dog pee

Urinary Incontinence In Dogs

Diane Weinmann Animal Health, animal hospice , , , ,

Urinary Incontinence In Dogs

by Jean Hofve DVM

Urinary incontinence in dogs, means your dog has the inability to retain urine in his bladder … in other words, bladder leaks.

The urinary system is quite elegant. Urine is produced by the kidneys and fed through the ureters to the bladder. A sphincter (circular muscle) keeps the passage to outside closed until it’s voluntarily opened during urination. At that point, urine flows through the urethra to whatever object your dog decides to gift with his or her scent.

When the sphincter doesn’t stay fully tightened, involuntary leakage occurs. If the bladder is too full, urine can overflow into the urethra and escape. This often happens while your dog is resting or sleeping, or when she gets up from lying down.

Dribbling urine can also be a behavior issue if it happens when your dog is frightened or being submissive.

Signs Of Incontinence In Dogs

I probably don’t need to tell you how you’ll know your dog is incontinent. It’s usually pretty obvious!

The most common sign of urinary incontinence in dogs is wet spots wherever your dog sleeps. 

You might also notice …

  • Dampness around the hindquarters and thighs
  • Dribbling urine as she walks
  • Irritated skin or redness from the dripping (urine is caustic and can burn)
  • Licking the vulva or penis more than usual
  • Dribbling urine when she is excited, frightened, submissive, or stressed

What Causes Incontinence In Dogs

There are many potential causes and contributors to incontinence, including:

What this adds up to is the need for adequate testing to pin down an accurate diagnosis.

Breeds Prone to Incontinence

Research shows that females are more prone to urinary incontinence in dogs than males. Two UK studies found that urinary incontinence affects 3% of females overall, but more than 15% in high risk breeds. These include …

  • Irish Setter
  • Doberman
  • Bearded Collie
  • Rough Collie
  • Dalmatian

Prevalence in males is less than 1%, with breeds affected including …

  • Bull Mastiff
  • Irish Red Setter
  • Fox terrier
  • Bulldog
  • Boxer

Spay/Neuter Increases Incontinence

Urinary incontinence in dogs is more likely in spayed females, especially if they’re spayed early.  One study of 492 female dogs concluded that …

“Neutering itself and early-age neutering (<6 months) are major risk factors for early-onset urinary incontinence.”

Another study found that size was a factor in spayed females developing USMI (urinary sphincter incompetence). For every month neuter was delayed in the dogs’ first year, the risk of USMI was reduced in dogs weighing over 25 kg. The risk did not change for dogs under 15 kg.

So, if you decide to spay your dog of 50 lbs or more, it’s best to defer the procedure as long as you can.

RELATED: Read about other risks of early spay/neuter.

How Vets Diagnose Incontinence

Your vet will do (at least) a thorough physical exam, standard blood tests and urinalysis.

If these tests don’t point to an answer, your vet may do more specialized blood tests, urine culture, radiographs, ultrasound, or other types of scans.

If leaks started when your dog was very young, and the vet suspects an anatomical abnormality like ectopic ureter (see below), she may do a dye “urography” that traces the course of the ureter.

You want to determine the cause of your dog’s incontinence so you can treat it appropriately.  For example …

  • An older spayed female dog is most likely to have estrogen-responsive incontinence from spaying. But you don’t want to waste time and money treating that when the real problem may be something else that requires very different therapies.
  • Ectopic ureters or other anatomical issues may be corrected with surgery.
  • Incontinent dogs are more likely to develop urinary tract infections. That’s because the presence of urine in the urethra can provide a route for bacteria to climb up to the bladder and set up housekeeping.
  • If the problem is a urinary tract infection or uroliths (stones), then resolving that problem may quickly take care of the incontinence.
  • The same applies to hormonal issues that can be treated appropriately.

PRO TIP

Before we get to the details, my #1 recommendation for any kind of bladder problem is protect your stuff! Managing a dog with incontinence, a UTI, or inappropriate urination for any reason is unpleasant and frustrating.

