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Dog: Urinary Incontinence

General information

Other common/scientific names: inappropriate urination, urethral sphincter incompetence, dribbling, unable to control bladder, USI

The urinary tract consists of the kidneys, ureters (tubes that carry urine from the kidney to the bladder), the urinary bladder and the urethra that carries urine outside the body. The bladder acts as a storage vessel for urine. At the bottom of the bladder is a urinary sphincter. Muscles around this sphincter contract to close the sphincter and keep urine in the bladder. When a dog needs to urinate, these bladder sphincter muscles relax and urine flows from the bladder to the urethra and outside the body.

Abb. GGTEP0IB
Abb. GGTEP0IB: Schematic illustration of the canine female urinary and reproductive organs.

Causes

Urinary incontinence is most commonly seen in larger breed, middle-aged, spayed females and is caused by a weakened bladder sphincter or Urethral Sphincter Incompetence (USI). The exact cause of this weakened bladder sphincter is unknown. When a female is spayed, her uterus and ovaries are removed and over time, hormone levels decline. It is theorized that the decrease in hormones results in a weakened urinary sphincter. However, other factors may contribute to a spayed female’s urinary incontinence.

Other causes of urinary incontinence include:

  • Urinary tract infection (cystitis): results in irritation to the bladder, urethral spasms and the increased urge to urinate.
  • Bladder stones (urolithiasis): results in irritation of the bladder, urethral spasms and the increased urge to urinate.
  • Excessive water consumption due diabetes mellitus, Cushing’s disease, chronic renal failure.
  • Spinal injury in the lower lumbar area resulting in damage to the nerves which control urination.
  • Submissive urination: involuntary urination seen with puppies and some adult dogs when they are frightened, insecure and overly excited.
  • Canine Cognitive Dysfunction: age related changes seen in older dogs.
  • Prostate enlargement
  • Tumors of the prostate
  • Ectopic ureters: A congenital defect seen in puppies where the ureters connect directly to the urethra, vagina or rectum instead of connecting to the bladder. Therefore, there is no storage of urine in the bladder and the puppy leaks urine.

Cardinal symptom

Dribbling urine

Symptoms

Clinical signs of urinary incontinence include dribbling of urine. Inappropriate urination is commonly seen when the dog is sleeping and very relaxed. When the dog awakes, a puddle of urine or a wet spot is seen on the rug, carpet or bedding. Dogs with urinary incontinence may have skin irritation in the genital area from the dribbling urine. These dogs may be seen excessively licking and cleaning this area and the hair may be stained and matted.

Diagnosis

All dogs which are urinating inappropriately should be examined by a veterinarian. Your dog’s age and history of symptoms will aid in the diagnosis. A urinalysis is performed to analyze the urine.

This test consists of two parts: the first examines different properties of the urine such as pH, specific gravity (concentration), amount of protein, blood, glucose, ketones and other biochemicals. This is performed by using a special reagent strip dipped in the urine. The second part of the urinalysis involves examining the sample under the microscope for abnormal cells, bacteria and crystals. A urinalysis is used to rule out a urinary tract infection, bladder stones, kidney disease, and other systemic diseases. A complete blood count (CBC), serum biochemistry and electrolyte panel, radiographs and ultrasonography may be also necessary to diagnose the cause of the incontinence.

Treatment

Urinary incontinence due to urethral sphincter incompetence is usually treated with medications to strengthen the urethral sphincter. Some dogs will need lifelong treatment.

When medical treatment is unsuccessful, reconstructive surgery can be performed to treat incontinence. There are 2-3 different surgical techniques used depending on the dog.

The newest therapy for urinary incontinence involves injecting collagen into the urethra resulting in improved urethral closure. At this time, this treatment is not commonly used but shows promise for the future.

Other cases of urinary incontinence are treated based on the underlying cause.

Prognosis

Spayed females with a weakened urethral sphincter usually respond well to medications and prognosis is good for controlling incontinence. These dogs are more prone to urinary tract infection, however. Other causes of urinary incontinence carry varying prognoses based on the original cause.

Update version: 4/24/2014, © Copyright by www.enpevet.de
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