Written by Tamsin De La Harpe
Medically approved by Cathy Piche BA, RVT, CCRP
Written by Tamsin De La Harpe
Medically approved by Cathy Piche BA, RVT, CCRP
Dog incontinence is a common issue, and a dog that can't hold pee or is leaking urine all over the house is tricky for a pet parent to navigate. Although it can occur at any age, bladder control incontinence is most often seen in female and senior dogs.
A dog that is dripping urine is not only an issue of smell and hygiene but often a symptom of underlying health issues. Overexertion or stress can cause incontinence in dogs, and it can disappear as quickly as it appears. Additionally, medical conditions can begin slowly or suddenly and become a chronic problem if left untreated. So let's look at some of the causes and solutions for dogs who can't hold their pee.
There are plenty of reasons why your dog may be incontinent. Urinary tract disorders and bladder infections are just a few possible causes. In addition, if left untreated, dog incontinence usually worsens over time. Here are some symptoms of urinary incontinence in dogs:
If your house-trained dog suddenly becomes incontinent, there may be an underlying health problem. In this case, it is vital to note when this happens and in what context. Dogs with genuine urinary or urethral incontinence often pee while resting or sleeping with no obvious triggers. A relaxed or sleeping dog that can't hold their bladder is usually a sign of an underlying issue, such as age-related incontinence, urinary tract infections, or diabetes.
At the same time, dog owners can mistake puddles of urine around the house for incontinence, but this can also indicate behavior problems and not a health issue. Again, context is everything.
For example, dogs with separation anxiety may pee in the house while their owners are gone, or a dog with noise phobia might pee during a thunderstorm.
A male dog could also begin marking in the house if they are not neutered or feel threatened by other dogs. Although this last example is not a bladder control problem, it could still be a reason why you’re suddenly finding puddles around the house.
While it's not always immediately apparent why your dog has suddenly become incontinent, there are several possible reasons:
Both male and female neutered dogs can experience hormone-responsive incontinence, but female dogs are more likely to have trouble with it. Dogs with low estrogen levels, obesity, and larger breed size can experience bladder sphincter and valve laxity, leading to urine leakage, especially while they sleep. Symptoms of hormone-related incontinence can develop in a neutered pet months or even years after the procedure.
A dog leaking urine may be under stress. This happens because of the dog's inability to regulate the muscles in a stressful situation. A dog may become stressed for many reasons, such as a new environment, loud noises, strangers, the presence of another more intimidating dog, or changes at home. Fearful dogs are particularly prone to peeing under stress.
Incontinence can occur in dogs suffering from anxiety, particularly separation anxiety. A dog with separation anxiety will usually begin barking and exhibiting other distress behaviors within minutes of being left alone. This can include frantic attempts to escape their house, digging, destructive chewing, defecating, or peeing in the house.
Urinary ectopia is a common physical cause of urinary incontinence. This birth defect causes one or both ureters to enter the bladder neck incorrectly, for instance, into the urinary tract or vagina. Dogs with ureteral ectopia will have incontinence from the time they are born.
Urinary and fecal incontinence can be permanent consequences of spinal cord injuries. Storage and emptying are the two primary functions of the bladder and bowel. Both are affected after a severe spinal cord injury, as damaged nerves can't control full bladders.
In rare cases, dogs can suffer a stroke. One example is fibrocartilaginous embolism, or FCE. This is a scary situation where a piece of cartilage can block the blood flow in the spine. The good news is that dedication and physical therapy can help your dog recover over time.
Dogs diagnosed with diabetes insipidus (DI) excrete large amounts of highly diluted urine. Dogs that need to pee so much may become incontinent or unable to regulate how fast urine exits their bodies. As a result, even though the dog drinks a lot of water, they can still become dehydrated.
Dogs with diabetes also drink more water and can exhibit extreme thirst. All this water drinking can cause bladder control problems.
Some medications could cause your dog to leak urine as a side effect. Prednisone, a cortisone derivative, and furosemide, a diuretic, are two commonly prescribed drugs that can increase thirst. Like diabetes, an increase in water consumption can lead to increased urination and leakage.
Dribbling pee can occur due to a urinary tract infection (UTI). In many cases, a bladder infection or vaginitis in female dogs causes an inflamed sphincter, resulting in the dog leaking urine when relaxed. However, if dogs suffer from urinary incontinence, they are also more likely to develop UTIs. So the two issues can compound one another.
Incontinence is less common in male dogs than in female dogs. Urinary incontinence in male dogs is frequently caused by UTIs, old age, and prostate disease. Unlike female dogs, male dogs have no increased risk of incontinence due to their body weight or neutering.
Bacterial prostatitis frequently coexists with urinary tract infections. This is a common prostate disease in intact male dogs. As a result, the infection spreads to the urinary tract because of the prostatic fluid that leaks into the bladder. An intact dog with this illness may have a problem holding their pee.
The urethral sphincter mechanism incompetence (USMI) is one of the most common causes of incontinence. Dogs with this condition lack strength in the muscles that regulate urine output from the bladder. The most commonly affected dogs are female, spayed, and of a middle or older age.
Hormone imbalances can occur after a female dog is spayed. This is because the urinary tract tissue's proper functioning depends on adequate estrogen exposure, and a pet's estrogen levels are low after her ovaries have been removed. This can lead to a weaker urethral sphincter, the muscle that controls the flow of urine out of the urethra.
Treatment with reproductive hormones is often effective in treating the condition, which is commonly hormone-responsive. Supplementing the female dog's hormones may help treat USMI.
When you see your aging dog can't hold their pee any longer, it can be a distressing sign that your pet's quality of life is deteriorating. Unfortunately, it's normal for dogs to lose control of their bowels and bladder as they get older. Some dogs may have only a few mishaps, but others may lose their ability to contain their bladders completely.
