Urinary Incontinence in Older Dogs - Dr. Buzby's ToeGrips for Dogs

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Urinary incontinence in older dogs (or any dog, for that matter) is never normal. Dr. Julie Buzby, integrative veterinarian and founder of Dr. Buzby’s ToeGrips® dispels this myth, shares common causes, and explains what you can expect when you seek veterinary care for your dear old dog’s incontinence.

What is urinary incontinence?

By definition, urinary incontinence in dogs is the involuntary leaking or dribbling of urine. It’s important to point out that “involuntary” is the key operative word that sets urinary incontinence apart from a dog having an accident in the house. Let me explain…

A dog who suffers from urinary incontinence does not have knowledge of the accident—at least not initially—because peeing is not done consciously. The incontinent dog is “taken by surprise” by her damp hind end. In the case of accidents, a dog typically is aware that urination is taking place while the accident happens.

With incontinence, think relaxed dog lying on the bed or couch experiencing leakage. With an accident, think dog posturing and urinating in an inappropriate location.

Is incontinence a “normal” sign of aging in dogs?

Here’s a myth that I hope you will help me dispel:

Urinary incontinence is normal in older dogs.

There is no truth to this statement.

Incontinence is never normal for old dogs, or dogs of any age for that matter. If your dog leaves “wet spots” on the bedding (a common sign of incontinence), it’s important to talk with your veterinarian.

older dog sitting on floor by a puddle of urine — It is a commonly held belief that “accidents” are normal in older dogs. This is a myth we must dispel.

What causes urinary incontinence in older dogs?

If your dog is suffering from urinary incontinence, your veterinarian will consider a host of underlying causes or a combination of causes. As an veterinarian, when my client shares that their beloved dog is incontinent, I will consider a list of possible medical conditions and issues. These include:

Diabetes, Cushing’s disease, and kidney disease. These diseases cause tremendous thirst. Since the dog is drinking excessively, urination increases. It’s simply an input-output equation.
Thyroid disease and other types of metabolic diseases. Dog incontinence can be one symptom of thyroid disease or other diseases related to a dog’s metabolism.
Urinary tract infection (UTI). Urinating in the house—whether it be in the form of accidents or leakage—is a classic sign of a UTI. Fortunately, UTIs are very treatable. However, left undetected, they can be very serious. To learn all the signs of bladder infections, read my article: Does Your Dog Have a Urinary Tract Infection?
Arthritis or other mobility-limiting conditions. Incontinence is not a specific symptom of canine arthritis or other mobility-limiting condition. However, when a dog has difficulty rising and walking, “housebreaking accidents” and even incontinence may be a result.
Neurological conditions. Since the bladder and the sphincter (the outflow gate that opens and shuts during urination) are under control of nerves, a nervous dysfunction may lead to incontinence in your dog.
Estrogen deficiency. Especially for older, spayed female dogs, a lack of estrogen (hormonal imbalance) may result in incontinence.
Bladder cancer or urethral cancer. Signs are similar to those seen with a UTI and include incontinence. This is why it’s important to seek veterinary care—don’t wait!

Can medications cause urinary incontinence?

Although this cause is a bit more obscure, certain medications have been associated with incontinence in dogs. Specific categories of medications include seizure medications and even some pain meds. Before your dog’s veterinary visit, make a list of medications your dog is taking. Then discuss them with your vet to see if there could be a correlation between incontinence and medications.

It’s worth mentioning here that prednisone is a “bad actor” when it comes to housebroken dogs having accidents in the house. Prednisone can cause dramatically increased thirst, resulting in a fuller bladder and more chance of urinary incontinence and accidents.

Diagnosing incontinence in older dogs: What you can expect at the vet visit

If your dog is suffering from either incontinence or having accidents in the house, it’s important to contact your veterinarian and make an appointment for your dog. In some cases, your vet may ask you to bring a sample of your dog’s urine to the appointment. (For instructions on how to collect a clean urine sample, please read: 7 Tips for Improving Your Dog’s Lab Tests.)

During your dog’s appointment, your dog’s doctor will perform a physical exam and check your dog from nose to tail. To determine the underlying cause for your dog’s incontinence, your veterinarian may run tests including:

Blood work (CBC) to check red blood cell count and white blood cell counts
Biochemistry panel to look at kidney values, liver enzymes, proteins, blood sugar, and electrolytes
Blood pressure testing for an indication of certain types of diseases including kidney disease
Urinalysis (analysis of the urine)
Urine culture to check for bacteria in the urine—the gold standard diagnosis for UTIs.

These tests help your dog’s doctor assess the health of your dog’s organ systems, including the urinary system.

What can you do for old dog incontinence?

The treatment for old dog incontinence will depend on your veterinarian’s assessment based on the results of the testing. That’s why it is so important to talk with your vet sooner rather than later. Your veterinarian’s diagnosis is the foundational piece that identifies the trajectory for treatment.

Why I DO NOT recommend limiting water intake

If you notice that your dog is leaking small or large amounts of urine, limiting your dog’s water intake may seem like a common-sense solution. However, it is definitely the wrong thing to do. In my 20-year career, I can count on one hand the number of times I’ve performed a water deprivation test, and it was done only after other diseases had been ruled out and with specific safety instructions. At home, limiting water intake can make certain dogs very sick, even to the point of a life-threatening crisis.

Primary and secondary UTIs

The last thing I will note is that incontinent dogs are more prone to developing urinary tract infections, even if they didn’t start with one as a part of their problem. Leakage occurs because the process of the urine moving from the bladder to the outside world is not appropriately “secure.” Unfortunately, this also impacts the dog in reverse. Bacterial pathogens from the outside world are more likely to ascend the path into the bladder on the inappropriately “open highway.”

Incontinent dogs, therefore, may have a primary or secondary urinary tract infection, and it’s hard to know what came first—the chicken or the egg. No matter the cause, incontinence should be taken seriously.

You are your dear old dog’s biggest advocate

You know your dog better than anyone else, and your observations are your dog’s first line of defense in keeping her healthy.

Here are three things that you can do right now to help your dog:

Be observant. If you notice that your dog is dribbling or leaking urine (spots on the bed, blankets, etc.), talk to your veterinarian.
Remember, incontinence is never normal. Help spread the word and dispel this myth.
Don’t wait or hesitate. Your veterinarian is your teammate in caring for your dog’s health.