Urinary Incontinence

Barry Burtis, Pet Tales
September 26, 2008

Megan is a 10-year-old, spayed female black Labrador retriever. She is very secure with the esteemed place she has in the hearts and in the home of her family.

Her natural intelligence had been demonstrated very early in life by her rapid and complete mastering of the house-training measures that her owners had instituted when Megan moved in at 10 weeks of age. Her fastidious bathroom habits had been strictly maintained ever since.

It was, therefore, with considerable dismay that Megan's concerned owners arrived one day to see the family's other family doctor - Megan's veterinarian.

Megan, they reported, had begun to urinate in the house. With further questioning, the veterinarian learned some other significant information. Megan's appetite, thirst, health, activity level and behaviour otherwise was unchanged. She had continued to perform her bathroom duties at other times as usual. She was not asking to go outside more often, there was no straining or apparent discomfort when she did urinate and Megan's owners had noticed no change in the volume, appearance or odour of her urine.

One of the most important points gleaned by the veterinarian in the history-taking phase of the examination was the location where these wetting accidents happened.

Urine was being found in different places in the house. Often, they were at the patio door where Megan loved to lay and watch the squirrels and birds in the backyard. Once or twice it had happened on the rug, in front of the fireplace where Megan stretched out when her owners watched television in the evening. Several times, Megan's favourite blanket that cushioned her sleeping area had required laundering because of urine soiling. These all were locations where Megan slept, rested or relaxed. Whenever Megan's family found her near one of these accident sites, she seemed quite oblivious to the fact anything unusual had occurred.

It is said that 80 per cent of a medical diagnosis can be made on the basis of a good history taking in a consultation, while the physical examination contributes only 20 per cent. Well, there were some other steps that still needed to be taken, but Megan's problem is certainly one where a firm tentative diagnosis can be made with a thorough collection of the facts of the case. Urinary incontinence was thought to be the cause of Megan's problem.

Urinary incontinence can be defined as the loss of voluntary control of passing urine which is usually observed as involuntary leakage of urine.

A physical, including a rectal examination, revealed no abnormal findings. Analysis of a urine sample showed Megan was concentrating her urine normally and there was no evidence of infection, crystals or tumour cells in the sample. In some cases, further laboratory tests, x-rays or ultrasound examinations might be recommended in patients with the clinical signs Megan was showing.

However, this condition occurs in approximately 20 per cent of spayed female dogs. Medium to large-sized breeds are more commonly affected.

The problem is much more rare in male dogs that are neutered or in spayed or neutered cats. Mixed or multiple causes are observed in humans with this disorder and probably the same is true in dogs and cats. Combinations of bladder and urethra (the tube that carries urine away from the bladder) storage dysfunctions, and combinations of anatomic and functional disorders are most likely. Obesity may increase the risk of this problem in spayed female dogs.

There are a number of medications, given by mouth, that can be used to treat uncomplicated urinary incontinence.

Megan was successfully treated with stilbestrol that was given daily for a week and then continued every five days. With her urinary tract issues under control, Megan can enjoy the life and freedom in her home to which she had grown accustomed.

Barry Burtis is a local veterinarian with a companion practice.