Waterproof dog beds and washable pee pads make clean-up easy and convenient. If your dog sleeps on the bed, at the very least get a waterproof mattress pad, and perhaps a flannel or comfy waterproof flat sheet to put over the covers. Temporary use of doggy diapers may also reduce the emotional toll on the human family.

Conventional Treatments For Incontinence

There are several conventional approaches to treating incontinence problems.

Phenylpropanolamine (Proin®, Propalin®)

This drug releases chemicals that strengthen the bladder sphincter muscles. It’s not a cure … so if your dog stops taking it, she’ll go back to leaking urine.

Side effects in the manufacturer’s clinical trials included …

  • Vomiting
  • High blood pressure
  • Diarrhea
  • Lack of appetite
  • Weight loss
  • Proteinuria (protein in the urine)
  • Excessive thirst
  • Restlessness or difficulty sleeping
  • Irritability or anxiety
  • Lethargy

Some more serious side effects can occur, usually at higher dosages. These include cardiac issues, tremors and difficulty urinating.

At low doses the risk of side effects is minimal, so some holistic vets may use this drug along with other alternative therapies.

Estrogen (Estriol/Incurin, DES)

This synthetic estrogen drug is often used for females with spay incontinence.  It comes with quite a list of side effects. Studies show adverse effects like …

  • Vomiting
  • Swollen/itchy vulva
  • Lethargy
  • Aggression (leading to euthanasia in some cases)
  • Hyperpigmentation and lichenification of vulva (black skin spots and thickened skin)
  • Hair loss
  • Vaginal hemorrhage
  • Seizures

Those are quite unpleasant side effects. But this drug also has some even more serious risks. It may cause cancer and bone marrow toxicity. There are good non-pharmaceutical substitutes.

Surgery To Correct Anatomical Abnormalities

If your dog’s incontinence is caused by an anatomical abnormality, your vet may recommend surgery.

The most likely kind of abnormality is ectopic ureter. It’s fairly rare, with reported incidence of less than 0.1%.

The ureters transport urine from the kidneys to the bladder. Ectopic ureter means that one or both ureters by-pass the bladder and connect to the urethra, uterus or vagina. This can cause continual dripping of urine.

This problem is usually seen in 3 to 6 month old dogs, and females are 8 times more prone than males.

High risk breeds for this problem are …

  • Siberian Husky
  • Miniature and Toy Poodle
  • Labrador Retriever
  • Collie
  • Welsh Corgi
  • Wire-haired Fox Terrier
  • West Highland White Terrier

This condition may be corrected with surgery to redirect the ureter into the bladder.

A less invasive method is cystoscopic-guided laser ablation. It’s done under anesthesia and involves inserting a ureteral catheter into the ectopic ureter. A laser then “ablates” (removes) the wall of the ureter. This effectively moves the opening from the urethra to the bladder. One study showed a 47% success rate for this procedure.

PRO TIP

However you decide to treat your dog’s incontinence … adjust and increase your dog’s potty break time. This will help reduce the amount of urine in the bladder at any one time.  Make sure she goes out to pee before you leave for work or school, and right before bedtime.

Natural Treatments For Incontinence

These are some of my favorite alternative approaches for urinary incontinence In dogs.

Chiropractic, Acupuncture, And Osteopathy

These hands-on treatments are excellent choices that can be very successful in resolving incontinence. They’re especially effective if urinary incontinence in dogs is due to physical issues like spine misalignment, muscle spasms, or nerve injury or impairment.

Read how to find a practitioner under the “Find A Holistic Vet” section below. You may also be able to find a local veterinary rehab facility that offers these modalities.

Herbs And Nutraceuticals

These are some effective options, depending on the cause of your dog’s incontinence.

