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This month I’m going to cover the first of two conditions or diseases that can affect your older dog or cat’s lower urinary tract, specifically the bladder. These conditions are urinary incontinence and urinary tract infections. I’ll cover urinary incontinence in this column.


Urinary incontinence (UI) is defined as the involuntary dribbling or leakage of urine. The most common type of UI in older pets is usually found in older spayed female dogs. It is caused by a weakened bladder sphincter. A sphincter is a ring of muscle at the neck (bottom) of the bladder. When these muscles contract, the urine is kept in the bladder; when they relax or don’t contract strongly enough, urine can pass out from the bladder through the tube called the urethra to the outside.


A dog or cat with this type of urinary incontinence usually dribbles urine when she is lying down. After she’s been lying down for a while, when she gets up you’ll notice urine where she’s been resting: on her bedding or the floor or furniture. It is pretty rare to see her dribbling urine as she walks around..


If spots or pools of urine on the bedding, floor, or furniture come about from your dog voluntarily squatting or lifting (his) leg to urinate on those areas, then she doesn’t have UI.


Some older animals, especially dogs with the senility of canine cognitive disorder, will urinate in the house, but in this case, they squat or lift their leg to urinate (forgetting former housetraining rules). The same can be true for older, arthritic animals who can’t make it outside in time, or who don’t want to go outside to eliminate if the weather is too cold or wet. In all these cases it’s not a case of leaking urine while they’re lying down.


You may have to observe your animal for a while to see which of these scenarios is going on with her or him.

With the simple UI of weakened bladder sphincters, the urine usually doesn’t have a bad odor (unless it’s been collecting unnoticed for a while), for older animals’ urine is usually pretty dilute. There also shouldn’t be any blood in it. (These are more signs of a urinary tract infection or UTI. These will be discussed in next month’s column.)


If you’re finding your older dog or cat is “wetting her bed”, you should take her in to your veterinarian to be checked over and to have some urine tests run - probably at least a complete urinalysis (UA) and possibly a urine culture. A blood panel and/or X-rays may also be done to check for other types of organic or skeletal disease if these are suspected.


UI due to weakened bladder sphincter is diagnosed if the UA is pretty much within normal limits for an older animal, if there is no sign of infection in the urine culture, and if the physical exam and other diagnostic tests show no signs of conditions such as spinal injuries/disease, diabetes mellitus, kidney disease, or Cushings disease. (Spinal injuries can cause incontinence if the nerves controlling the muscles of the bladder and sphincters are damaged. In diseases such as diabetes mellitus, kidney disease, and Cushings disease, the patient drinks excessive amounts of water, causing such large amounts of urine to be produced that the bladder can’t always hold it all, so some leaks out.)


So, assuming your older dog or cat has been diagnosed with simple, uncomplicated urinary incontinence due to a weakened bladder sphincter, how is she to be treated?


Most animals with this condition (remember, they’re usually older, spayed female dogs) respond very well to treatment. One of two different kinds of drugs is used for it: either diethylstilbestrol (DES), a female hormone (the male hormone testosterone works better for the few older male dogs affected with this condition), or phenylpropanolamine (PPA), a drug which has also been used as a nasal decongestant and an appetite suppressant. These medications help to “tighten up” the bladder sphincter. Used properly, there are few unwanted side effects with these drugs, and they usually bring about a cessation of the incontinence fairly soon after they are started. The one drawback is that the medication(s) have to be given for life, or the problem will return.


If you have access to a holistic veterinarian, acupuncture, chiropractic, and herbal formulae can also be helpful in the treatment of simple UI. They may or may not be sufficient by themselves to resolve the condition, but they vary well may allow lower dosages/frequency of whichever drug has been described. (As I’ve written here before, don’t try herbs, supplements, etc without consulting your veterinarian.)

Next month I’ll write about urinary tract infections.

Dr. Kathleen Carson, DVM
Veterinarian & Author

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