The decline in estrogen levels after neutering in female dogs may cause a decrease in the vasculature of the urethra and its supporting tissues, which is an important part of maintaining a closed urethra. However, if dogs suffer from urinary incontinence, they are also more likely to develop UTIs. In women, UI is often caused by detrusor hyperreflexia, or overactive bladder. On the other hand, testosterone, a hormone found in male dogs, aids in the strengthening of the muscles that lead out of the urinary bladder. In the spayed female dog, the removal of the negative feedback effect of estrogen leads to increases in follicle stimulating hormone (FSH) and luteinizing hormone (LH). This condition is referred to as weak bladder sphincter incontinence. The dog may also have rashes in the genital area, which are due to urine drops that damage the skin. In women, there have been significant complication rates with these procedures, frequently requiring removal of the tape. With 2.1 mg deslorelin implants, oestrus can be suppressed for up to 27 months (Wright et al. Androgens have a variety of uses such as treating hormone-responsive urinary incontinence in male dogs, suppression of heat cycles and alleviation of false pregnancies in female dogs, and as part of the therapy for some types of immune-mediated . Reichler IM, Jchle W, Pich CA, Roos M, Arnold S. Effect of a long acting GnRH analogue or placebo on plasma LH/FSH, urethral pressure profiles and clinical signs of urinary incontinence due to sphincter mechanism incompetence in bitches. Bloodwork is indicated if the patient has a low urine-specific gravity, particularly in the face of dehydration. Phenylpropanolamine (PPA) is a frequently used dog incontinence medicine because its well-tolerated by several dogs and has been extensively used in veterinary medicine. No studies have been performed to assess its efficacy in male dogs with UI. Congenital causes can be ectopic ureters, congenital urethral sphincter mechanism incompetence, persistent urachus, bladder diverticula, hypoplasia of the bladder, prostate, or urethra, and hypospadia. There are many causes of incontinence in dogs, including:. Clinical response and side effects associated with testosterone cypionate for urinary incontinence in male dogs. In addition to the obvious urine in unusual places and the persistent urine smell, your dog may display other symptoms as well. These side effects are generally mild and resolve with appropriate dose reduction. Always follow the instructions provided by your veterinarian. Some dogs with DUD, however, will have more than 15 mL/kg. Bone marrow suppression has not been reported with estriol at the very low doses needed to correct urinary incontinence associated with USMI. Milder adverse effects associated with PPA include restlessness, aggression, changes in sleeping patterns, and gastrointestinal signs. Exercise and playtime can also help indirectly. AEs of estrogen therapy include mammary and vulvar swelling and attractiveness to male dogs. The perineal urethra has the 2 types. This can include frantic attempts to escape their house, digging, destructive chewing, defecating, or peeing in the house. Training for anxiety-inducing behaviors is another way you can help alleviate the condition. Urethral incompetence is most common in dogs who are spayed or neutered; however, the exact mechanism and relationship to estrogen and testosterone decline is unclear. In this case the urethral pressure is overcome by the bladder pressure only after a certain filling volume in the bladder. Unauthorized use of these marks is strictly prohibited. One advantage of using DES to treat UI in dogs is the convenience of treating a patient on a weekly basis rather than daily (Table 1). There are anecdotal reports of the successful use of conjugated estrogens in spayed female dogs with UI (Table 1); however, no studies have been published. In. Although urine leakage may be exacerbated by a urinary tract infection (UTI), the incontinence itself may predispose the patient to a UTI. Often, incontinence starts when dogs are mature or middle-aged. Located in: Wrightstown, New Jersey, United States. If your dog's skin is exposed to urine for an extended period, they could suffer from discomfort or an infection. As a result, even though the dog drinks a lot of water, they can still become dehydrated. Medications often need to be adjusted over time and sometimes a combination of medications can be more helpful than one on its own. Storage and emptying are the two primary functions of the bladder and bowel. In one study Boxer dogs were the most common breed with adult onset of incontinence. This might be the case in urethral sphincter mechanism