A recent visit with my sister and her nearly 16 year old
Pembroke Welsh Corgi, “Penny,” reminded me of the importance of healthy
“plumbing” for pets. In her golden
period, Penny developed spinal degeneration that has compromised her ability to
walk and contributed to her urinary incontinence. Penny’s longevity is a tribute to the loving
and constant care provided by my sister and her husband as they clean up
puddles and wash throw rugs daily.
Penny’s
story is just one example of the multiple causes of canine urinary
incontinence. I am reminded also of
Roxie, the spayed, female Boxer that began to leak small amounts of urine by
two years of age. The cause of her
incontinence is likely associated with her breed, as well as being spayed. Dobermans, Giant Schnauzers and Boxers all
have a greater incidence of “Primary Sphincter Mechanism Incompetence,” whereby
the sphincter or “valve” connecting the urinary bladder to the opening of the
urethra does not always stop urine from flowing between urinations.
Evidently,
this sphincter also needs some input from sex hormones like estrogen and
testosterone because sterilized female and male dogs are over-represented with
urinary incontinence. In fact, urinary
incontinence is most likely to occur in spayed females and is sometimes
referred to as “estrogen deficient urinary incontinence.” Roxy was just lucky enough to be a Boxer and
be spayed.
Then
there is “Stella,” the female Giant Schnauzer puppy, whose owner has shown
remarkable tolerance as Stella has been more than a challenge to
housebreak. Stella would urinate hourly
while indoors or outside, could not consistently hold her urine for a period of
even a few hours, and commonly “leaked” small amounts of urine when lying down. Stella would even urinate during car rides. She just wasn’t progressing with her bladder
retention abilities like every properly housetrained puppy.
At
four months of age, Stella had not even approached puberty, nor been spayed,
but she has been diagnosed with Primary Sphincter Mechanism Incompetence and has
been started on incontinence medication.
We are expecting that the dose of her medication will need upward
adjustment as she grows and that spaying her will result in the need for
hormone replacement therapy to maintain control of her “plumbing.”
Finally,
yet another patient, “Gracie,” the Labrador Retriever, was unfortunate enough
to be born with her ureters (the tubes that transport urine from the kidneys to
the bladder) connected to her lower urinary tract at inappropriate locations
beyond her sphincter. As early as two months of age, it was evident that Gracie
probably had an “ectopic” or misplaced ureter as she continuously leaked urine
on herself, whether standing or lying down.
Gracie’s
diagnosis was confirmed by excretory urography, a procedure that involves the
injection of dye intravenously to highlight the entrance points of the ureters
into the bladder on x-rays. Ectopic
ureters require surgical correction to transplant the ureter to its proper
location. More recently, veterinary
specialists are also implanting devices to help the ureters and sphincter do
their jobs more efficiently.
The
common thread for all of these dogs is that they need to urinate more
frequently and they leak urine, which results in unpleasant odors, urine
scalding around the urethra and vulva, and the strong possibility of secondary
skin and urinary tract infections. Their
owners are burdened with extra labor and expense to keep these pets and their
homes socially acceptable.
Treatment
for urinary incontinence may be as simple as oral administration of a drug
called phenylpropanolamine (PPA) or low doses of estrogen. Some incontinent dogs require a combination
of both drugs. The doses of these drugs may be gradually decreased once the
incontinence appears controlled, but lifelong therapy is usually required. Many incontinent dogs experience frequent
urinary tract infections, making it important to have your incontinent pet’s
urine periodically analyzed by your veterinarian.
Incontinence
is more likely to occur in obese pets so prevention and treatment should also include
maintenance of proper body weight. More
frequent trips outdoors to eliminate, especially at bed time and prior to being
left alone, are very helpful, too, as it is difficult for incontinent pets to
endure long time periods between urinations.
You
and your pet do not need to suffer the consequences of urinary
incontinence. If your pet leaks even a
small amount of urine (especially when lying down), dribbles urine while
walking, persistently licks its urethral area, smells like urine, or has
frequent urinary tract infections, ask your veterinarian if your pet could be
incontinent. With proper diagnosis and treatment,
your dog’s incontinence can be managed for many years to come.
Author: Dr. Bonnie Jones
Image courtesy of vectorolie at FreeDigitalPhotos.net
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