Urinary Incontinence
What is urinary incontinence?
Urinary incontinence is a term meaning inappropriate and unconscious leakage of urine. It must be distinguished from behavioural inappropriate urination.
Which animals are affected and what are the symptoms?
Older female dogs are most commonly affected by incontinence, although all ages and sexes can be affected. There is a link between early neutering of bitches and development of urinary incontinence, although this link is not yet completely understood. Cats are very rarely diagnosed with urinary incontinence. Symptoms include wetness around the back end, including skin scalding/dermatitis. Some dogs develop urinary tract infections (UTIs) secondary to incontinence, while in some dogs the UTI can cause incontinence. Urinary incontinence in young dogs can be a symptom of ectopic ureter (abnormal emptying of the ureters), which is managed differently.
Investigations
You will have a consultation with either one of our internal medics or surgeons, who will take a thorough history of your pet’s problems. Next, the vet will perform a full physical, including urine tests and possibly blood tests. An ultrasound, radiographs or a CT-scan is often then performed to determine the position and health of the urinary tract organs.
Medical management
Most dogs are treated medically first, before embarking on surgical management. Any dog with a UTI is treated for this first, and urine tests are repeated until a sterile sample is obtained. Following this, medical management is begun, involving daily medication aimed at strengthening the urethral sphincter muscle. In most cases, medical management results in adequate control of the symptoms.
Surgical management
If medical management of urinary incontinence does not work (usually after a period of 6-8 weeks), then surgical management is appropriate. Options include repositioning the bladder and urethra into the abdomen by gently moving the organs of the genitourinary tract, or by placement of a pressurised “bag” around the urethra to give it additional control.
Prognosis
Following surgical management, approximately 60% of dogs have complete urinary control, 30% have improved control, but unfortunately approximately 10% have no improvement.