  • Wild Yam extract has estrogenic and anti-spasmodic effects, but may require fairly high doses (100 mg per 25 lbs. body weight). It’s often included in herbal blends with Rehmannia, licorice, red clover, cranberry, and other herbs. Follow package directions for products intended for dogs. If using a human product, the dose is based on a 150 lb person, so reduce the dose proportionally for your dog’s weight.
  • Soy isoflavones are the best natural substitute for estrogen, but be sure you choose an organic product, since most soy in the U.S. is GMO (genetically engineered). Vetriscience Vetri-Bladder chews are a good choice; give 1 chew per 30 lbs. body weight once a day. The same dose applies to their canine Bladder Strength tablet, which also contains supportive herbs.
  • Estroven® contains Rheum raponiticum extract. he dose is based on a 150-lb person, so reduce the dose proportionally for your dog’s weight. It may work by itself or need to be combined with estrogenic herbs. Estrogenic herbs include soy, Mexican wild yam, black cohosh, dong quai, red clover.  It’s best to ask a holistic vet or herbalist for help using these herbs.
  • Herbs that are good for urinary tract infections (if that’s the cause of your dog’s leakage) include cranberry, ginger, turmeric, olive leaf, and uva ursi. Cranberry prevents E. coli bacteria from attaching to the bladder wall; olive leaf has antibiotic properties; uva ursi is antiseptic and anti-inflammatory; turmeric and ginger are great antioxidant and anti-inflammatory herbs. They are available in a wide variety of combinations, usually with other natural antioxidants.
  • Anti-arthritic herbs, such as turmeric, ginger, Boswellia, yucca, and barberry, have antioxidant and anti-inflammatory effects. Antioxidants work best in combination; many such products are available, but my favorite (which I take myself!) is Boswellia Complex by Standard Process. A small or medium size dog can take 1/2 tablet twice a day; for large and giant breeds, give a whole tablet twice a day. CBD also relieves pain and may be a good adjunct.
  • Chinese herbs are very useful; but it’s important to work with a veterinarian trained and experienced in Traditional Chinese Veterinary Medicine. These herbs are powerful, and appropriate formulas must be individualized for your dog.
  • Glandular support. Here again, Standard Process shines. Symplex F is excellent as a replacement for hormones missing due to spaying. Symplex M is for neutered male dogs. Both products also support the thyroid, adrenal, and pituitary glands. Both synergize well with Vasculin, which contains a multitude of herbs and vitamins that support healthy blood vessel and nerve function.
  • Omega-3 fatty acids from a marine source have antioxidant and anti-inflammatory properties.
  • Protein and collagen are both important for any muscle, including the bladder sphincter. The bladder itself is also a muscular organ. Protein is also a natural urinary acidifier. Bone broth and a higher protein diet may be helpful.

Homeopathy

A good homeopath can work virtual miracles. There are many remedies indicated for urinary incontinence in dogs, but it’s important to work with a qualified homeopathic veterinarian. The choice of remedy and potency must be highly individualized for not only incontinence, but also for the dog’s personality, environment, history, and many other factors. 

I have seen homeopathy restore bladder and bowel control in a dog who had been hit by a car, after months of unsuccessful medical management. Find a homeopath at The Academy of Veterinary Homeopathy (AVH).

RELATED: Homeopathy Basic For Dogs

The next two approaches are newer and less common, but worth exploring with your holistic vet. Studies show promising results with these therapies.

Botulinum Toxin Injections

Research has found that injections of Clostridium botulinum toxin into the bladder wall (50-100 botulinum toxin units per animal in 10 injections) successfully prevented recurrence of incontinence in dogs for up to 5 months.

Electrical Stimulation

Researchers are currently experimenting with implants that provide electric stimulation to the nerves in dogs with a spinal cord injury. While it’s not likely to be coming to your local veterinary clinic, veterinary teaching hospitals may incorporate it in the not-too-distant future.

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Support Your Dog’s Overall Health

Finally, as with all chronic health problems, it’s important to keep your dog as healthy overall as you can.

Not all incontinent dogs can be completely cured. But with the right management and therapies, it can be well controlled … so you and your dog can enjoy a long, happy, and puddle-free life together.

What Does a Dog’s Peeing Position Mean?