incompetence. Otherwise healthy dogs should have less than 1 to 2 mL/kg of urine in the bladder after a normal void. Dog diapers could be helpful to avoid messes, but you must be on the lookout for any signs of urine scalding or infection on the dog's skin. Hormone-responsive incontinence occurs in neutered dogs of both sexes but most commonly in female dogs. The good news is that dedication and physical therapy can help your dog recover over time. Prednisone, a cortisone derivative, and furosemide, a diuretic, are two commonly prescribed drugs that can increase thirst. Some dogs may have mild USMI but are rarely incontinent until a secondary factor, such as increased urine volume, comes into play. Male dogs may be affected by urinary incontinence after they are neutered; if the dog is not neutered, the incontinence may occur only after the age of 9 and rarely before this age. Pets can be incontinent for many reasons, including abnormalities in parts of the brain and spinal cord that control bladder function, birth defects, and disease. See details. Retrospective evaluation of urethral bovine cross-linked collagen implantation for treatment of urinary incontinence in female dogs. If so, the treatment is simple; the dog can be treated with a non hormonal medication known as PPA or Phenylpropanolamine. Medication for dogs including uses, administration, pharmacokinetics, precautions, adverse reactions and more. For example, increasing exercise and using positive reinforcement to help your dog learn place or crate training can help reduce separation anxiety. Dogs who have kidney or liver problems may need to move to a low-protein diet. A normal amount of testosterone will prevent incontinence, while a low amount or no testosterone will cause urinary incontinence. It appears that the obstruction can involve either the smooth or skeletal muscle of the urethra or a combination. Clients should be instructed on indications for and technique of urethral catheterization in their male dog. Scott L, Leddy M, Bernay F, Davot JL. At the same time, dog owners can mistake puddles of urine around the house for incontinence, but this can also indicate behavior problems and not a health issue. So let's look at some of the causes and solutions for dogs who can't hold their pee. We routinely perform cystoscopy in patients with medically unresponsive UI to rule out anatomic abnormalities that may be contributing to clinical signs. Copyright 2023 Today's Veterinary Practice Web DesignbyPHOS Creative. In this case series, we report the effect of testosterone cypionate, given at a median dose of 1.5 mg/kg intramuscularly every 4 wk, in eight male dogs with USMI. Treatment must be tailored based on whether the problem involves an inability to hold urine during bladder filling or an inability to empty the bladder during active urination. In healthy dogs, intra-abdominal pressure transmits to the bladder and proximal urethra. Urinary incontinence and micturition disorders: pharmacologic management. Overexertion or stress can cause incontinence in dogs, and it can disappear as quickly as it appears. 2017). See details. In animals with a caudally positioned or pelvic bladder, the proximal urethra is not within the abdominal cavity, and this pressure is not exerted on the urethra. Resumption of testosterone treatment clearly improved the symptoms in the two dogs. Keeping your dog fit and as active as possible may not specifically help incontinence, but it can help their overall well-being and bodily functioning. In animals with a normally positioned bladder, rises in intra-abdominal pressure transmit to the proximal urethra as well as the bladder, preventing urine leakage. Management of urethral incompetence in dogs may require adjustments in their therapy as they age or develop additional health concerns. While you can't make your female dog do kegel exercises like humans, exercise can still reduce stress hormones and help with anxiety issues. Unfortunately skunk spray is pretty common in the US and Canada, so if your dogs come off worse for wear, dont panic, heres what you need to get rid of that awful smell. -Antagonists are a mainstay of smooth muscle relaxation, while the addition of low doses of diazepam just before urination can relax the skeletal muscles. FSH and LH plasma levels in bitches with differences in risk for urinary incontinence. This creates a pressure gradient from bladder to urethra and leads to urine leakage. Testosterone will cause the urinary sphincter to tighten and regain control again. WebMD does not provide medical advice, diagnosis or treatment. It has been hypothesized that the increase in these gonadotropins has either a direct negative impact on the urethral closure pressure or