Dog Bladder Control

Overview

There is a difference between dogs that truly have bladder control problems and those that have control over their bladder, but urinate inappropriately. We are going to discuss dogs with bladder control trouble. If no physical reason for the problem can be found, the problem may be behavioral. In that case, behavioral training will be the solution.

It is important to treat dog bladder control problems, even if your dog lives outdoors. Failure to treat the condition can be life threatening and result in:

• Behavioral Problems - if your dog is uncomfortable they might drink more than usual (polydipsia)
• Skin Irritation (eczema) which can lead to pain
• Odor
• Illness if the problem is due to bladder stones or infection.

Over 64% of young dogs get urinary tract infections (UTI) which can result in multiple symptoms and damage to the bladder. Complications of UTI include damage to the bladder wall, kidney inflammation (pyelonephritis) and a bacterial infection in the blood or tissues (sepsis).

USMI (urethral sphincter mechanism incontinence) is a condition that sets in within 1 year of spaying a female dog. It occurs when your dog cannot close the flow of urine with the muscles that surround the urethra (the tube that leads from the bladder to outside the body).

Symptoms of Dog Bladder Control Problems

Symptoms of dog bladder control problems will include a housebroken dog having "accidents" in the house. Symptoms may also include a dog dribbling urine or urination at night.

Older female dogs and medium to large breeds are most likely to have bladder control problems.

Causes, Diagnosis, and Treatment Options for Canine Bladder Control Problems

If your dog is losing bladder control, he or she should be seen by a veterinarian, as this could be a symptom of serious health problems such as muscle control (USMI), diabetes or kidney failure.

Your veterinarian will use X-Rays and a test called an endoscopy which is a device with a video camera on the end that can be passed into the bladder. If there are any abnormal problems with the way the bladder is structured, then surgery is often recommended.

Bladder Infection

Often, the cause of dog bladder control problems is a bladder infection. This is diagnosed by a urine culture, with signs of infection such as white blood cells or bacteria visible in the urinalysis.

A bladder infection is treated with antibiotics. After a week or two of antibiotics, another urine culture should be done to make sure the infection is all cleared up. You should notice improvements in your dog's symptoms within a couple of days, however. It is important to still give the full course of antibiotics in order to prevent a recurrence.

If your dog frequently gets infections consider adding some cranberry juice to the diet since the berries have properties which keep bacteria from clinging to the walls of the bladder. You can also try a homeopathic natural remedy designed to strengthen the urinary system so that infection cannot take hold. One product to research made specifically for this purpose is is PetAlive UTI-Free Formula for pet urinary tract infections.

Weak Bladder Sphincter (Urethral Sphincter Mechanism Incompetence - USMI)

Aging, obesity, and reduced sensitivity of neurological receptors in the bladder sphincter can cause dog bladder control problems. It is particularly common in female dogs. Once other problems have been ruled out, your vet may try treating your dog for a weak bladder sphincter.

A weak bladder sphincter can be treated with a number of medications, including estrogen. It's not entirely clear how estrogen works, but it is believed that it helps the receptors in the bladder get the message from the brain to "hold it".

In male dogs, testosterone is often more helpful than estrogen, perhaps due to its influence on the prostate gland which sits at the neck of the bladder and incorporates the sphincter.

Other medications enhance the release of the neurotransmitters that tell the bladder to "hold it". These medications are called alpha-adrenergic agonists, sympathicomimetics or estriol.

It is possible to control this condition with medications for the entire life of your dog. This approach tends to work faster than surgery.

There is also a new homeopathic remedy that has been formulated to provide temporary relief of dog bladder problems by strengthening the bladder. It is called PetAlive Better-Bladder Control. Discuss this and other options with your veterinarian so that he or she can track progress.

Medications for Dog Bladder Control

Success rates with various medications for bladder control are as follows:

Ephedrine: This approach is the lowest cost treatment option. It is given to dogs in one or two doses per day. There is a high success rate in female dogs with up to 90% of female incontinent dogs responding to the drug. The problem is that over the long term the drug only helps 60% of dogs up to 3 years.

Side effects are seen in 25% of dogs including restlessness, aggression, panting and apathy.

Phenylpropanolamine (PPA): This drug has achieved better results than ephedrine with side effects only seen in 9% of dogs that are taking the medication. It is given to dogs in the form of a syrup. It is not prescribed for dogs with heart problems since it may impact blood pressure.

Estriol: This form of estrogen is safe for long term use. This medication could have a positive effect on female dogs that have been neutered and helps bladder storage function. The most prevalent side effect is depression. Dosage needs to be adjusted to the needs of your dog with the full impact of the drug possibly taking months.

Imipramine: This medication is known as an anti-depressive drug. It is used when a dog is hyperactive or nervous, and if this condition would worsen if other drugs are used.

Gonadotropins: Recent studies have shown this drug to be effective in female dogs suffering from urinary incontinence.

If medication does not work to treat a weak bladder sphincter, surgery can be done to correct the problem.

Dog Bladder Surgery

Endoscopic Treatments

Surgery is conducted using an endoscope, a device that can be inserted into the bladder through an opening in your dog's skin.

The endoscope is used to inject collagen (a natural gel) into the urethra. This approach works in 60% of cases and has a success rate that is lower than surgery. Since it is what is known as a minimally invasive approach, there is a low risk of complications from surgery and in older dogs is usually preferred by veterinarians.

The entire procedure takes 20 minutes.

Types of Surgical Treatment for Canine Urinary Incontinence

• Vasopexy: This approach is the most common approach and works better for female dogs then male dogs. It is minimally invasive and has a success rate of 20% to 30%. It is used in combination with medication.
• Colposuspension: is the one most commonly used. There is a low rate of complications with 13% of female suffering from painful urination (dysuria). 55% of dogs have not had problems in the long term.

If other procedures are not considered viable then the following approaches are considered:

• Urethral Sling Procedure: This approach helps female dogs control the incontinence in 75% of cases and it also helps medications work better.
• Cystourethropexy: In this procedure the bladder and uretha are sewn to the abdomen. This approach has a low success rate.

Other Possible Causes for Dog Bladder Control Problems

As mentioned earlier, dog bladder control problems can be caused by serious illnesses such as diabetes or kidney failure. It can also be caused by Cushings Disease, thyroid disorders, or other medical conditions. These are less common causes of urinary incontinence, but your vet will check them out.

Sources

Canine Urinary Incontinence Clinical Briefs: Common Causes
Nickel, R.

Canine Urinary Incontinence Clinical Briefs: Discussing Treatment Options with Your Clients
Nickel, R.
Small Animal Hospital Norderstedt, Germany