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Understanding the Causes of Urinary Incontinence in Your Senior Dog

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Disclaimer: I am not a veterinarian and this article is not a substitute for veterinary care. Any information found on this site is meant to serve as a starting point for a conversation with your dog’s veterinarian about what options or treatments are appropriate for your dog’s specific needs.

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What is the first thing you taught your dog when he was a puppy?

What was one of the first things you asked about when you found a dog you might want to adopt?

I bet it was house-training. And for a good reason.

It’s kind of a big deal.  

I think we can all agree that a house that smells like pee is pretty much the last place you want to live.

When I was researching the questions that people were asking about caring for their aging dog, one of the biggest topics was urinary incontinence.

Many people seem to take for granted that incontinence, or the loss of bladder control in a previously housetrained dog, is a normal part of animal aging. But its’s not.

I struggled to find any exact numbers, but there were some major allusions to incontinence being a big factor in elderly dogs being abandoned in shelters or euthanized.

Which is doubly heartbreaking because there are so many available options for treating this (which I’m going to discuss in a future post).

Incontinence can happen in dogs of any age, but it is most common in older dogs. It also tends to affect female dogs more than males for reasons that will be talked about below.

Here are some of the top causes of urinary incontinence in your large, senior dog.

Hormone Changes

Just like in humans, dogs go through hormone changes as they age. These changes can have many side effects, including urinary incontinence. The most common cause of urine leakage in dogs is decreased estrogen and testosterone.

For female dogs, spaying them a little bit later has been shown to decrease the risk of developing incontinence later in life. But if your dog was adopted, you may not have had any control over this.

Dementia

Elderly dogs can be at risk for the dog equivalent of Alzheimer’s disease, known as Canine Cognitive Dysfunction (CCD). One of the symptoms can be urinating in the house.

This isn’t directly due to a medical problem, but more a result of confusion. Dogs with CCD can have episodes of forgetfulness. They may have moments where they can’t remember where they are.

If the urge to pee strikes during one of these moments, they might not recall that they are in a place where peeing isn’t allowed. Or they might not remember their training for how to alert you that they need to go outside.

Arthritis

Arthritis is another indirect cause of urinary incontinence in senior dogs. A dog with arthritis can experience pain when getting up to go outside, walking out to a potty spot, or navigating any stairs that may be involved. This can result in avoidance and holding their urine until they have an accident.

Your dog may also have difficulty lifting its leg or getting into a squatting position. This can result in them not completely emptying their bladder during a walk or potty break. Retained urine could lead to an accident later or even an infection down the line.

Neurological Issues

Nerves are like phone lines that bring messages from the brain to the body. When the phone lines are damaged or cut, the whole message might not get through. If those phone lines were supposed to go to the bladder or the muscles around it, you can have urine incontinence.

This can happen when the muscles at the neck of the bladder holding it closed become weak and urine leaks out.

This can also happen when the signals that tell the brain that the bladder is full or the return message to the bladder to empty doesn’t go through. Urine backs up in the bladder and it becomes large and distended. Eventually, it can’t hold anymore and, like a dam bursting, the bladder overflows and your dog has an accident.

Infections

Another of the common causes of urinary incontinence in dogs is a urinary tract infection (UTI). Like in humans, the urinary tract is usually sterile (there are no bacteria). If bacteria do get it, they cause problems like UTIs or bladder and kidney infections.

These infections can make going to the bathroom painful. So much so that your dog avoids it until the can’t hold it any longer and they have an accident.

If left untreated or if there are many infections, over time scarring of the bladder can develop. This scarring doesn’t allow the bladder to expand to hold urine. Your dog ends up with a sudden strong need to pee or the urge to pee much more frequently. This can result in accidents in the house if your pet can’t get outside in time.

Stones and Blockages

Stones that form in the kidney or bladder can get stuck in the urinary tract and cause obstruction. Tumors or polyps can also cause obstructions.

Partial or complete obstructions block the flow of urine out of the body, causing it to back up.

Dogs with a partial blockage of the urethra with a stone or tumor can have incontinence. They can’t fully empty their bladder. The bladder gets large from backed-up urine and the back pressure can force some urine to leak around the blockage. The enlarged bladder can usually be felt on exam.

A total blockage of urine flow is an emergency. If you suspect this, get to an emergency veterinarian immediately. A complete block can be fatal in 3 to 4 days.

Stress

Some dogs have behavioral incontinence. Too much stress or anxiety can lead to urine leakage. This isn’t true incontinence and is usually only temporary until the stressor is removed.

Senior dogs are more prone to get stressed out easily. What might seem like small changes to you can cause a lot more upset to your dog than you would expect.

The good news is that this type of incontinence is usually only temporary until the stressor is removed. Although sometimes finding the source can pose a challenge.

Drinking Too Much Water/Making Too Much Urine

Conditions such as diabetes, Cushing’s disease, or kidney problems can cause your dog to drink more water than usual.

This means they produce more urine and have to go out more frequently.

Certain types of heart medications can also cause the body to produce more urine. This is a good thing if your dog is suffering from a build-up of fluid in the body, but it can result in you and your dog needing a more frequent potty break schedule to avoid accidents.

Discussing Urinary Incontinence with Your Vet

Your vet will likely have some questions when you bring your dog in. Here is some information that will help your vet more quickly discover the problem, so you can start coming up with solutions:

  • What is your dog usually doing when they are incontinent: resting or being active?
  • When did you first notice this?
  • Is it all the time or only occasionally?
  • Did your dog have any surgeries (including spaying/neutering)?
  • Are they on any medications?
  • Do they seem to be drinking more than usual?
  • Are they acting as if they may be in pain?
  • Do they have any signs of nerve problems, like weakness or seizures?

Things to Remember

Incontinence in elderly dogs is not a normal part of the aging process any more than it is a normal part of human aging.

It is often a signal of an underlying medical condition. Proper diagnosis and treatment from your veterinarian can often improve or eliminate it.

Dogs, by nature, want to please the leader of the pack. If your dog has started having accidents in the house, he is she is probably just as upset about it as you are.

If your dog is suddenly experiencing incontinence, talk to your vet and see if one of these issues may be causing it. This is the first step in finding a solution that keeps your house clean and helps your dog carry on living a healthy, enjoyable life.

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