results in decreased bladder function.11,12. Male spayed dogs might also suffer from "Spray incontinence" due to the decrease of testosterone. Urethropexy may have an increased complication rate (21%) compared with colposuspension, with surgical revision being required in animals with urethral obstruction.21, A recent report of a combined technique of urethropexy and colposuspension revealed an improved success rate (70%) and durability compared with either procedure alone, as well as fewer complications (10%).22. Treatment with reproductive hormones is often effective in treating the condition, which is commonly hormone-responsive. Aaron A, Eggleton K, Power C, Holt PE. Diethylstilbestrol (DES) is a synthetic, nonsteroidal estrogen first synthesized in 1938. These medications provide a very low dose of estrogen to increase urethral tone and relieve urinary incontinence in many dogs. In some cases, urodynamic evaluation can be performed at specialized centers to rule out overactive bladder and confirm the diagnosis of USMI. Evaluation of the prevalence of urinary incontinence in spayed female dogs: 566 cases (2003-2008). Often it is initiated on an empirical basis, with minimal pretreatment diagnostics other than a urinalysis and urine culture. Middle-aged to older spayed female dogs are prone to what is referred to as spay incontinence. This is a form of incontinence commonly caused by lower estrogen levels, which can lead to a loss of muscle tone in the urethra. Conjugated estrogens (Premarin, pfizer.com) naturally derived from the urine of pregnant mares have been used to treat a variety of postmenopausal symptoms in women. In support of this theory, data from one study have shown that the administration of GnRH analogues to dogs with USMI can lead to improvement of continence.5, In animal models, estrogen has trophic effects on the vasculature and tissue matrix of the lower urinary tract and its support structures. official website and that any information you provide is encrypted As a result, neutered male dogs are also more likely than unneutered dogs to experience urinary incontinence. Urodynamic evaluation can be performed to rule out overactive bladder and confirm the diagnosis of UI. Symptoms of hormone-related incontinence can develop in a neutered pet months or even years after the procedure. One of the most common causes of urinary incontinence in dogs is the Urethral Sphincter Mechanism Incontinence or USMI. Neutering removes a male dog's testicles. Vet Rec. Some studies findings have implicated a rise in luteinizing hormone and gonadotropin-releasing hormone (GnRH) levels as well as increases in their receptors in female animals secondary to the decline in estrogen levels after neutering.4,5 These changes may affect smooth muscle contractility in the lower urinary tract. So the two issues can compound one another. The material is injected submucosally into the proximal urethra via cystoscopy (Figure 1). #2: Hormonal disruption in neutered male dogs heighten the risks of other growth centers. Female dogs appear to have similar response rates to estriol and DES (89% and 87%, respectively).9,10 Adverse effects with its use include mammary and vulvar swelling and attractiveness to male dogs. A dye study of the bladder is usually performed, and it is common to collect a urine sample for bacterial culture and to see if the urine is dilute or shows evidence of an infection that could be the cause of incontinence. 1-Agonists are likely the most commonly used UI therapy in veterinary medicine. Urinary and fecal incontinence can be permanent consequences of spinal cord injuries. Estrogen plays an important role in the strength and robustness of pelvic and periurethral tissues. The median duration of continence without additional medical therapy ranged from 8 months to 2 years.11, Other surgical therapies for UI focus on increasing the transmission of intra-abdominal pressure to the proximal urethra and improving stability and pressure within the urethra. [Urinary incontinence in castrated female dogs. This article reviews the medical and surgical options available for treatment of urethral incompetence and provides guidelines to choosing the best one for each patient, as well as comments on prevention for potentially at-risk dogs. This may be more common in breeds such as greyhounds, Doberman pinschers, and Weimeraners.6. Breeds that are more prone to incontinence include: Most pet owners will notice their dog leaking urine while asleep or on the bed resting. There is strong evidence that estrogen increases the baseline resting urethral pressure in animal models of incontinence.6 These compounds are usually well tolerated and are a good choice for female dogs with