Urine Scald in Dogs: Prevention & Treatment

Urine scald in dogs can be a persistent and painful problem—especially for senior dogs, paralyzed dogs, or those with urinary incontinence. But integrative veterinarian Dr. Julie Buzby is here to help. She explains why dogs get urine scald, what urine scald looks like, and how to treat and prevent urine scald.

As a veterinarian with a special passion and soft spot for senior dogs, I often treat senior dogs who are facing some challenges that aren’t as common in their younger counterparts. One such condition is urine scald.

My patient, Annabelle, a 10-year-old Beagle mix, had suffered several orthopedic injuries in her younger days. As she aged, resulting arthritis made it increasingly difficult for her to get up and go outside. Plus, she had started to experience fairly significant urinary incontinence.

This combination of spending more time lying down, and leaking urine turned out to be the perfect storm for urine scald.

What is urine scald in dogs?

As I looked at Annabelle’s skin, I was reminded of why urine scald is also called urine burn. The skin on her belly and hind legs were bright red—almost like she had a sunburn. And it was painful for her too. Prolonged contact with urine—or more specifically the ammonia in the urine—had quite literally scalded her skin.

Thankfully, Annabelle had a fairly uncomplicated case of urine scald. However, as I mentioned to my client, the other problem with urine is that as it sits on a dog’s skin, it weakens the skin’s natural protective barriers. As a result, the dog can develop a bacterial skin infection (i.e. pyoderma in dogs) secondary to the urine burn. Plus, by weakening the skin, urine scald also increases the chances of pressure sores in dogs.

What does urine scald look like on a dog?

The appearance of the scalded skin can vary a bit depending on how severe the urine scald is and whether or not the dog also has a skin infection or pressure sores. But in general, urine scald symptoms include:

• Red, irritated skin—especially around the belly, groin, and hind legs
• Rash or bumps on the skin
• Increased moisture of the skin and haircoat
• Unpleasant odor associated with the affected area
• Increased licking or chewing of the skin
• Signs your dog is in pain
• Crusts or sores on the skin

Plus, before you see signs of urine scald, you may see evidence your dog is leaking or dribbling urine or having urinary accidents. Signs include:

• Wet spots on your dog’s bed or blankets
• Increased licking around the vulva or prepuce
• Moisture on the fur and skin around the vulva, prepuce, belly, or hind legs

What makes dogs prone to urine scald?

To be clear, not every dog who leaks urine or has urinary accidents will develop urine scalding. But if the urine sits on the dog’s skin for long periods of time, it can (and does) burn the skin.

This raises the question of what might lead a dog’s skin to be in prolonged contact with urine. Well, as it turns out, these dogs tend to have urinary incontinence plus decreased mobility or even paralysis.

Incontinence

Dogs with urinary incontinence (i.e. an inability to control urination) often dribble urine where they are lying down and may not realize it. Sometimes the urine can be in contact with the dog’s skin for a long time, especially if the dog isn’t moving around much.

There is a range of causes of urinary incontinence in dogs, including:

• Bladder stones
• Weak bladder sphincters (sometimes develops as a dog ages)
• Certain medical conditions (e.g. kidney failure in dogs, hypothyroidism in dogs, diabetes mellitus, Cushing’s disease in dogs)
• Low sex hormones in spayed female dogs
• Bladder cancer in dogs
• Urinary tract infections (UTIs in dogs)
• Enlarged prostate in dogs
• IVDD in dogs or other neurological conditions that lead to weakness or paralysis

Poor mobility or pain

Incontinence is especially a problem when the dog also has poor mobility due to pain or injuries. Not only do these dogs not always notice they are lying in urine, but also they might not be very likely (or able) to get up, change positions, or move to a dry location.

However, lying in puddles of urine can also happen to dogs who aren’t incontinent. For example, painful dogs might be less motivated, or unable, to move from their sleeping spot in order to urinate. Therefore, they may simply urinate where they lie.

Mobility-altering conditions that may predispose a dog to urine scalding include:

• Osteoarthritis in dogs
• Injury or trauma (e.g. hit by a car or a broken leg)
• Recent surgery
• Blindness
• Neurologic conditions (e.g. stroke in dogs and vestibular disease in dogs)

Paralysis or spinal cord injury

Paralyzed dogs often have two strikes against them. They are dealing with urinary incontinence and they probably can’t move out their own urine even if they wanted to. These dogs often leak urine for the same reasons they can’t walk—spinal cord damage.

