Incontinence in senior dogs

As our dogs age, we see health issues beginning to arise. One problem that affects many of our senior canine companions is incontinence. Incontinence, alongside other quality-of-life indicators, is a reason that many owners consider euthanasia towards the end of their pet’s life, as this loss of control can be upsetting to both.  

Both urinary and faecal incontinence can occur for multiple reasons. We will explore some of these, alongside a few available treatment options. We will also give you some practical advice on the best ways to care for your pet at home during this tricky time.  

Urinary Incontinence 

Urinary incontinence is the loss of control of urination. Your dog passes urine without realising, often when they are relaxed or sleeping. They may still urinate normally at other times during the day. 

This is a different scenario to dogs with cystitis (inflammation of the bladder), for example, who still have control but are urinating more frequently and consciously positioning themselves to pass urine.  

Loss of control of urination can lead to issues such as – 

• Wet bedding after resting or sleeping 

• Urinary accidents in the house 

• Wet, smelly fur around their back end 

• Urine scalding on their genitals or surrounding skin 

• Urine dribbling or dripping out of their genitals 

• Excessive licking of the genitals 

Dogs with urinary incontinence are also more prone to secondary urinary tract infections, so owners could also notice blood in the urine, straining to pass urine, and going little and often.  

What are the common causes of urinary incontinence in older dogs? 

There are several different causes of urinary incontinence in dogs, and sometimes it can be a couple of things in combination. Here are some of the most common ones for elderly pets –  

Urethral Sphincter Mechanism Incompetence (USMI) 

USMI is the most common cause of acquired urinary incontinence in older dogs. It mainly affects females, especially large breeds (>20kg), or dogs that are overweight. Being neutered, especially at an early age, also seems to be a risk factor.  

The urethra is the tube that delivers urine from the bladder to the outside world, and this normally stays closed for most of the day, except when your dog urinates. In pets with USMI the muscles inside the urethra, especially around the bladder neck, have become weak, meaning urine is allowed to escape at other times, not just during urination.  

Most dogs respond well to treatment for this condition. Daily medication can be given to increase the sphincter muscle tone, such as phenylpropanolamine (PPA), or in neutered females, hormone replacements such as oestrogen or estriol. This is effective in 85-90% of cases according to one source, with these dogs being able to continue leading happy lives. In some cases, surgery may be considered.  

Neurological disorders

Dogs who have neurological issues could struggle to control their bladder function. This includes spinal cord disease, such as intervertebral disc disease (IVDD), a tumour pressing on the spinal cord or a traumatic injury. But direct damage to the nerves controlling the bladder or a problem higher up in the brain, could all cause issues with urine control.  

Some of these problems may be resolved through medication or surgery. It will depend on the exact underlying cause of your dog’s neurological disorder, however. 

Prostatic disease

Diseases affecting the prostate gland in male dogs, such as benign enlargement (often associated with age), tumours or infections, can have an impact on the urethra which runs through it.  

Treatment will depend on the type of prostate disease, but castration may be recommended in some cases.  

Other health issues

Other health problems could lead to urinary accidents in the house. This includes any condition that causes your dog to drink much more than usual. Examples include – 

• Diabetes Mellitus 

• Chronic Kidney Disease 

• Cushing’s disease 

• Malignant cancer 

• Liver disease 

• Urinary tract infections 

• Certain medications such as glucocorticoids (steroids) 

For some dogs, increased drinking due to a health problem coupled with something else like an anatomical abnormality or USMI can tip things over the edge into incontinence.  

Faecal Incontinence 

Faecal incontinence can be more challenging to treat than urinary incontinence for many elderly dogs. Signs of faecal incontinence in your pet include – 

• Soiling their bed 

• Passing stools without noticing, while walking around, playing or barking 

• Passing stools in the house despite having just been outside 

• Loss of anal tone (your pet’s anus looks more relaxed – ‘flaccid’) 

• Soiling on your pet’s back legs or tail 

• Weak or wobbly back legs 

Faecal incontinence can occur when there is damage to the sphincter muscles in your dog’s anus, caused by a wound or tumour, for example. This may be treated surgically. 

As with urinary incontinence, it can also occur due to issues with the nerves that control your dog’s anus. Some neurological issues may be fixable through surgery (e.g. certain spinal disorders) but often there is no clear treatment available, and owners need to concentrate on management.  

Other conditions can make it more likely for your dog to have accidents in the house, such as arthritic pain, underlying digestive disorders and cognitive decline (dog dementia). 

Helping your pet with incontinence 

Here are a few tips to help you and your dog – 

Follow your vet’s advice

Urinary incontinence can often be resolved through appropriate medication, surgery or by keeping other health complaints, like diabetes, under control.  

Faecal incontinence can be trickier but, even if there is no direct cure, the aim could be to improve other conditions that your pet suffers from, like arthritis. In this case, pain relief and weight management may help increase their mobility and muscle tone, potentially reducing faecal accidents in the home. 

A change of diet

A higher fibre diet may be needed if your dog is passing loose stools by accident. This will make cleaning up easier. Alternatively, it may be better to start a low-residue (more digestible, low-fibre) diet to decrease the number of stools they pass. Your vet will be able to help with this. 

Adapt the home

Keep your pet confined to an easy-to-clean area of the house, by using pet gates or baby gates.  

Regular bathing 

Regularly bathing your pet to remove any soiling will help to reduce odours, make them more comfortable, and limit urine scalding. 

Invest in bedding

Having plenty of spare bedding that is easy to wash and dry, so that your pet doesn’t have to sleep anywhere damp. 

Dog nappies

Dog nappies may be an option for some dogs, but they will need changing regularly and not all dogs will feel comfortable wearing them. Speak to your vet first about this. 

Increase opportunities for toileting

Make sure your pet has plenty of opportunity throughout the day to go to the toilet. Letting them out just before bedtime is really important too.  

Never punish your pet 

Punishing your pet can make them feel even more anxious over a situation that they cannot control.