1996). MeSH There are anecdotal reports of the successful use of conjugated estrogens in spayed female dogs with UI (Table 1); however, no studies have been published. | Find, read and cite all the research you need on . Thrusfeld MV, Holt PE, Muirhead RH. It is often necessary to use both smooth and skeletal muscle relaxants in these patients to achieve the desired result. Neutering removes a male dog's testicles. Epub 2017 Mar 3. Testosterone supplementation can be used in male dogs with USMI. and transmitted securely. Urethral bulking agent. This is particularly important in males because functional obstruction and overflow incontinence may be more common than previously thought. This site needs JavaScript to work properly. Please enable it to take advantage of the complete set of features! The material is injected submucosally into the proximal urethra via cystoscopy (Figure). Clinic for Small Animal Internal MedicineVetsuisse FacultyUniversity of ZrichZrich, Switzerland. A dog leaking urine may be under stress. As with estriol, these are usually dose-related and subside with dose reduction. While you can't make your female dog do kegel exercises like humans, exercise can still reduce stress hormones and help with anxiety issues. A normal amount of testosterone will prevent incontinence, while a low amount or no testosterone will cause urinary incontinence. A good general guideline is to perform an indirect systolic blood pressure on any patient before treatment with PPA and repeat the evaluation after 1 to 2 weeks of therapy. Although this last example is not a bladder control problem, it could still be a reason why youre suddenly finding puddles around the house. FOIA As a result, the infection spreads to the urinary tract because of the prostatic fluid that leaks into the bladder. For instance, ectopic ureters can appear later in life because of the urethral closure pressure decreasing with age. The hormone testosterone, in particular, is secreted by the male dog's testes and is known for producing several physiological and behavioral effects. The good news is that dedication and physical therapy can help your dog recover over time. It has been hypothesized that the increase in these gonadotropins has either a direct negative impact on the urethral closure pressure or results in decreased bladder function.11,12. -Agonists increase stimulation of the adrenergic receptors on the internal urethral sphincter, whereas estrogens may upregulate the expression of such receptors. Normal return to fertility after . Smaller breeds are known to be at lower risk of urinary incontinence, and it appears that risk is not affected by age of spay. Here are some symptoms of urinary incontinence in dogs: If your house-trained dog suddenly becomes incontinent, there may be an underlying health problem. In spayed female dogs, this is acceptable; however, in intact females and in males, further evaluation for other urinary tract disorders, particularly urethral functional obstruction and overflow incontinence, is warranted. Although many materials have been investigated, the theory behind all injectable bulking agents is to increase the stretch in the sphincter muscle fibers, leading to increased resting closure pressure in the urethra. Urine leaks could cause infection in the bladder or kidneys or on your dogs skin. Dog incontinence is a common issue, and a dog that can't hold pee or is leaking urine all over the house is tricky for a pet parent to navigate. Hormone-responsive incontinence occurs in neutered dogs of both sexes but most commonly in female dogs. Treatment of deficient sex drive in male animals Deficient libido in male. Urethral Bulking Agents A: I guess I would be suspicious of hormonally based incontinence in a dog that developed urine leakage after neutering. Acquired causes can be hyperreflexia of the detrusor muscle, acquired urethral sphincter mechanism incompetence, detrusor atony because of bladder over distention, prostatic disease, neoplastic disease of the bladder, prostate or urethra, or neurologic disease (lower motor neuron disease). The prostatic urethra contains primarily smooth muscle, and the penile urethra contains primarily skeletal muscle. This article reviews the medical and surgical options available for treatment of urethral incompetence and provides guidelines to choosing the best one for each patient, as well as comments on prevention for potentially at-risk dogs. Some medications could cause your dog to leak urine as a side effect. Otherwise healthy dogs should have less than 1 to 2 mL/kg of urine in the bladder after a normal void. Special financing available. 