concurrent diseases that predispose them to hypertension or that are intolerant of -agonist treatment. Urinary incontinence in dogs can often be successfully treated or managed with surgery and medications. Other AEs of phenylpropanolamine include restlessness, aggression, decreased appetite, and insomnia. Urethral Bulking Agents Dogs with ureteral ectopia will have incontinence from the time they are born. -Receptors, which are part of the sympathetic nervous system, are mediators of smooth muscle contraction and relaxation in a variety of tissues. Often, these medications do not need to be given as frequently as other medications. As with estriol, these are usually dose-related and subside with dose reduction. Little is known about long-term outcomes in male dogs with DUD, and evidence for treatment efficacy is lacking. This information is not meant to be a substitute for veterinary care. This procedure has been adapted for use in dogs with some success; however, its use is not widespread. Based on owners' assessments, a good to excellent response was reported in three of eight dogs (38%), a slight response was reported in one of eight dogs (12%), and a poor response was reported in four of eight dogs (50%). The pet can urinate normally, but they leak urine while resting. Medical treatment for DUD generally consists of muscle relaxation and, occasionally, anxiolytic therapy (Table). Dr. Byron is a clinical professor in the department of veterinary clinical sciences at the Ohio State University (OSU) College of Veterinary Medicine. Canine incontinence. Estrogen also appears to have a trophic effect on the periurethral tissues and vasculature and thus may reduce incontinence through improved urethral support. Another home remedy for incontinence worth exploring is corn silk supplements. Some dogs exhibit worsening clinical signs when stressed or anxious, and these patients may benefit from trazadone, fluoxetine, or other anxiolytic medication. Based on owners assessments, a good to excellent response was reported in three of eight dogs (38%) (Palme et al. You can start by assessing your dog's lifestyle and diet. Osteosarcoma is a common cancer in medium/large and larger breeds with a poor prognosis. The diagnosis is made by assessing urine stream and residual urine volume. Prostate diseases should be managed with suitable medication. Phenylpropanolamine (PPA) (Proin, prnpharmacal.com) is the most widely used -agonist for the treatment of UI. Oops! A normal amount of testosterone will prevent incontinence, while a low amount or no testosterone will cause urinary incontinence. Not every dog needs a weekly appointment at their favorite groomer though, theres plenty you can do yourself at home. The surgical placement of an artificial adjustable hydraulic urethral sphincter (Figure 2) around the urethra has been studied in female dogs and anecdotally used in males. Fluid inside the cuff can be adjusted by the veterinarian to achieve a level of pressure that maintains continence during bladder filling but does not lead to obstruction when the bladder and abdomen contract. -Agonists can be used in dogs and cats and in both sexes. This can occur across a range of severity, from small leaks to large amounts of urine.Incontinence is a separate issue from behavior-related urination problems. This is because estrogen and progesterone strengthen the muscles that keep urine in the bladder. Stay current with the latest techniques and information sign up below to start your FREE Todays Veterinary Practice subscription today. Normal return to fertility after . Therapy depends on the underlying disease. This FDA-approved drug is commercially available in doses designed for use in dogs. The most visible sign that your dog is incontinent is dripping urine. Depending on the findings of these tests, other tests may be necessary too. Epub 2017 Nov 13. Epub 2017 Mar 3. Both are affected after a severe spinal cord injury, as damaged nerves can't control full bladders. Reversion of feminization in male dogs following removal of estrogenic testicular . Blood work might help to identify underlying diseases. At The Ohio State University Veterinary Medical Center, we recommend obtaining baseline systolic blood pressure before starting phenylpropanolamine, because hypertension is a potential adverse effect (AE) of -agonist therapy. The few existing reports. Congenital urethral sphincter mechanism incompetence can occur in combination with other malformations or alone. Urinary incontinence in dogs is treatable, even curable. A bladder infection can cause a strong urge to urinate, but the animal is usually not truly incontinent since they knowthey are urinating. In this case, the urethral closure is