Urinary incontinence in older dogs (or any dog, for that matter) is never normal. Integrative veterinarian Dr. Julie Buzby 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 in dogs?
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.
What are the signs of urinary incontinence in older dogs?
An incontinent dog doesn’t know he or she is urinating while it’s happening and has no control over it. If you notice your dog exhibiting any of these signs, contact your veterinarian for an evaluation:
- Dribbling urine while walking
- Urinating while sleeping, or wet bedding after getting up
- Urine-soaked fur
- Puddles of urine after getting up from sitting or lying down
Is incontinence a “normal” sign of aging in dogs?
No, incontinence is not a normal sign of aging in dogs. In fact, this is a common myth, and one that I hope you will help me dispel.
Myth: Urinary incontinence is normal in older dogs.
Truth: 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.
What causes urinary incontinence in dogs?
Next, let’s look at the causes of urinary incontinence in dogs, including 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 integrative veterinarian, when my client shares that their beloved dog is incontinent, I will consider a list of possible medical conditions and issues including the ones below.
Diabetes, Cushing’s disease, and kidney disease
These diseases— diabetes, Cushing’s disease in dogs, or kidney disease— cause tremendous thirst. Since dogs with these conditions drink more water, 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 in dogs. Fortunately, UTIs are very treatable. However, left undetected, they can be very serious.
Bladder stones (often go hand-in-hand with urinary tract infections)
Bladder stones irritate a dog’s sensitive bladder lining, leaving it susceptible to infection. They may have a genetic component, and may also be related to your dog’s diet.
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.
Spinal injuries
Our poster child for spinal injuries is a “down” Dachshund. If the nerves of the spinal cord are injured or severed, this has a cascading effect to other parts of the body. I often see urinary incontinence with severe cases of IVDD in dogs.
Estrogen deficiency
Especially for older, spayed female dogs, a lack of estrogen (hormonal imbalance) may result in incontinence.
Prostate issues in male dogs
An enlarged prostate or prostate disease may cause difficulty urinating or urinary incontinence in male dogs.
Bladder cancer or urethral cancer
Signs of bladder cancer in dogs or urethral cancer are similar to those seen with a UTI and include incontinence. This is why it’s important to seek veterinary care—don’t wait!
Another condition worth mentioning is Canine Cognitive Dysfunction. Although this condition does not cause urinary incontinence, it does often lead to regression in house training. It can sometimes be hard for pet parents to distinguish accidents from incontinence in older dogs, especially if they are not seeing them happen and are only finding the “evidence” after the fact.
Can medications cause urinary incontinence in dogs?
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 medications.
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. Side effects of prednisone can include dramatically increased thirst, resulting in a fuller bladder and more chance of accidents and even urine leakage.
Diagnosing incontinence in dogs
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 my tips for improving dog lab tests.)
What you can expect at the vet visit
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
- X-rays and/or ultrasound to look for bladder stones or masses, and to evaluate for arthritis or back injuries
- Specialized blood work to rule out certain diseases such as Cushing’s disease or thyroid disease
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.
Some causes of urinary incontinence in older dogs can be managed with medication. This of course depends on the results of diagnostic testing, and your veterinarian will discuss these treatment options with you.
Some causes of urinary incontinence are not easy fixes, and some causes, such as spinal injuries, may be permanent. In these cases, I discuss with pet parents options and considerations for managing urinary incontinence to maintain a good quality of life.
Here are 4 tips for helping your incontinent dog:
- Prevent urine scald!
- This is probably the biggest issue I counsel dog owners about when managing incontinence. Urine is extremely irritating to dogs’ skin, and if they are left with skin contact, even sometimes for short periods of time, it can essentially burn them. Urine scalding can lead to very dangerous skin infections, and is quite painful. I cannot stress enough the importance of ensuring incontinent dogs are kept clean and dry to keep urine scald at bay.
- Consider dog diapers.
- No one wants to constantly clean up urine in their house, and an incontinent dog can even threaten the human-animal bond due to frustration of frequent messes. In some cases dog diapers (or even belly bands for male dogs) may be helpful to contain the mess in dogs whose incontinence cannot be controlled or managed otherwise. It is EXTREMELY IMPORTANT to be fastidious about hygiene if using diapers to prevent compounding issues. For this reason, diapers should be used with caution.
- Place waterproof covers over bedding.
- Take your dog on frequent walks and “potty breaks.” The more your dog pees outside, the less your dog will pee inside.
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 25+ year career as a veterinarian, I can count on one hand the number of times I’ve performed a water deprivation test. In those few cases, it was done only after other diseases had been ruled out and with very 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.”
Female dogs are especially susceptible to these ascending urinary tract infections, due to the female dogs’ shorter urethras.
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 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.
Finally, 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 in dogs 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.
What questions do you have about urinary incontinence in dogs?
Please comment below.
My 16yr old dog, who is blind & deaf, has been constantly urinating on her bedding for over a year and more. The moment clean bedding is introduced she pees on it. She also uses the kitchen floor during the day & night despite having access to the garden & the odd walk. We don’t walk her as much as it is a bit of an ordeal for her nowadays. I’m constantly washing bedding and my home has been defrocked of soft furnishings as she pees on them too. Is this something I just have to live with?