8600 Rockville Pike Not every dog needs a weekly appointment at their favorite groomer though, theres plenty you can do yourself at home. Careers. Barth A, Reichler IM, Hubler M, et al. All rights reserved. This is possibly caused by misdiagnosis of dogs with functional urethral obstruction and overflow incontinence. Sometimes, males may benefit from testosterone injections, but this is less common. There is strong evidence that estrogen increases the baseline resting urethral pressure in animal models of incontinence.6 These compounds are usually well tolerated and are a good choice for female dogs with concurrent diseases that predispose them to hypertension or that are intolerant of -agonist treatment. Both procedures have pros and cons, and careful patient selection is necessary for an optimal outcome. Diethylstilbestrol isnt commercially available in the US, but if your vet recommends it, a compounding pharmacy may be able to provide it. The results have been somewhat disparate, but there is general agreement that the risk of UI increases if a female dog is spayed before 3 months of age. However, these drugs can also have side effects on the bone marrow, so we monitor . The few existing reports evaluating the efficacy of medical therapy in controlling USMI in males have demonstrated limited success. Medical treatment for DUD generally consists of muscle relaxation and, occasionally, anxiolytic therapy (Table). Clinical response and side effects associated with testosterone cypionate . This may be more common in breeds such as greyhounds, Doberman pinschers, and Weimeraners.6. Bladder leaks are not an uncommon occurrence in older dogs. Reeves L, Adin C, McLoughlin M, et al. Less than 50% of male dogs respond to medical therapy, and the most successful treatment is phenylpropanolamine.13 There is some evidence that testosterone cypionate may provide some improvement.14 Alternative treatment in males that fail medical therapy include surgical placement of an artificial urethral sphincter and urethral collagen injections, which may be performed antegrade through a cystotomy incision or retrograde via perineal urethrotomy. See details. Older pets can also develop senility and simply be unaware they are dribbling urine. Fluid inside the cuff can be adjusted by the veterinarian to achieve a level of pressure that maintains continence during bladder filling but does not lead to obstruction when the bladder and abdomen contract. Finally, a neurologic and orthopedic evaluation should be conducted if the dog is unable to posture normally to urinate, as this can lead to incomplete emptying of the bladder and UI. UI must be distinguished from behavioral conditions and systemic problems (eg, polyuria, pollakiuria), and it is important to establish that the animal is unaware of the passage of urine. We routinely perform cystoscopy in patients with medically unresponsive UI to rule out anatomic abnormalities that may be contributing to clinical signs.
Female dogs that have been spayed have lower levels of estrogen and progesterone. It is likely that many of these dogs have overflow incontinence secondary to an inability to empty the bladder rather than a weak urethral sphincter. These side effects are generally mild and resolve with appropriate dose reduction. A weak urethral sphincter is treated with phenylpropanolamine. Breeds that are more prone to incontinence include: Most pet owners will notice their dog leaking urine while asleep or on the bed resting. In this case series, we report the effect of testosterone cypionate, given at a median dose of 1.5 mg/kg intramuscularly every 4 wk, in eight male dogs with USMI. Blood tests can detect evidence of kidney damage from infection or for the presence of diseases that might lead to increased urine production. These medications provide a very low dose of estrogen to increase urethral tone and relieve urinary incontinence in many dogs. In one study Boxer dogs were the most common breed with adult onset of incontinence. . Always follow the instructions provided by your veterinarian. Retrospective evaluation of urethral bovine cross-linked collagen implantation for treatment of urinary incontinence in female dogs. Images courtesy of Mary McLoughlin, DVM, MS, DACVS, The Ohio State University. This is because estrogen and progesterone strengthen the muscles that keep urine in the bladder. Dogs with brain or spinal cord disease may either dribble urine or be unable to pass urine. This happens because of the dog's inability to regulate the muscles in a stressful situation. Little is known about long-term outcomes in male dogs with DUD, and evidence for treatment efficacy is lacking. Some practitioners avoid the use of estrogen compounds because of the potential for irreversible myelosuppression seen in dogs treated with estrogen compounds for mismating or to induce estrus.8,9 While this is a potential toxicosis, the doses associated with bone marrow suppression are generally at least 10 times higher than those recommended for management of UI. It is usually caused by a medical condition, and your dog likely is not aware its happening. 