Urinary incontinence

What is urinary incontinence?

Urinary incontinence is the inability to voluntarily control urination. It is more common in females than in males. True urinary incontinence is less common than conditions that mimic incontinence, including behaviour problems, urinary tract disease and increased volume of urination.

What causes urinary incontinence?

Urinary incontinence may be caused by any of the following types of condition:

  • Ectopic ureter: If one or both ureters (the tubes that carry urine from the kidneys to the bladder) empty further back than the bladder, their emptying can't be controlled.
  • Neurological problems: Where the signals from the brain that control urination are not getting through properly.
  • Urinary sphincter mechanism incompetence (USMI): Oestrogen helps maintain control of the urinary sphincter, so we sometimes see incontinence in older speyed female dogs due to lack of oestrogen and therefore weak urinary sphincter control.

Conditions that can mimic urinary incontinence include:

  • Urinary tract infections
  • Urinary crystals or stones
  • Urinary tract neoplasia (cancer)
  • Prostate disease
  • Anything that increases drinking and urinating, including kidney disease, liver disease and hormonal diseases.

How can we diagnose the cause of urinary incontinence?

We will start by performing a full physical examination, neurological examination and urine analysis to look for evidence of prostate disease, urinary infection, crystals or stones, or kidney disease. If you are bringing your dog to us for a urinary problem, you should try to obtain a urine sample to bring with you – this will speed up the process of diagnosis considerably. If the physical examination and urine analysis are normal, the next step will be determined by the age and sex of the animal. In a young dog we may check for congenital anatomical problems using special x-ray studies, whereas in an older dog we may do an ultrasound to check for urinary tract neoplasia or trial oestrogen supplementation to see if this corrects the problem. If we suspect that increased volume of urination may be the problem, we will recommend blood tests to check for organ or hormonal disease.

How is urinary incontinence treated?

The treatment for urinary incontinence depends on the cause.

  • For a urinary tract infection we will prescribe antibiotics
  • For urinary crystals or stones we will prescribe a special diet and may need to perform surgery
  • For prostate disease we will usually recommend castration
  • For anatomical defects or urinary tract neoplasia we will usually recommend surgery, which may require referral
  • For urinary sphincter mechanism incompetence we will prescribe oestrogen supplements or drugs to strengthen the urinary sphincter
  • For neurological problems we will usually need to perform further diagnostics to be able to provide specific treatment.

What is the prognosis for an animal with urinary incontinence?

The prognosis depends on the cause, but the vast majority of cases are treatable.