A common problem for which families bring their pet to veterinarians is urinary incontinence or involuntary leakage of urine. This week’s post is dedicated to this medical problem in an effort to increase awareness. I hope you find the information helpful and will share it with other pet owners. Happy reading!

What causes urinary incontinence?

The urinary tract has different sections, including:

• Kidneys – majors functions are to filter metabolic waste products, make urine, help control electrolytes & blood pressure, make various hormones
• Ureters – small tubes that connect the kidneys to the urinary bladder
• Urinary bladder – storage site of urine
• Urethra – tube that connects the urinary bladder to the outside world
• Prostate (males only) – reproductive organ that produces a fluid that combines with sperm from the testicles and fluids from other glands to make up semen. The prostate ensures semen is forcefully pressed into the urethra and expelled during ejaculation
• Vestibule & Vulva (female only)

Problems can arise in any of these anatomic locations, leading to urinary incontinence. Major causes of urinary incontinence are:

• Urethral sphincter mechanism incompetence
• Pelvic bladder
• Urethritis (inflammation of the urethra)
• Cystitis (inflammation of the urinary bladder)
• Cancer in any part of the urinary tract
• Urethral dysplasia
• Detrusor hyperspasticity (aka “urge incontinence”)
• Urolith (urinary stone) formation
• Spinal cord disorders
• Dysautonomia
• Prostatic diseases

How is it diagnosed?

Diagnosing the cause of a pet’s urinary incontinence is not always straightforward. For that reason, a veterinarian will ask you a lot of questions to get a better idea of what’s going on with your pet. It’s very important to answer all questions as thoroughly as possible.

Whenever possible, please video record your pet urinating. If a picture is worth a thousand words, a video is priceless!

Questions who will likely be asked are:

• Does your pet posture to urinate normally?
• Does your pet strain to urinate?
• Do you believe your pet experiences pain or discomfort when urinating?
• Describe your pet’s urine stream?
• Describe the volume of urinate your pet eliminates?
• Does your pet need to urinate more frequently?
• Does you believe your pet feels an urgency to urinate?
• What color is your pet’s urine?
• Is your pet drinking more water than normal?
• Does your pet lick their vulva or penis more frequently than usual?
• Does your pet “wet the bed”? Does your pet leak urine after laying down but not sleeping?
• Does your pet walk around dribbling urine? If yes, do you believe your pet knows they are dribbling urine?

Your answers to the above questions – in combination with findings from a veterinarian’s complete physical examination – will help the doctor choose the most appropriate diagnostic test(s) for your pet. Common tests that may be recommended based on your pet’s history and physical examination are:

• Complete blood count
• Serum biochemical profile
• Urinalysis
• Urine culture
• Diagnostic imaging – potential imaging modalities include radiography/x-rays (with contrast), abdominal sonography, computed tomography (CT scan), and cystoscopy

How is it treated?

Treatment of urinary incontinence depends on the underlying cause. For example, pets with urethral sphincter mechanism incompetence (USMI) are treated quite differently than those with spinal cord problems causing urinary incontinence. Suffice it to say, some causes are curable while others require chronic / lifelong management. For this reason, obtaining a definitive diagnosis is of paramount importance. Pet owners may find it helpful to partner with a board-certified veterinary internal medicine specialist to develop both logical diagnostic and treatment plans.

The take-away message about urinary incontinence in pets…

Urinary incontinence is a common problem for which pets are presented to their veterinarians for evaluation. Obtaining an accurate diagnosis is essential to maximize the likelihood of positive outcome.

To find a board-certified veterinary internal medicine specialist, please visit the American College of Veterinary Internal Medicine.

To find a board-certified veterinary surgeon, please visit the American College of Veterinary Surgeons.

Wishing you wet-nosed kisses,

CriticalCareDVM