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Dog diapers could be helpful to avoid messes, but you must be on the lookout for any signs of urine scalding or infection on the dog's skin. If medical treatment does not work, surgical therapy may be an option. In incontinent male dogs, steroid therapy may be prescribed. Phenylpropanolamine toxicosis in dogs: 170 cases (2004-2009). A weak urethral sphincter is treated with phenylpropanolamine. . In addition, treatment frequency can be adjusted (eg, every 5 days rather than every 7) to accommodate the declining response to treatment in some patients without having to increase the capsule size or medicate multiple times a day. The most serious potential adverse effect is hypertension, because of the lack of specificity of the agonists for the lower urinary tract and stimulation of vascular smooth muscle. For example, dogs with separation anxiety may pee in the house while their owners are gone, or a dog with noise phobia might pee during a thunderstorm. Effect of phenylpropanolamine and pseudoephedrine on the urethral pressure profile and continence scores of incontinent female dogs. 2017;53:285290. 2010 Oct;186(1):18-24. doi: 10.1016/j.tvjl.2010.06.011. In. Female dogs appear to have similar response rates to estriol and DES (89% and 87%, respectively).9,10 Adverse effects with its use include mammary and vulvar swelling and attractiveness to male dogs. However, if dogs suffer from urinary incontinence, they are also more likely to develop UTIs. It was widely used in the United States and worldwide to reduce pregnancy complications and treat a variety of conditions in women until 1971; it was found to contribute to an increased risk of neoplasia and birth defects in the children of expectant mothers who took the drug. The absence of testosterone may be caused by the neutering procedure. Byron JK, Taylor KH, Phillips GS, Stahl MS. J Vet Intern Med. Urethral sphincter mechanism incompetence (USMI) is reported much more seldom in male dogs than in female dogs. Dogs with brain or spinal cord disease may either dribble urine or be unable to pass urine. . If the veterinarian suspects that the . The decision of when to spay a dog can be challenging. This might be the case in urethral sphincter mechanism incompetence. Estrogen plays an important role in the strength and robustness of pelvic and periurethral tissues. This equalizes the pressure between the bladder and its outflow tract, preventing leakage. For patients with UI that fail medical therapy, or for which medical therapy is not an option, several interventional and surgical options exist. The vet will examine the dog and ask you questions based on what you observed. If your dog suffers from hormonal imbalance, the vet may recommend hormone therapy. The etiology of functional obstruction or DUD is elusive and may involve the reticulospinal tract. Urethral sphincter mechanism incompetence in male dogs: a retrospective analysis of 54 cases. However, pet parents should monitor their dogs closely on this medication due to the risks and potential side effects. In this case the urethral pressure is overcome by the bladder pressure only after a certain filling volume in the bladder. Unlike female dogs, male dogs have no increased risk of incontinence due to their body weight or neutering. Reichler IM, Hubler M, Jochle W, et al. 2017). Her research and clinical interests include urinary incontinence and lower urinary tract disease in dogs and cats. In addition, some preparations are very costly and others are not available in North America. This is because the urethral muscles are not as strong as they used to be. This can include frantic attempts to escape their house, digging, destructive chewing, defecating, or peeing in the house. In animals with a caudally positioned or pelvic bladder, the proximal urethra is not within the abdominal cavity, and this pressure is not exerted on the urethra. Incontinence can be continuous and the dog loses urine all the time. Shipping: US $4.90 Standard Shipping. Another important factor in maintaining continence is bladder position. 