If you are noticing wetness where your dog’s been sleeping it may be the start of urinary incontinence.  Whether due to aging, injury, or a medical condition, urinary incontinence is a frustrating issue for both dogs and their guardians. But don’t worry, there are steps you can take to help manage it. Let’s explore the common causes of canine incontinence and discuss what you can do to make life easier for both you and your dog.

Urinary incontinence (UI) in dogs is the involuntary leakage of urine, commonly due to an inability to store urine in the bladder. This condition can stem from neurological issues, bladder dysfunction, and even surgical procedures such as spaying.

Pathophysiology Normal bladder function is a balance between storing and voiding urine, controlled by both the sympathetic and parasympathetic nervous systems. When this balance is disrupted, involuntary leakage or an inability to store urine properly can result in urinary incontinence.

Bladder storage disorders in dogs occur when the bladder muscles contract involuntarily, leading to leakage of urine. This can happen due to bladder irritation from infections (like UTIs), bladder wall inflammation (due to stones, tumors, or chronic conditions), or nerve-related issues. Terms like “detrusor hyperreflexia” refer to these sudden and uncontrollable bladder contractions, which can result from nerve damage, brain conditions, or just an overactive bladder. Sometimes, the bladder contracts even without a clear cause. This can lead to “urge incontinence,” where dogs feel a sudden need to urinate but can’t hold it.

Urethral disorders in dogs occur when the urethra (the tube that carries urine out of the body) doesn’t close properly, leading to urine leakage. This can be caused by inflammation (urethritis), congenital issues, or nerve problems that affect the bladder and urethra. For example, conditions affecting the spine or nerves can reduce the pressure needed to keep the urethra closed. In some spayed female dogs, a condition called Urethral Sphincter Mechanism Incompetence (USMI) is common. It happens when the muscles that close the urethra weaken, often due to lower estrogen levels after spaying, genetics, or weight gain. Male dogs may experience a different issue called detrusor-urethral dyssynergia, where the muscles don’t coordinate properly during urination, causing blockage.

• Hormonal Imbalance (often due to spaying): A decline in estrogen after spaying can contribute to the weakening of the urethral muscles, leading to leakage.
• Urinary Tract Infection (UTI)
• Bladder Stones
• Weak Bladder Muscles (especially in older dogs)
• Nerve Damage (due to injury or spinal disease)
• Chronic Kidney Disease
• Diabetes
• Hyperadrenocorticism
• Bladder or Urethral Tumors
• Congenital Defects (e.g., ectopic ureters)
• Obesity (which can add pressure to the bladder)
• Medications such as steroids, Furosemide.
• Arthritis

1. First rule out underlying causes such as urinary tract infection, metabolic diseases that increase urination such as diabetes and cushing’s disease, bladder stones and bladder abnormalities. This can be done by checking a urinalysis/culture, bloodwork and abdominal ultrasound. Contrast cystourethrography may be considered to evaluate for anatomical abnormalities and other lower urinary tract disorders. Advanced imaging (i.e. computed tomography, magnetic resonance imaging) may be indicated when neurologic deficits are present.
2. Chiropractic, Acupuncture, and Osteopathy Misalignment in the spine or nerve injuries can cause bladder control issues. Holistic treatments like chiropractic adjustments and acupuncture can relieve nerve pressure and improve bladder function.
3. Manage arthritis. Decreased mobility and arthritic pain can contribute to urinary incontinence. I have found many of my patient’s incontinence problems resolve once the arthritis is properly managed. Check out my blog to learn more about arthritis management.
4. Herbal Remedies and Herbs like wild yam extract, soy isoflavones, and cranberry can naturally support bladder function by mimicking estrogen or reducing bladder inflammation. They are often included in supplements designed to promote urinary health.
5. Anti-inflammatory remedies such as turmeric, ginger, PEA and Boswellia help reduce bladder inflammation and support overall bladder health. These herbs are useful for both urinary incontinence and conditions like arthritis, which may indirectly affect bladder function.
6. Homeopathy when tailored to the dog’s specific needs, can be highly effective in treating UI. Remedies like Leaks No More have shown success in managing incontinence when combined with other holistic treatments.
7. Manage exercise: If your dog loves sprinting, chasing balls, or sticks for long periods, it’s best to take a break from those activities for about a month when urinary incontinence becomes an issue. Instead, try walking or hiking. Sprints can put extra strain on their lumbar region, leading to muscle spasms and nerve issues that worsen incontinence. Taking these steps will give their muscles a chance to rest and heal.

In addition to holistic therapies, there are conventional treatments for dogs that may be appropriate, especially in cases where natural remedies alone do not provide sufficient relief.

• Medical Therapy: I reserve this type of therapy for those patients where natural remedies and methods have been unsuccessful and the urinary incontinence is severely affecting the dog (and the guardian’s) quality of life. Medical treatment often aims to increase urethral sphincter tone or decrease detrusor muscle contraction. Common drugs include:
  • Phenylpropanolamine (PPA): An alpha-adrenergic agonist that increases urethral tone, helping many dogs manage USMI. However, it may cause side effects like hypertension and tachycardia, especially in dogs with existing heart or renal conditions.
  • Estrogen Therapy: Post-spay incontinence can be treated with estrogen supplements like Estriol (Incurin®) or Diethylstilbestrol (DES), which enhance urethral responsiveness.
  • Testosterone Cypionate: Used in male dogs with variable success to improve sphincter tone.

• Combination Therapy Combining PPA with estrogen therapy can sometimes produce better results than using a single agent, offering a synergistic effect that improves incontinence control.

When holistic and medical therapy fail, surgical options are available:

1. Colposuspension This surgical technique moves the bladder neck and proximal urethra to improve urethral closure pressure and length, with a success rate of 53%-70%.
2. Artificial Urethral Sphincter Placement This involves the insertion of a hydraulic sphincter around the urethra, which can be adjusted to control continence. This procedure is becoming more popular and has a high success rate in both male and female dogs.
3. Bulking Agents Collagen or other bulking agents can be injected into the urethra to enhance muscle fibers and improve closure. However, these injections are temporary and may need to be repeated.
4. Botulinum Toxin Injections Injecting botulinum toxin into the bladder wall has shown positive results, preventing incontinence for up to 5 months in some cases.
5. Stem Cell Therapy Early studies show promise in using autologous muscle progenitor cells to treat USMI by improving urethral function.

Urinary incontinence in dogs can be managed through a variety of integrative and conventional approaches, depending on the underlying cause. By combining holistic methods such as chiropractic care, herbal supplements, and homeopathy with conventional treatments like medical therapy or surgery, pet guardians can significantly improve their dog’s quality of life. Always consult with a veterinarian, particularly a holistic vet, to create a tailored treatment plan for your dog.

1. What is the best natural remedy for urinary incontinence in dogs?
   Herbal remedies such as Phosphoric Acid 1M, wild yam extract, and Boswellia can support bladder health. Consult with a holistic vet for proper dosage and guidance.
2. Is urinary incontinence more common in spayed females?
   Yes, particularly in females spayed before 6 months of age. Hormone-responsive incontinence is often due to decreased estrogen levels post-spay.
3. How effective are surgical treatments for urinary incontinence?
   Surgical treatments such as colposuspension and artificial urethral sphincter placement have high success rates but may be considered after holistic and medical therapies are exhausted.
4. How do holistic treatments compare to conventional treatments for UI?
   Holistic treatments aim to address the root causes of incontinence and improve overall health, whereas conventional treatments focus on managing symptoms.

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