Hi Allison,
I understand your frustration and am sorry you are in this difficult situation. From what you describe, I am suspicious your pup might be experiencing some early signs of dementia. This can make preventing accidents in the house almost impossible. Have you tried using diapers? You could just have her wear one when in the house but still allow her outside time to urinate as normal. Also, please make sure your vet is aware of this issue. It is always good to rule out possible medical causes and there could be a supplement that might help reduce the severity of her symptoms. Make sure you are giving yourself lots of grace. Caregiver fatigue is very real and the stress of constantly cleaning up accidents and washing bedding can take its toll. ♥
Hi, Have you ever heard of a dog no longer being incontinent after a few years on Proin.
My Belgian Malinois, Molly, is 10 years old. She had been on Proin for a few years and I was going to switch to Incurin. However, I stopped giving her Proin a couple weeks ago and there has been no accidents or leakage whatsoever. What is you experience with this situation.
Thank you!!!
Hi Laura,
Wow that is very interesting. I have not heard of any cases where urinary incontinence resolved on its own unless it was caused by trauma or some other injury. I did some research and did not find any mention of this either. I am glad Molly is doing well and seems to be symptom free. Make sure your vet is aware of this change so they can follow up to make sure everything checks out ok. Thank you for sharing and good luck!
My 5 year old Boxer (spayed female) has become incontinent suddenly. We took her to the vet and she did at the time, have a UTI. She also had an extremely low heart rate. We discovered that she has hypothyroidism, which has suddenly appeared out of the blue.
We have her on thyroid medication (thyro tab .8 mg) and the vet says her levels are now normal but the incontinence has gotten worse.
We are talking soaking through a human diaper covered by a dog diaper, a comforter, a quadruple folded blanket, sheets, and moisture resistant mattress proctor in the matter of 3 maybe 4 hours.
She is acting like she has never seen food in her life and her fluid intake has severely increased.
We have tried Proin 50 mg and are now on hormone therapy (DES 1 mg nearly a month now) and I swear she is getting worse.
The vet swears it is because she is a spayed female, I think it is thyroid related (as it began when the thyroid issue began). But, they said her thyroid levels are ‘normal’ now?!?!
What are some medications, therapies, or (worst case) surgery for incontinence due to thyroid issues?
Please and Thank you,
Wendy Subler
Hi Wendy,
I am sorry your Boxer is experiencing these severe symptoms. I know you have done a great deal of testing and tried several treatments with no improvement. It may be a good idea to schedule a consultation with an internal medicine specialist. I would want to rule out any other potential causes before going down the path of incontinence treatment. Your vet should be able to make the referral if needed. I am glad your girl’s thyroid level has stabilized. Hoping you can find the answers you need to help your pup get back to living her best life.
Hi our 13 yo female Toy Poodle In the past few weeks cannot make it past 4-5 hours after bedtime before wanting to go out at 4 or 5am. She wakes us up!
She holds it in, but she used to be able to go 6-8 hours if not more. This changed in the past few weeks.
No diet changes, food, or activities. Water intake may have increased but not much. Same routines. We did notice that she used the emergency pee pad more often when we are home. We would find that she peed on it.
We never had a problem until this.
So is there a potential bladder problem? There is no leakage during day or night or wet bed at night.
We will be taking her to the Vet over the weekend. Any thoughts or comments?
Hi Marc,
I understand your concern for your senior girl and these new changes in her urination habits. Unfortunately, without examining her myself, there are just too many possibilities to make specific conclusions or recommendations. This could be issues from a UTI, cognitive dysfunction, nighttime anxiety, sundowners, incontinence, etc. I am glad you have an appointment already scheduled with your vet. I am hopeful you will find the answers you need to get to the bottom of this situation. Wishing you both the best.
we have a 12 year old fixed female havachon, very sweet dog, gone blind,unknown reason,has been for 2 years now. we put her in diapers last year and know she eats the seat out of them and eats the poop and the diaper part. she is 10.5 lbs went to vet yesterday and she is fine otherwise. we are at our wits end about the poo and peeing thing. and eating the diaper off in middle of night 2:30 am. i have to get up to go to work at 4am. and she sleeps on the top of covers. she eats and tail wags and wags when she is taken for a walk. but in the house she just wants to sit in your lap and sleep.
Hi P. Meredith,
I am sorry your senior girl is having accidents and the diapers are a frustration. The only bit of advice I can think to mention is have you tried the cloth diaper covers? They make washable covers with Velcro tabs to cover diapers or male wraps to prevent them from being chewed or removed by your pup. If your dog is small enough, you might also be able to use a baby onesie to cover the diapers and prevent chewing. I am hopeful you can find a way to make this stage of life a little easier for everyone involved. Wishing you all the best.
Thanks for the good info Doc.
My 10 yr old girl just became incontinent this past week and I’ve been reading up on the possible causes and solutions.