In older dogs, bladder leaks are a common occurrence, the urethral muscles are simply weaker than they used to be.
Dog incontinence often begins in their mature or middle-aged stages of life. USMI is thought to be caused by a variety of factors. Some examples are changes to the vaginal support structures, genetics, estrogen deficiency or decline, and abnormal bladder positioning.
Urinary incontinence is a problem that affects some dog breeds more than others. In addition, purebred dogs are more likely to suffer from involuntary leaks than their crossbred counterparts, as line breeding can cause more genetic problems. Breeds that are more prone to incontinence include:
Most pet owners will notice their dog leaking urine while asleep or on the bed resting. Sometimes owners find small pools of where their dog was sitting or lying.
If you notice your dog urinating while sleeping or resting, they may have urinary incontinence. This is most likely to happen to spayed female dogs in their middle years. This is because estrogen and progesterone strengthen the muscles that keep urine in the bladder.
Female dogs that have been spayed have lower levels of estrogen and progesterone. On the other hand, testosterone, a hormone found in male dogs, aids in the strengthening of the muscles that lead out of the urinary bladder. As a result, neutered male dogs are also more likely than unneutered dogs to experience urinary incontinence.
While your pet sleeps, the muscles that keep urine from leaking from the bladder relax. Therefore, if they have any underlying health issues, they may experience urine leakage during this time. In addition, during the night, dogs are most likely to go without a bathroom break for longer when sleeping, making a full bladder part of the problem.
Urinary incontinence in dogs is treatable, even curable. For example, your vet can prescribe drugs to strengthen the bladder muscles if no specific cause for incontinence can be found.
Medication can be tried in different doses until an effective combination is found. Phenylpropanolamine (PPA) is a frequently used dog incontinence medicine because it’s well-tolerated by several dogs and has been extensively used in veterinary medicine. However, pet parents should monitor their dogs closely on this medication due to the risks and potential side effects.
Hormone therapy can help spayed female dogs. Sometimes, males may benefit from testosterone injections, but this is less common. These drugs can affect the bone marrow; your vet will need to do frequent blood work with this therapy.
If medical treatment does not work, surgical therapy may be an option. There are various surgical options, including colposuspension, injections of bulking agents like collagen, and stem cell therapy.
Therapy works well for many dogs and they can enjoy a normal life with their families with proper care and attention. Unfortunately, once a dog begins taking medication for incontinence, it's usually for the rest of their life.
Dog diapers could be helpful to avoid messes, but you must be on the lookout for any signs of urine scalding or infection on the dog's skin. If your dog's skin is exposed to urine for an extended period, they could suffer from discomfort or an infection.
A variety of home remedies for dog incontinence can be very helpful in the fight against urinary incontinence. In addition, many natural and alternative treatments can be used in conjunction with conventional treatment.
You can start by assessing your dog's lifestyle and diet. Problems like a UTI or kidney issues usually benefit from more moisture with their food. Proper hydration is absolutely key for renal tract and bladder problems. Adding a cup of water to their kibble can help take the pressure off their kidneys and liver, rather than relying on completely dry kibble.
Issues like kidney stones also need diets specific to the dog's kind of stone, while a dog with diabetes often benefits from a high-fiber, high-protein diet.
Older dogs without renal or kidney issues also have a greater need for protein. They don't have a problem absorbing amino acids in a protein, but they can have a problem synthesizing them in the body.
Certain amino acids, like L-arginine, are necessary to clear out ammonia build-up in the body, which can help the urinary tract. Similarly, other compounds like L-carnitine help build muscle and may prevent the muscles in the urinary tract from atrophying. However, keep in mind that not every dog benefits from the same diet. Dogs who have kidney or liver problems may need to move to a low-protein diet.
If you are considering moving to a raw meat diet, you can read our article here.
Exercise and playtime can also help indirectly. While you can't make your female dog do kegel exercises like humans, exercise can still reduce stress hormones and help with anxiety issues. Keeping your dog fit and as active as possible may not specifically help incontinence, but it can help their overall well-being and bodily functioning.
Cranberry supplements may also help alleviate the symptoms of a urinary tract infection while also promoting good bladder health. Cranberry extract can block the harmful bacteria from attaching to the bladder wall, allowing them to be flushed out of your dog's system. The research is promising, but the total amount of actual cranberry extract is vital. Cranberries added in dog food are usually not enough to prevent UTIs, so reliable, dog specific supplements are necessary.
Another home remedy for incontinence worth exploring is corn silk supplements. Corn silk contains mucilage, a thick gel-like substance that coats the interior of the bladder. It can also soothe any irritation in your pet's urinary tract if infected and has a mild diuretic effect. In addition, phytoestrogens found in corn silk may help with spay incontinence.
If your dog’s leaking urine frequently due to fear or anxiety, help them by identifying the type of anxiety they're experiencing and potential triggers. Then, you can make changes to avoid these triggers. For example, increasing exercise and using positive reinforcement to help your dog learn place or crate training can help reduce separation anxiety.
Training for anxiety-inducing behaviors is another way you can help alleviate the condition. To improve your dog's quality of life without altering their routine, you can also:
Urinary incontinence is a distressing condition that can affect the relationship between pet owners and their dogs. The condition must be carefully managed to avoid welfare issues for the affected dogs, such as urinary tract infections and skin sores from urine leakage. The good news is that making a few lifestyle, diet, and supplement changes can help alleviate or prevent incontinence in dogs.
While incontinence is common in aging dogs, it can also signify a more serious health problem. If you suspect a more serious problem, it is always good to consult with your veterinarian for a more accurate diagnosis and treatment plan.