Diane Weinmann Animal Health, animal hospice , , ,

By Jennifer Coates, DVM

An old study from the 1970s identified 12 positions that 60 intact male and 53 intact female adult beagles used to pee:

  • Stand: Standing normally
  • Lean: The body is leaning forward and the hind legs are extended to the back.
  • Flex: The hind legs are partially flexed so the rear end is slightly lowered. The hind feet usually remain under the body (no straddle).
  • Squat: The hind legs are straddled and sharply bent to bring the hind end close to the ground. The back is kept straight.
  • Handstand: Both hind feet are lifted off the ground. They may be unsupported or placed against a vertical surface.
  • Arch: The hind legs are usually spread and bent to bring the hind end close to the ground. The back is rounded, and the tail is lifted away from the ground.
  • Raise: One hind leg is bent and raised off the ground but the leg is kept relatively low.
  • Elevate: One hind leg is bent and raised off the ground. The foot and leg is held high.
  • Lean-Raise: A combination of the Lean and Raise postures.
  • Flex-Raise: A combination of the Flex and Raise postures.
  • Squat-Raise: A combination of the Squat and Raise postures.
  • Arch-Raise: A combination of the Arch and Raise postures.

The researchers found that females squatted most of the time but that the squat-raise was also quite popular. Females used most of the other positions too, albeit on a limited basis. Male dogs, on the other hand, had a more restricted repertoire. All of them demonstrated the elevate posture and some used the raised position, but the squat-raise and lean-raise only occurred rarely and the other positions weren’t noted at all. Keep in mind, however, that all the male dogs in this study were mature and intact.

 

What Does a Dog’s Peeing Position Mean?

 

Now that all the positions that a dog is likely to take to urinate have been identified, the question “Why?” has to be asked. What does it mean when a dog picks a particular posture at a particular time?

It’s important to remember that urination serves two purposes for dogs—elimination and marking. Both male and female dogs scent mark, but the behavior is more pervasive in males. Dogs who are marking preferentially urinate on vertical surfaces. If they urinate high up on that surface, the urine can flow downward covering a greater area, which leaves a stronger message to anyone who subsequently passes by. Peeing up high may even make a dog seem bigger than he actually is. This is probably why the elevate posture is so popular among males.

Interestingly, leg-raising is a behavior that only develops in male dogs as they mature. The authors of the study on beagles note that the lean posture, which deposits urine directly on the ground, “is typically used by male puppies and juveniles.”

But what about females? That’s where the handstand posture comes in. There’s no better way for a female dog to urinate at least as high as and maybe even higher than a similarly sized male can.

Research supports this hypothesis in female dogs. A paper published in 2004 looked at the urinary behaviors of six spayed and six intact female Jack Russell Terriers while they were being walked close to and further away from their “home area.” The scientists found that when away from their home area, these dogs were more likely to urinate frequently and aim their urine at objects in comparison to when they were walked close to home. The authors concluded “urination in female dogs does not function solely in elimination, but that it also has a significant role in scent marking…”

So, when dogs take a position that results in their urine hitting an object above the ground’s surface, chances are they are doing so to maximize the value of the scent they are leaving behind.

It’s important to note how many peeing positions are perfectly normal for both male and female dogs. Which ones they use depends on many factors including the dog’s location, age, sex, and possibly their reproductive status. The only time to be concerned is when a dog that usually pees in one position switches to another. This could be a sign of pain or another medical problem that needs to be addressed.

Problem Urination in Dogs

Diane Weinmann Animal Health, healing your pet ,

By Dr. Becker

If when you arrive home your excited, delighted dog leaves a little puddle of pee at your feet (or even on your feet), it could be your furry family member is dealing with a submissive or excitement urination problem.

It’s important to understand your piddling pooch has very little control over the situation, so it’s pointless, unkind and confusing to punish her for the behavior.

The first thing to do is make an appointment with your veterinarian to rule out a physical cause for her random peeing. Urinary incontinence is a disorder with similar symptoms but very different causes.