constantly overwhelmed. Problems like a UTI or kidney issues usually benefit from more moisture with their food. However, these drugs can also have side effects on the bone marrow, so we monitor . Fearful dogs are particularly prone to peeing under stress. Older pets can also develop senility and simply be unaware they are dribbling urine. Hypertension, or a predisposition to hypertension caused by concurrent disease, is a major contraindication to using PPA. In addition, during the night, dogs are most likely to go without a bathroom break for longer when sleeping, making a full bladder part of the problem. Here are some symptoms of urinary incontinence in dogs: If your house-trained dog suddenly becomes incontinent, there may be an underlying health problem. Estriol (Incurin, merck-animal-health-usa.com) is the only commercially available FDA-approved estrogen for the treatment of UI in the United States (Table 1). Frequently both an estrogen and PPA are used in the same patient for severe or refractory incontinence. If your dog is exhibiting any signs of urinary incontinence, you should call your veterinary clinic or schedule an appointment with one of the internal medicine veterinarians at the WSU Veterinary Teaching Hospital by calling 509-335-0711. Due to the fact that the dog cannot control his bladder muscles, he will be more likely to develop urinary infections. On the other hand, testosterone, a hormone found in male dogs, aids in the strengthening of the muscles that lead out of the urinary bladder. Byron JK, Chew DJ, McLoughlin ML. These tests can help determine the root cause and best treatment plans for your dog. A dog that is dripping urine is not only an issue of smell and hygiene but often a symptom of underlying health issues. Dogs with genuine urinary or urethral incontinence often pee while resting or sleeping with no obvious triggers. 18 It is important to mention that benign prostatic hyperplasia was induced in beagles treated with testosterone . This birth defect causes one or both ureters to enter the bladder neck incorrectly, for instance, into the urinary tract or vagina. In cases like bladder stones and congenital abnormalities, your vet may recommend surgery. Are large breeds at greater risk? Male dogs with USMI have a lower and less predictable response rate to alpha agonists (<50%) but may respond to injections of testosterone cypionate given every 6-8 weeks. Some examples are changes to the vaginal support structures, genetics, estrogen deficiency or decline, and abnormal bladder positioning. 2018 Jan/Feb;54(1):22-29. doi: 10.5326/JAAHA-MS-6524. Sometimes, males may benefit from testosterone injections, but this is less common. Dogs with this condition lack strength in the muscles that regulate urine output from the bladder. Certain amino acids, like L-arginine, are necessary to clear out ammonia build-up in the body, which can help the urinary tract. White RN. Dogs that need to pee so much may become incontinent or unable to regulate how fast urine exits their bodies. 2001), but recent studies have suggested an average of 10.2 5.1 months (2.1-23.3 months) with the use of 4.7-mg implants (Maenhoudt et al. When no specific cause can be identified for the incontinence, drugs may be given that increase the tone of the muscles that hold urine in the bladder. A big part of your dog's hormonal endocrine balance comes from hormones made in the testicles (in males) or the uterus and ovaries (in females). Some practitioners avoid the use of estrogen compounds because of the potential for irreversible myelosuppression seen in dogs treated with estrogen compounds for mismating or to induce estrus.8,9 While this is a potential toxicosis, the doses associated with bone marrow suppression are generally at least 10 times higher than those recommended for management of UI. Some patients may require significant dose adjustments of medications to determine the optimal therapy. The material is injected submucosally into the proximal urethra via cystoscopy (Figure). These drugs can affect the bone marrow; your vet will need to do frequent blood work with this therapy. Urinary incontinence (UI), a common problem encountered in small animal practice, can result from congenital anatomic abnormalities, urine retention and overflow incontinence, or sphincter incompetence. Severity can range from small leaks to the voiding of a large amount of urine. Most often they will have other signs of nervous system disease, such as muscle weakness or paralysis. A careful history is essential when discussing UI with pet owners. Sontas HB, Dokuzeylu B, Turna O, Ekici H. Estrogen-induced myelotoxicity in dogs: A review. This review focuses on 2 of the most common causes of UI: urethral sphincter mechanism incompetence (USMI) and functional urethral obstruction, also known as detrusor urethral dyssynergia (DUD). After dose reduction or withdrawal, two of eight dogs had recurrence of urinary incontinence. Similar to colposuspension, this increases transmission of intra-abdominal pressure increases to the urethra as well as the bladder and bladder neck, preventing a negative pressure gradient into the outflow tract. "At the time of the inquiry, the average age of the bitches was 6.5 years and the average age at the time of surgery was 7.1 months," the study sates. 