Urinary Incontinence in Puppies and Dogs, My Experiences and Solutions.
With contributions by Dr. Tracy Acosta, Acosta Veterinary Hospital In 2006,
I raised a large litter of Wirehaired Pointing Griffon puppies. One of the pups I kept was a wonderfully comical, joyful female that I named Bellibone. She was a healthy, precocious pup until she was around 8 weeks old. At that young age, she became depressed, lethargic, and began drinking more water than she should have been. Upon examining her, I discovered that she had some white discharge from her vulva and she did not smell right. My reproductive specialist veterinarian at the time prescribed ten days of amoxicillin. The puppy felt better and we just assumed that she had a low grade UTI. However, a few weeks after the last dose of antibiotics, Bellibone began to show signs of discomfort again, began peeing in her crate after only an hour or two, and was ‘spot peeing’ small amounts frequently in and out of the house. After another round of amoxicillin, the same thing happened. She felt better during the course (this time her vet ran a urine sample to confirm the infection), but a few weeks after the course, the symptoms returned, but worse. This cycle continued and she ended up with a canine urologist at UC Davis for diagnosis. After Nuclear Scintigraphy, a Contract Study, and thousands of dollars, the specialist ruled out Ectopic Ureters, anatomical contributors, and everything else he could think of. But the infection still raged on, migrating to her kidneys and making her extremely ill. She was five months old, in stage one kidney disease, and was taking 675mg of Clavamox twice a day. But the cycle continued to repeat itself for three months…14 days of Clavamox and better health, two weeks later, symptoms that the infection was still present. Then she had her first heat cycle at 8 months old, the infection did not return, and Bellibone became the outgoing, nutty puppy she had been.
Bellibone’s persistent infection remained a mystery until I sent a puppy up to a family in Washington State. They took her to their country vet for her puppy wellness exam. The vet was so impressed by her that he phoned me to enquire about getting a pup from me in the future. He commented that the pup brought to him was wonderful and healthy, that the only thing he would advise was that the owners should keep her vulva clean with zinc free baby wipes once a week until she had her first and ideally second heat cycle before she was spayed. When I asked why, he told me that she had a ‘cloaked vulva’ which simply meant that she had excessive skin around her vulva that could retain debris, causing chronic UTIs until she had a heat cycle whereby her vulva would become stretched out permanently, eliminating the creases that retained and brewed infections.
That call was an “EUREKA!” moment. I took the information back to Bellibone’s urology specialist and he confirmed that she had a cloaked vulva. Since that experience, I have seen this condition in many, many other dogs and breeds. Over the years, owners frequently contact me for help with their incontinent puppies. If female, I ask them to examine their pup to discover if she has a cloaked vulva right away. Dr. Tracy Acosta, who has her own successful practice in Biloxi, MS, agrees. She says, “…it [the female puppy’s vulva] should be checked on any routine exam, especially those with urinary issues of any kind.” But a cloaked vulva in a female pup is only one of many causes of UI. This UC Davis article about Urinary Incontinence suggests a few causes including Ectopic Ureters, but does not cover Cloaked Vulvas or other juvenile causes such as simple immaturity.
It needs to be mentioned that Urinary Incontinence and ‘tinkling’ when excited, are two, completely different things. When a puppy loses urine in excitement or submission, I simply ignore it and the behavior eventually goes away on its own. Sometimes it will resolve by the time they are a few months old, and sometimes it can persist until they are adults. Focusing on it, scolding the behavior, always makes it worse; a dog has no idea why a person is angry when they are piddling from excitement or submission and only become confused and nervous, often leading to more piddling. Dr. Acosta agrees, “Do NOT scold [for excited or submissive dribbling], ignoring this behavior works best.”
Puppies, like humans, do not have completely mature urinary tracts for some time. Each breed and each puppy will have their own maturation rate and owners must do what is necessary to accommodate their pups during house training and crate training. As I mentioned earlier in this article, I frequently get calls from puppy owners (of both male and female pups) who report that their pups were doing very well with house training but they have suddenly regressed. These pups might be ‘spot peeing’ in frequent, small amounts, ‘leaking’ (pooling) while asleep, piddling in their crates after a short time, drinking excessively, acting otherwise normally or behaving lethargically, their urine might be poorly concentrated (looking like water), etc. The first thought is to have the puppy examined by a veterinarian to rule out infection. However, many puppies will run a low grade UTI but be negative in a urine culture. This can be extremely difficult for a vet to treat.