These can include a birth defect, central nervous system trauma, damage to the pudendal nerve, bladder stones or a urethral obstruction, age or hormone-related incontinence, or a disease of the kidneys, adrenal glands, or the bladder (including infection).

Many causes of urinary incontinence are serious and require medical intervention, so it’s essential to rule all those things out before deciding your dog’s dribbling problem is behavioral in nature.

Once your veterinarian gives your pet a clean bill of health, the next step is to determine the trigger for his inappropriate urination.

Excitement Urination

Generally speaking, if your dog doesn’t pee when you look him in the eye, bend over him, or greet him face-to-face – in other words, when you’re in what canines consider a dominant position – he’s an excited rather than a submissive dribbler.

His triggers are probably playtime and when family members come home or guests drop by. If he’s still a puppy, he’ll quite likely outgrow the problem if addressed correctly, so the challenge is to avoid as many triggers as possible.

Managing Excitement Triggers

Take playtime outdoors whenever possible, and when it isn’t possible, make sure your dog has had a chance to relieve himself before engaging in play. Prepare an area of your floor with newspaper or puppy pads before play begins.

This should help keep accidents to a minimum, but when he has one (and he will), don’t discipline or punish him.

The best approach is to simply stop the action, grab some treats, and take him outside to his potty spot (or to his puppy pad). Give him lavish praise and treats the second he pees where he should. Once that’s done, clean the floor without making a fuss.

If your dog tends to leak when you come home, make sure to keep greetings on your end very low key. Move around quietly and speak in a calm, soothing tone.

If that doesn’t alleviate the leaking, try ignoring him when you first arrive home to help him learn to calm down on his own. Once he’s relaxed and if he hasn’t peed, offer him praise and treats.

Boosting a Submissive Dog’s Self-Confidence

Submissive peeing is most often seen in timid, nervous, shy dogs. Common triggers for these dogs include being greeted or approached by someone, or being yelled at or disciplined. Many pets with this problem have a history of receiving harsh punishment for peeing accidents.

If your dog has a submissive urination problem, it’s extremely important to avoid scolding or punishing her when she has an accident. This will only increase her anxiety and make peeing mistakes more likely.

A much better approach is to give your dog plenty of affirmative, high quality attention to build her confidence. Use positive reinforcement behavior training to teach her basic commands like sit, stay, come, and drop it, as well as simple tricks. Lavish her with praise each time she does what you ask.

The goal is to give your dog tons of opportunities to succeed and earn praise, while avoiding situations that trigger submissive peeing.

How to Approach a Submissive Dog

It’s also important to approach a submissive dog using non-dominant body language, which means you should:

·     Avoid direct eye contact

·     Approach from the side vs. head-on

·     Lower yourself to your dog’s level

·     Scratch her under the chin vs. the top of the head

When your shy dog has an accident (and she will), as I mentioned earlier, it’s extremely important not to raise your voice or punish her. Instead, handle the situation as I outlined above for dogs with excitement peeing.

Calmly get a few treats and take your pup outside to her potty spot (or to her puppy pad). Praise her like crazy and offer treats the second she pees where she should.

If she tends to dribble when you arrive home, make sure to keep greetings low key. You can also try ignoring her when you first come through the door to help her learn to self-soothe. Once she’s calm and as long as she hasn’t peed, give her some loving attention and treats.

Additional Suggestions

Something else to consider is a wrap (belly band) for male dogs or bloomers (I call them hot pants) if your dog is female.

 

You can put it on before indoor playtime or when you’re expecting guests. It’s important to remove it once the situational trigger has passed, since you never want to leave urine against your dog’s skin.

A wrap or bloomers will not only save your floor, it may also help gently remind your pup that if he pees, he won’t be able to walk away from it. Canines are naturally disinclined to soil themselves. I have clients whose dogs have been completely cured of excited or submissive urination after a few weeks or months of wearing a wrap.

It’s also important with a leaky dog to continue to offer lots of praise and treats whenever he pees in his outdoor potty spot and on walks.