1-Agonists are likely the most commonly used UI therapy in veterinary medicine. A relaxed or sleeping dog that can't hold their bladder is usually a sign of an underlying issue, such as age-related incontinence, urinary tract infections, or diabetes. Most often they will have other signs of nervous system disease, such as muscle weakness or paralysis. However, these muscles may weaken and the dog may urinate in inappropriate places. This FDA-approved drug is commercially available in doses designed for use in dogs. Dr. Byron is a clinical professor in the Department of Veterinary Clinical Sciences at The Ohio State University. If your dog is affected by incontinence before the age of 9, he may have a tumor that needs to be detected. Stay current with the latest techniques and information sign up below to start your FREE Todays Veterinary Practice subscription today. #3: Early neutering of male dogs increases the risk of developing bone cancer. Byron JK, March PA, Chew DJ, DiBartola SP. Evaluation of the prevalence of urinary incontinence in spayed female dogs: 566 cases (2003-2008). Urodynamic and morphologic changes in the lower portion of the urogenital tract after administration of estriol alone and in combination with phenylpropanolamine in sexually intact and spayed female dogs. Specific treatment of an underlying disease or condition with surgery or medications may resolve incontinence. The .gov means its official. Cranberry extract can block the harmful bacteria from attaching to the bladder wall, allowing them to be flushed out of your dog's system. Similar to colposuspension, this increases transmission of intra-abdominal pressure increases to the urethra as well as the bladder and bladder neck, preventing a negative pressure gradient into the outflow tract. At The Ohio State University Veterinary Medical Center, we recommend obtaining baseline systolic blood pressure before starting phenylpropanolamine, because hypertension is a potential adverse effect (AE) of -agonist therapy. In addition, purebred dogs are more likely to suffer from involuntary leaks than their crossbred counterparts, as line breeding can cause more genetic problems. government site. Estriol (Incurin, merck-animal-health-usa.com) is the only commercially available FDA-approved estrogen for the treatment of UI in the United States (Table 1). The ureters carry urine from the kidneys to the bladder, and if one or both ureters bypass the bladder and connect to an abnormal location, such as the urethra or vagina, the puppy may drip urine. Exclusive offers, a heads up on new things, and sightings of FOTP in the wild. "At the time of the inquiry, the average age of the bitches was 6.5 years and the average age at the time of surgery was 7.1 months," the study sates. Residual urine volume should be measured after voiding in dogs that have a narrow urine stream, exhibit stranguria, or only drip urine. As pets age, they may become incontinent because muscles that hold urine in the bladder weaken. Dogs with genuine urinary or urethral incontinence often pee while resting or sleeping with no obvious triggers. For example, increasing exercise and using positive reinforcement to help your dog learn place or crate training can help reduce separation anxiety. The larger the dog, the more pronounced this alteration in risk becomes. To improve your dog's quality of life without altering their routine, you can also: Urinary incontinence is a distressing condition that can affect the relationship between pet owners and their dogs. Stimulation of 1A receptors in the smooth muscle of the urethra and bladder neck leads to increased urethral closure pressures and is an important part of resting urethral tone. After your dog is diagnosed with urinary incontinence and started on treatment, it is important to continue to monitor urination. Radiography, ultrasound, computer tomography, or cystoscopy might help to identify the cause of the incontinence. Tips from the Experts for the Management of Bacterial Isolation from Urinary Tract Infections, Lower Urinary Tract Disorders in Boxer Dogs, Adverse Effects of Rapid Fluid Administration, Anesthesia & Pain Management for Dentistry, Dental Radiology Techniques & Interpretation, Role of Animal Shelters in Disaster Management. Keep an eye on your dog's condition and consult your vet for treatment plans. JAVMA 2011;239(11):1463-1469. In most USMI cases, otherwise healthy patients are treated initially with either -agonist medications, such as phenylpropanolamine (Proin, PRN Pharmacal), or estrogen compounds, such as diethylstilbestrol or estriol (Incurin, MSD Animal Health).