2017;53:285290. The ureters carry urine from the kidneys to the bladder, and if one or both ureters bypass the bladder and connect to an abnormal location, such as the urethra or vagina, the puppy may drip urine. While there are a multitude of reasons to eliminate testosterone from your male dog, there are some instances where testosterone is advised as a treatment for certain health conditions. Colposuspension, which attaches the uterine remnant to the pelvic ligament and thus draws the bladder neck and proximal urethra farther into the abdomen, has been found to have variable success and a high failure rate due to breakdown of the attachment to the pelvic ligament.12. Copyright document.write(new Date().getFullYear()) MH Sub I, LLC dba Internet Brands. Lane IF, Westropp JL. Behavioral changes are important factors as well. Testosterone intensifies the male behavioral patterns in male puppies and adolescent dogs. Urethral sphincter mechanism incompetence in 163 neutered female dogs: diagnosis, treatment, and relationship of weight and age at neuter to development of disease. Peterson KL, Lee JA, Hovda LR. If your dogs leaking urine frequently due to fear or anxiety, help them by identifying the type of anxiety they're experiencing and potential triggers. If your dog is affected by incontinence before the age of 9, he may have a tumor that needs to be detected. Barth A, Reichler IM, Hubler M, Hssig M, Arnold S. Evaluation of long-term effects of endoscopic injection of collagen into the urethral submucosa for treatment of urethral sphincter incompetence in female dogs: 40 cases (1993-2000). Here's the information you need on what causes dog incontinence and what you can do about it. Oftentimes the dogs only lose urine while sleeping. Adverse effects were not reported, and benefit was judged sufficient to continue therapy in two cases. The timing of the onset of UI and the ability of a dog to empty its bladder are important in determining the underlying cause. Sometimes we can use testosterone in males. PMC A bladder that is always small indicates continuous loss of urine, a bladder that is not empty after urination indicates an obstructive lesion or detrusor atony. The artificial urethral sphincter. Since that time, DES has not been available commercially and is only available to the veterinary community through compounding pharmacies. This is possibly caused by misdiagnosis of dogs with functional urethral obstruction and overflow incontinence. The larger the dog, the more pronounced this alteration in risk becomes. Incontinence can occur in dogs suffering from anxiety, particularly separation anxiety. When they fall below .4ng/ml, the dog is considered infertile. Because it is inexpensive and infrequently administered, it is the first choice to treat urinary incontinence in female dogs. Heres all you need to know about those early adventures. To improve your dog's quality of life without altering their routine, you can also: Urinary incontinence is a distressing condition that can affect the relationship between pet owners and their dogs. A good general guideline is to perform an indirect systolic blood pressure on any patient before treatment with PPA and repeat the evaluation after 1 to 2 weeks of therapy. It was widely used in the United States and worldwide to reduce pregnancy complications and treat a variety of conditions in women until 1971; it was found to contribute to an increased risk of neoplasia and birth defects in the children of expectant mothers who took the drug. 2010 Oct;186(1):18-24. doi: 10.1016/j.tvjl.2010.06.011. Diethylstilbestrol isnt commercially available in the US, but if your vet recommends it, a compounding pharmacy may be able to provide it. The pet can urinate normally, but they leak urine while resting. 2012). Some medications could cause your dog to leak urine as a side effect. Male dogs with UI pose a more difficult challenge. Bladder leaks are not an uncommon occurrence in older dogs. Dogs with low estrogen levels, obesity, and larger breed size can experience bladder sphincter and valve laxity, leading to urine leakage, especially while they sleep.