes, Cushing’s disease, or kidney disease)

• A weak bladder sphincter (which most commonly occurs in female dogs)

• A spinal cord injury or disease, especially ones affecting the lumbar spine (for example, lower body paralysis caused by intervertebral disc disease, also known as IVDD)

• A rare disorder called urethral sphincter mechanism incompetence (USMI), which is an acquired urinary incontinence that may develop after a female dog is spayed, with larger breed dogs more prone. Also known as “spay incontinence,” this may occur due to a female dog having lower levels of estrogen as a result of ovariohysterectomy (having both the ovaries and uterus surgically removed). 

• An ectopic ureter in female dogs (which is when the ureter drains to an area other than the normal area in the bladder)

A basic exam with your veterinarian will be the first step in diagnosing your dog’s urinary incontinence. They will check for any physical or behavioral abnormalities that may be causing the incontinence. They will also perform full blood work and a urinalysis, which is a laboratory test that analyzes a urine sample collected from your dog. These tests will look for any signs of a urinary tract infection or possible other underlying medical condition that may be causing the incontinence. 

Other diagnostics your veterinarian may perform include:

• Radiographs or an ultrasound of the bladder or other nearby structures

One of the first lines of treatment for urinary incontinence in male dogs is to ensure that the dog is neutered, as this may contribute to marking/territorial urination behaviors. If a male dog is experiencing urinary incontinence despite being neutered, the next line of treatment usually involves medications.

With female dogs, spaying is not necessarily the first line of treatment, as removal of the ovaries can lower estrogen levels, which can sometimes contribute to the development of urinary incontinence. Urinary incontinence in female dogs is most often treated with medications. 

Medications that may help treat and control urinary incontinence in dogs include: 

• α-Agonists (Proin): This is a type of medication that increases urethral sphincter tone and produces closure of the bladder neck This type of medication may be administered to both female and male canines. 

• Estrogens: Exactly how estrogens are beneficial to female dogs with incontinence is unclear. However, it has been found that certain estrogens (such as diethylstilbestrol, also known as DES, or estriol, which is known as Incurin) may help stimulate the neuroreceptors inside of your dog’s bladder sphincter, re-establishing urinary control and function.

• Testosterone treatments in male dogs have also been found to be appropriate for treating urinary incontinence in cases that do not respond to Proin. 

• Collagen injections: This is when collagen is injected into a dog’s urethra via an endoscopic procedure in order to create a man-made obstruction to reduce the flow of urine. This is done in cases of ectopic ureters that do not respond to surgery.

Another treatment option for urinary incontinence that does not respond to medication may include bladder surgery, such as surgical repair of the bladder sphincter. Other times, surgery may be considered as treatment if the underlying cause is due to a specific condition that requires surgical correction, such as an ectopic ureter or IVDD. 

Is there a cure for urinary incontinence in dogs?

Urinary incontinence may in some cases be cured, depending on the underlying cause. For instance, if a urinary tract infection is the cause, once the infection is treated and cleared, any secondary urinary incontinence also resolves. 

Most cases of urinary incontinence that are not cured are still able to be successfully managed through the administration of daily medications that may help improve bladder function. 

Is urinary incontinence in dogs contagious for humans or other pets? 

No, urinary incontinence in dogs is not contagious for humans or other pets, unless the underlying cause is due to a zoonotic disease (meaning an infection that may be passed from dog to human or human to dog).

Recovery of urinary incontinence is dependent on the underlying cause. In most cases of incontinence, once medication is started, a dog may start seeing improvement of their signs and symptoms within just a few weeks. 

If your dog is receiving treatment for urinary incontinence, your veterinarian will want to monitor their blood work on a regular basis to ensure that the prescribed medications are not causing any side effects.

Some tips for in-home management of urinary incontinence in dogs include:

• Dog diapers: Dog diapers come in both male- and female-specific varieties, and they may be purchased at any pet store or online. You must be careful with these as they can lead to skin infections from urine scald if not changed regularly.

• Pee pads: These may be placed on the floor or furniture to help absorb any urinary accidents

• Enzymatic cleaners may help remove odors (this works by breaking down the actual urine molecules, instead of only covering them up).

There is no current prevention for the development of urinary incontinence in dogs. 

While messy and sometimes frustrating to deal with, both as an owner and for your dog, urinary incontinence is an easily diagnosed and treated condition, with which your dog may continue to live a long and happy life.