Several nerves that exit the spinal cord are responsible for helping the bladder fill (i.e. retain urine) and then release that urine (i.e. urinate). For example, one nerve controls the opening and closing of the urethral sphincter (i.e. valve that regulates the flow of urine from the bladder to the urethra). Plus, other nerves tell the bladder muscles to contract or relax to help the bladder fill or to initiate the flow of urine.

If a dog suffers from a spinal cord injury that affects these nerves, he or she may be unable to voluntarily control urination. This can lead to urine leaking and/or the need for a dog parent to manually express the bladder. Unfortunately, the end result may be a dog who spends a lot of time lying in urine.

Wet diapers or belly bands and soiled bedding

As we will discuss in a bit, diapers and belly bands (which wrap around a male dog’s abdomen to cover the penis) can sometimes help prevent urine scald. However, they can also cause a urine rash. Think about it this way. Babies can get diaper rash if they are left in dirty diapers for too long. And your dog can develop urine scald from his or her wet diaper or belly band.

Along the same lines, sometimes your dog may urinate on the bedding and you don’t realize it. Or maybe something happened and you aren’t able to change out the wet blankets as quickly as normal. As a result, the dog may spend a long time lying on urine-soaked bedding, which can start to damage the skin.

How can I prevent urine scalding?

If your dog is struggling with incontinence, poor mobility, urinary accidents, or any of the other issues that predispose dogs to urine scald, you may understandably want to know how to prevent your dog from getting urine scald.

Based on what you have learned about urine scald, it makes sense that the most important thing you can do is attempt to keep your dog clean and dry. I know this isn’t always an easy thing to do, so I want to share a few tips that might help.

1. Work with your vet to create a game plan

It probably goes without saying, but your vet is an invaluable resource when it comes to managing your dog’s urinary incontinence and/or mobility challenges. He or she can help you find the underlying cause(s) and work with you to create a treatment plan.

Depending on the cause of the incontinence, there are medications (e.g. Proin for dogs) and procedures that might help your dog achieve better bladder control. Or sometimes addressing the underlying UTI, metabolic disease, or bladder stones can solve the problem. Your veterinarian can discuss the various options with you and let you know which might be best for your dog’s situation.

Plus, he or she can help you find ways to improve your dog’s mobility and advise you about any other preventive measures that your dog may benefit from.

2. Line your dog’s bed with “pee pads”

The absorbent disposable pads made for pad-training puppies work great for dogs who are leaking urine or urinating while lying down. By absorbing urine as it dribbles out, these pads decrease the amount of urine that stays in contact with your dog’s skin.

They also make cleaning easier because you just pick them up and throw them away. And the plastic backing should keep the urine from leaking through to the bedding underneath, which cuts down on the amount of laundry you need to do.

As a word of caution, you do still want to ensure that you are changing the pad frequently. Lying on a saturated pee pad for a long time can still lead to urine scald.

3. Have your dog wear a diaper or belly band

Another way to absorb some of the urine is by utilizing dog diapers or belly bands. Typically, diapers work better for female dogs because they can effectively cover the vulva (i.e. cone-shaped area of skin between the hind legs where urine exits). Since a male dog’s prepuce (i.e. skin covering the penis) is typically located partially in front of the hind legs, traditional diapers may not work as well for them.

This is where a belly band comes in. There are a variety of types of belly bands on the market. But most of them are made up of fabric that fastens around a dog’s waist to cover the opening of the prepuce. Some are made to hold a disposable absorbent pad while others have absorbent material built into them.

Diapers or belly bands, when used properly, can be a great option for many dogs because they collect the urine so it doesn’t sit against the dog’s skin or soak the bedding. But I can’t stress this enough. It is very important to change your dog’s diaper or belly band regularly. Otherwise, it may actually increase the risk of urine scald.

4. Help your dog change positions frequently and get up to go outside

Another piece of the equation is keeping your dog from staying in the same position or location for a long time. If your dog is paralyzed or reluctant to get up from lying down, reposition him or her every two to three hours. Not only does that keep your dog from lying in urine for a prolonged time, but it also helps prevent pressure sores. Skin with urine scald is more prone to pressure sores, and pressure sores make the skin more susceptible to urine scald, so the two go hand-in-hand.

