What causes incontinence in dogs and what would be the treatment?

Original Question: For the last 6 weeks Abby has been leaking urine, sometimes quite a bit. Abby will still go outside and urinate. Abby started two pills a day of Proin and was increased to 2.5 pills a day with no change. The vet said we will stop the medication if it is not improving the situation. The vet is not sure what is causing this and I am looking for a solution and some answers. Thank you. - Barb

Dec 25, 2018

Hi Barb,

Thanks for the question.

Incontinence is a common problem in dogs and it has different causes. Since it has different causes, the treatment can be very different in each case.

Here is a short list of common causes and points for either urinary or fecal incontinence:

Bladder infection (urinary) – infections can cause urinary incontinence because the irritation makes dogs want to urinate often and in small amounts. This is called pollakiuria. The first test performed is typically a urinalysis and ideally a culture and sensitivity in order to identify the bacteria and antibiotic that would eliminate it.
Urinary sphincter atony (urinary) caused by a lack of estrogen and this is commonly seen in female dogs after spaying. The urinary sphincter becomes loose because of the lack of estrogen which acts to prime the tone of the sphincter. A classic example of this is a dog getting up from its bed after sleeping only to reveal a small urine stain that is present there as it tends to leak out during sleep. This can be treated with estrogen supplementation or a drug that acts to increase the tone of the sphincter through neurological action.
Urinary sphincter impairment (urinary) – this could be due to a traumatic injury affecting the sphincter or nerve that controls it (such as hit by car), spinal injury that impairs neurological control of the nerve, neurological decline, mass lesions in the bladder physically damaging the sphincter to name a few. The diagnosis of these is based on ruling out other causes, lack of response to treatment, radiographs, contrast radiographs, ultrasound and neurological examination.
Cognitive dysfunction/senility (fecal and urinary) – in older age, dogs can experience senility and lack the ability to discern where it is appropriate to eliminate. There are vitamins and diets that are meant to help reduce the decline they experience.
Anxiety (fecal and urinary) – dogs that are under a level of stress can start to eliminate inappropriately. Assessing this requires ruling out other causes with tests and a thorough history to understand the likelihood of it. Multiple anti-anxiety treatments are available and they span from behavioural modification, environmental management, natural supplements and medication.

These are the most common reasons for incontinence. Others exist but they are less common. I recommend that you work with your veterinarian to identify what cause may be present in your dog.