CONDITION

Urinary Incontinence

Why this matters now

Urinary incontinence—the involuntary leakage of urine—is particularly common in spayed female dogs, though it can affect intact females, neutered males, and elderly dogs of both sexes. In spayed females, the condition often develops months to years after surgery. Certain breeds including Boxers, Dobermans, Giant Schnauzers, and Old English Sheepdogs appear predisposed. The condition can significantly impact household management whilst being stressful for affected dogs.

Incontinence in spayed females typically develops gradually. Owners may first notice wet spots where the dog has been sleeping or damp fur around the vulva. The condition may worsen over time if untreated. Episodes are often most noticeable during sleep or relaxation when the urethral sphincter is most relaxed. Without intervention, persistent urine contact can lead to skin irritation and secondary infections.

Signals & patterns

Early signals

Wet spots on bedding

Finding damp patches where the dog has been lying or sleeping is often the first sign noticed.

Damp fur around hindquarters

The fur around the vulva or prepuce may appear wet or stained.

Dribbling urine when standing

Small amounts of urine may leak when the dog stands up from lying down.

Urine odour on dog or bedding

A persistent urine smell may be noticed despite normal toileting behaviour.

Later signals

Skin irritation

Urine scalding causes redness and inflammation of the skin around the vulva or perineum.

Frequent licking of the area

Dogs may lick excessively at irritated skin or in response to wetness.

Secondary skin infections

Chronically wet skin becomes susceptible to bacterial or yeast overgrowth.

Urinary tract infections

Incomplete bladder emptying or sphincter incompetence may predispose to recurrent infections.

Click to read about the biological mechanisms

How this is usually investigated

Investigation aims to confirm incontinence, identify the underlying cause, and check for secondary complications such as urinary tract infection.

Clinical history and examination

Purpose: To characterise the incontinence pattern and examine the urinary tract
Considerations: Details about timing, circumstances, and any associated signs help narrow the cause. Examination may reveal anatomical abnormalities or neurological deficits.

Urinalysis and culture

Purpose: To check for urinary tract infection and assess urine concentration
Considerations: Infection is common secondary to incontinence and may worsen signs. Dilute urine can contribute to larger volumes leaked.

Blood tests

Purpose: To assess kidney function and check for conditions affecting urine production
Considerations: Rules out metabolic causes of increased urination that might be confused with incontinence.

Ultrasound

Purpose: To evaluate bladder, kidneys, and surrounding structures
Considerations: Assesses bladder residual volume, wall thickness, and rules out masses or stones.

Advanced imaging (contrast studies or CT)

Purpose: To identify ectopic ureters or other anatomical abnormalities
Considerations: Ectopic ureters require surgical correction. Advanced imaging may be recommended in young dogs or those not responding to medical treatment.

Options & trade-offs

Treatment depends on the underlying cause. USMI typically responds well to medical management, whilst anatomical abnormalities may require surgery.

Phenylpropanolamine (PPA)

A medication that increases urethral sphincter tone.

Trade-offs: Effective in many dogs with USMI. Given once to three times daily. Some dogs experience restlessness or appetite changes. Long-term use is generally well tolerated.

Oestrogen supplementation

Replacing the hormone lost after spaying to restore urethral tissue health.

Trade-offs: Effective for some dogs. Various preparations available. Bone marrow suppression is a rare but important consideration with certain products.

Combination therapy

Using PPA and oestrogen together when single agents are insufficient.

Trade-offs: May provide better control than either alone. Balances the benefits and considerations of both medications.

Surgical options

Various surgical procedures can improve continence when medical management fails.

Trade-offs: Colposuspension, urethral bulking agents, and artificial urethral sphincters are options. Surgical complexity and success rates vary.

Management strategies

Waterproof bedding, frequent toileting opportunities, and skin care.

Trade-offs: Helpful alongside medical treatment or when medication is not suitable. Does not address the underlying cause but manages consequences.

Common misconceptions

Misconception:

"My dog is urinating in the house deliberately"

Reality:

Incontinence is involuntary—the dog is unaware it is happening. This is different from behavioural urination and should not be addressed with training or discipline.

Misconception:

"Incontinence cannot be treated"

Reality:

Most cases of USMI respond well to medication. Many dogs achieve complete or near-complete continence with appropriate treatment.

Misconception:

"Only old dogs become incontinent"

Reality:

Whilst age is a factor, USMI commonly develops in middle-aged spayed females. Congenital causes like ectopic ureters can cause incontinence in young dogs.

Noting when and where leakage occurs helps characterise the problem. Observing whether the dog is aware of urinating provides useful information—true incontinence typically occurs without the dog's awareness. Monitoring water intake and urination frequency helps identify patterns. Keeping the skin clean and dry reduces secondary complications whilst investigation and treatment proceed.

Last reviewed: 24 April 2026 · Dr Alastair Greenway MRCVS