If your dog isn’t truly “down” but does have trouble with mobility, the following options might be helpful:

• Apply Dr. Buzby’s ToeGrips® dog nail grips to help your dog gain traction on the floor. This can make him or her more confident in moving from one resting place to another or heading to the door to go outside.
• Give your dog joint supplements for dogs like Dr. Buzby’s Encore Mobility™ hip and joint supplement to improve joint health and, therefore, mobility.
• Talk to your vet about pain medications and natural pain relief for dogs to decrease your dog’s pain levels.
• Use a GingerLead® Support and Rehabilitation Harness or Help ‘Em Up® Mobility Harness to help your dog get outside for bathroom breaks or relocated from room to room (or bed to bed).

5. Increase the number of potty trips in a day

Additionally, some dogs can benefit from more chances to go outside to urinate. This might mean planning to take your dog out more frequently when you are home. Or if you are regularly away most of the day, you may want to hire a dog walker or ask a friend to take your dog out once or twice during the day.

6. Frequently check your dog’s fur and bedding for urine

Each time you take your dog outside or help him or her change positions or resting locations, get in the habit of checking your dog’s fur and bedding for urine. If your dog has urine on his or her skin or fur, clean it off with a warm, damp washcloth or baby wipes. Or give your dog a spot bath with a gentle shampoo. Then be sure to gently dry the area.

If the bedding is soiled, replace it with clean blankets or a fresh puppy pad. And change your dog’s diaper or belly band at this time too. Remember, the goal is to have urine in contact with your dog’s skin for as short a period of time as possible.

What if my dog already has urine scald?

Despite all of these preventive measures, sometimes dogs will still develop urine scald. If this happens, please don’t beat yourself up! It can be challenging to care for a dog with urinary incontinence and mobility issues. Your pup knows you love him or her and are doing your best.

If you suspect your dog has urine scald, the most important thing you can do is to have your dog seen by your veterinarian as soon as possible. The sooner urine scald is treated, the easier it will be to manage. And the less painful it will be for your dog.

Your vet will examine your dog to determine how extensive the urine scald is. Plus, he or she will also assess your dog’s overall health with a comprehensive physical exam. Then your vet may recommend some diagnostics to get to the bottom of why your dog is developing urine burns. Diagnostics may include:

• Bloodwork (chemistry panel, complete blood count, thyroid panel, etc.)
• Urinalysis (and possibly urine culture)
• X-rays or other imaging
• Skin cytology or culture
• Additional diagnostics as needed

What does treating urine scald in dogs involve?

As your veterinarian develops a treatment plan, he or she will likely focus on treating both the urine scald and the underlying condition. Treatment for the underlying problem will vary, so we won’t discuss it more here.

I do, however, want to mention some of the ways your vet may treat urine scald.

Skin care and cleansing

Typically, your vet will recommend gently cleaning up your dog with baby wipes, medicated wipes, or gentle shampoo each time the fur is soiled. If your dog has long hair, your vet may suggest trimming the fur in the problem areas too. This can help you keep your dog cleaner and allow better access to the skin for topical treatment.

Topical products

Your vet may also recommend various products to apply to the skin, including:

• Barrier sprays like 3M Cavilon™ no sting barrier film to protect the skin
• Lanolin and/or petrolatum-based ointments like Vaseline®, Aquaphor®, or A&D Original Ointment to protect and heal the skin
• Cornstarch or cornstarch-based baby powder to dry out the moist areas
• Silver sulfadiazine cream to promote healing

When using these remedies, it is best to keep your dog from licking the affected areas. That way he or she doesn’t ingest the product or keep it from doing its job.

As a word of warning, you will notice that diaper creams like Desitin® are missing from the treatment list. Diaper cream is great for baby diaper rash but zinc oxide (the active ingredient in many diaper creams) can be toxic to dogs if ingested. For this reason, I typically caution pet parents against using zinc-based diaper creams on their dogs.

Systemic medications

Since urine scald can be painful, your vet may also prescribe oral medications to help reduce pain and inflammation. Also, if your dog has a secondary bacterial skin infection, the vet may recommend a course of antibiotics.

Don’t be discouraged

It can be challenging to take care of a dog who is struggling with incontinence, urinary accidents, paralysis, and/or poor mobility. Sometimes, despite your best efforts, your dog might develop urine scalding. It happens. And it doesn’t mean you are a terrible dog parent!

Please know that veterinarians recognize and appreciate how much time, effort, and love you give your dear companion. And they are here to help and support you in every way possible—be that discussing prevention and treatment strategies or providing a listening ear. Sometimes it takes a bit of time, patience, and trial and error to find the right combination of solutions. But you can successfully manage your dog’s urine scald.

Do you have tips that have helped prevent or manage your dog’s urine scald?

Please share them below.