In these cases, I error on the side of caution—preferring to treat the situation like it is an infection rather than a behavioral issue. Either way, the solution is the same. I recommend that young puppies, between 8 and 14 weeks old perhaps (healthy or with a suspected infection), not spend more than three to four hours straight, in a crate (this might be less for some pups). I recommend plenty of outdoor breaks during the day, and a break or even two in the middle of the night to take the pressure off of the small, immature bladder. This is even more important for small breeds! From 14-24 weeks old, they may have matured enough to handle up to six hours straight in their crate. After six months old, I go on a case by case basis, allowing that some six to eight month old pups might have mature enough urinary tracts to handle a full night without a break. Female pups who have cloaked vulvas can follow the same protocol so long as their vulvas are kept clean on a weekly basis (or more frequently depending upon the amount of skin coverage, extreme cases apparently require minor surgery to remove excess skin in the area). Dr. Acosta advises, “I recommend that owners of female dogs who are having chronic urinary issues keep the area around the vulva clean. I usually recommend an eye wash (not saline) because some baby wipes can have zinc which is toxic to dogs.”
There are some owners who choose to crate their pups all day while they are at work during the week, I do not recommend this for many reasons, and urinary tract stress is one of them. During the day, all systems accelerate and the urinary tract is one of them. During the day, dogs drink more and pee more. During the night, systems slow down. Dr. Acosta provides the following solutions, “A good alternative to crating all day is for owners to seek out a reputable day care facility. That way pup is socialized and not crated all day, I have many clients who take advantage of these services.”
In older dogs, the reasons for UI can be different. In my own Griffons, I have noticed that some of my females have become incontinent after being spayed. Apparently this is due to a condition called Urethral Sphincter Mechanism Incompetence. You can read more about this condition in this article. When dogs experience UI, depending upon the cause, veterinarians might prescribe hormone treatments, medications that strengthen the urethral sphincter, collagen injections, or surgery. Some owners who have little or no luck with diagnosis or treatments will find waterproof dog bed liners like these (I have used these for my large household full of young and old dogs alike for years and really like them). Some owners will also buy waterproof throws like these (I have one of these, it is a decent throw. It is a little heavy, but definitely prevents urine, vomit, and other fluids from soaking through.) While not a fun aspect of dog ownership, UI is not uncommon and we just have to deal with it as it comes, and not blame the dog. These products make it easier for us to deal with our loved pets’ incontinence issues.
Certainly urinating in the home can be behavioral. Some dogs will begin to ‘mark’ the house for various reasons and some dogs will give up on owners who have not been sensitive to their urgencies. But these behavioral issues should not be confused with UI due to infection, immaturity, senility, hormonal imbalance, or anatomical abnormalities. Cloaked vulva is also known as, tucked vulva, hooded vulva, hypoplastic vulva, recessed vulva, and juvenile vulva, see this article for a medical description of this condition.
Common causes for Urinary Incontinence:
- Urinary Tract Infection
- Cloaked Vulva
- Hormonal Imbalance
- Weak Bladder Sphincter
- Urinary Stones
- Spinal Injury or Degeneration
- Prostate Issues
- Disease such as Diabetes (diabetes insipidus and mellitus), Hyperadrenocorticicm, Kidney Disease
- Certain Medications
- Congenital, Anatomic abnormalities such as ectopic ureters
To conclude, Dr. Acosta gives the following advice, “It is important for owners with male or female dogs with any form of urinary issue to have it medically investigated to rule out the easy rule outs. All female pups, no matter what breed, should have a good physical exam during their puppy vaccination series that determines if a cloaked/tucked vulva is obvious. I see tucked vulvas in all breeds, mixed and pure, and all sizes. Many female dogs that have this history of chronic UTI’s or urinary issues, have a tucked vulva. Tucked/cloaked vulvas are so easy to check for and can help relieve a lot of clients once they are diagnosed and other issues ruled are out. A very high percentage of the pups I see with this, resolve after first heat cycle. When I determine that a female has a tucked vulva, I let the owner know that they need to let the dog experience one heat cycle and then about 8 weeks after the cycle, let me examine her to determine if a spay can be done. Additionally, pups need potty breaks—and either owners make it happen, hire a pet sitter to do it, or utilize day care options.”
Written by Katy Stuehm with contributions by Dr. Tracy Acosta
**Do not copy or share without written permission from the author.**