The Edmond Sun

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December 31, 2012

VET Q&A: Urinary incontinence is very treatable

EDMOND — Q: I have a 7-year-old female dog that is leaking urine, especially when she is sleeping, but it can occur at other times as well. Her name is Ellie and she seems fine otherwise.  She is eating good, is playful and still eager to go on her walk every morning.

A:
It sounds like Ellie has urinary incontinence. Urinary incontinence can be life-threatening, but on the other hand, is easily treated when the cause is identified.

You did not mention whether or not she is drinking extra water lately or not, which may be important since other diseases can result in urinary incontinence. Medical conditions such as diabetes, a chronic kidney disease, Cushing’s Disease, etc., can result in urinary incontinence. For this reason, your veterinarian will want to do a full blood chemistry and complete blood count. The information from these tests can give a clue as to whether or not she has some other medical problem that is causing her incontinence.

A high blood glucose level can indicate diabetes, elevated BUN and creatinine on her blood work can indicate a chronic kidney disease. Levels of electrolytes as well as enzyme levels in her blood if abnormal, can give a hint that she may have Cushing’s disease, which occurs when her adrenal glands or pituitary are in an over-productive mode.

The most telling information will be a urinalysis to look at her kidney function, urine concentration, the number of white and red blood cells present and quite a number of other bits of information. If her blood glucose is high, and she has glucose in her urine, she is likely diabetic.

Let’s say all her blood work is normal. Should she have an increased number of white blood cells in her urine, she may have a simple urinary tract infection. If her urinalysis is normal then we likely have eliminated down to a loose sphincter muscle that encircles her urethra.  

A common problem in spayed female dogs is a low estrogen level. This causes the sphincter to become weak or incompetent. This sphincter is a ring of muscle that encircles the urethra or the tube carrying urine outside her body, and normally controls the flow of urine out of the body. This type of leakage usually occurs when she is sleeping or at least relaxed and cat-napping. She is totally unaware it is happening.

The danger is that when the sphincter muscle is relaxed and open, bacteria can travel up the urethra to the bladder and eventually even the kidneys, causing a raging infection.   

Treatment is with phenylpropanolamine or PPA. This is a tablet dosed to her body weight and given every 12 hours. The results are almost immediate. Some veterinarians will use a synthetic estrogen diethylstilbestrol or DES. This is not without some side effects and usually not good long-term, so PPA is usually the long-term choice.

There are other causes of sphincter incontinence but they are much more uncommon. One example involves a nerve disorder, especially in the lumbosacral region of the back. Another one is a degenerative myelopathy or lumbosacral disease.  

Your veterinarian will do a thorough physical exam and history with you prior to beginning her treatment so these other conditions can be considered. The greater majority of dogs has simple sphincter incompetence, however, and are easily treated. See your veterinarian as soon as you can to avoid secondary infections and to make her feel more comfortable in the long run.

DR. M. MARGARET KING, a longtime Edmond veterinarian, is a guest columnist. If you have any questions for her, email them to mkekdoc@sbcglobal.net.

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