She started leaking/dribbling the other day after urinating but yesterday coming back into the house after already going, she just leaked all the way from stairs into the hall and den… Didn’t even know she was doing it. And she’s always been very “self-cleaning” so I knew this was a new development.
She’s had a few chronic issues with her diet and stool, but now she’s got that “old lady” smell mixed with pee scent and it really hits when I get home. Appetite is way down as well as her weight and she feels old and frail when I pet her. She’s a pretty big girl at 80lbs (Portuguese water dog) and she’s been declining in the past two years, but her eyes are still bright and alert and loving. But I can’t help the feeling that this is likely the beginning of the final days.
Your article gives me a little hope that she might be treatable for the underlying or maybe we find it’s a more serious something. Either way, I appreciate being armed with more information before making the vet appointment.
Thanks!
Hi Preston,
I am sorry your senior girl is having these urinary issues. I know how worrisome it must be facing this unknown path ahead. I am glad the article was helpful and will offer guidance for the conversation with your vet. Your dog is lucky to have you in her life advocating for her health and well-being. Hoping for answers and an effective treatment. Wishing you and your sweet girl the best.
Hi I have a Jack Russel who is coming up 17 years old soon
She’s been peeing in her sleep for a while now and also not getting to the door quick enough when she wakes up so has the odd accident . My vets want to do blood tests on her but at her age it’s way to risky for her. I’ve been told there’s a high chance she wouldn’t survive having a general sedation
What other solutions are there for her as my vets are really not being too helpful .
Any advice would really be appreciated .
Hi Ian,
I am sorry your senior girl is starting to show signs of declining health. Some of the symptoms you describe sound like dementia/cognitive dysfunction that is very common in older dogs. I think it would be good to get some details about the testing your vet is recommending. Blood work is the most important first step in getting a diagnosis or ruling out specific issues. Taking a blood sample should not involve anesthesia. This is usually done by using a very small needle and syringe and accessing the vein on the front of your dog’s leg. The only time I have had to use any kind of sedation to obtain a blood sample was for an extremely aggressive dog that would have harmed me or my staff if not asleep for the needle stick. The tiny prick of the needle to draw blood shouldn’t be any worse than when giving a vaccine. I will attach links to other articles with more information. I hope you can find the best way to maintain your sweet girl’s quality of life. Wishing you all the best.
1. Canine Cognitive Dysfunction in Dogs: Signs, Symptoms, Solutions
2. Could Your Dog Have Dementia? Find Out With This Canine Cognitive Dysfunction Checklist
My 9 year old German shepherd has had a recent bite to her side my our other German shepherd. A big knot came up so long story short. We’ve been told it’s an abscess they think all the way to it’s a tumor but it’s never been tested. It popped up in a matter of minutes. Anyway, now she has incontinence she’s constantly trying to pee and she is peeing laying down and she doesn’t even know. She has never had any issues with this. We are so exhausted but will be here 24-7 for her. Any idea what can cause this. And if it’s a UTI or bladder infection would cephalexin help her. She’s on that already.
Hi Tammy,
I am sorry to hear that Lily is now having issues with her bladder. I just finished replying to your other comment you left a few days ago. I apologize it has taken me so long to catch up with these comments. If these new urinary issues were due to an infection, the cephalexin should have resolved the infection if the bacteria were susceptible to it. This means the bacteria may need a stronger antibiotic or an infection is not the root cause. Due to the previous concerns about cancer or hemangiosarcoma, I am worried this may be playing a role in the incontinence. If Lily has cancer, the cancer could have spread and be putting pressure on the bladder or be affecting the nerves that control the bladder sphincter. My best advice is to make sure your vet is aware of this new development. They may be able to have you get a urine sample at home and bring it into the clinic for testing to rule out an infection. I hope you can find the answers you need to help give Lily the best quality of life possible. Prayers for strength and clarity for you and comfort and peace for Lily. ♥
My 11 year-old male Boxer has degenerative myelopathy. He is currently taking aminocaproic acid and just started LDnaltrexone. He’s also taking LOTS of supplements.
Any ideas? I would so appreciate your help with any suggestions.
Thanks!
Katie
Hi Katie,
I am sorry your senior boy is facing such a difficult disease. It is hard to watch them struggle and know you can only do so much to help. Are you asking about ideas to help with urinary incontinence as a side effect of the degenerative myelopathy? There are medications that can be used to help the urinary sphincter work better to help prevent urine leakage. Unfortunately, with the progressive nature of degenerative myelopathy, I am not sure these medications would be of much help. It is probably best to schedule a consult with a veterinary internal medicine specialist. They can give you recommendations based on your dog’s specific issues and make sure to minimize potential side effects, taking into account the current medications that are being administered. I wish you and your sweet boy the best and pray you have more time to enjoy life together.
What supplement is good for UTI prevention?
Hi Sharon,
That is a tricky question! It really depends on what is causing the UTIs in the first place. There is a cranberry extract supplement specifically for dogs, but it is only effective against one strain of bacteria. Here is a link to another article with lots of great information: UTI in Dogs: Know the Signs, Treatments, Prevention