In these days of lockdown, urinary incontinence in dogs can become quite burdensome, especially when the animal has been an indoor dog all its life. While the reasons for urinary incontinence can be manifold, the vast majority of cases are seen in older spayed bitches or young puppies.
In older, spayed female dogs, the problem is mainly due to the incompetence of the urethral sphincter mechanism.
This is the mechanism that keeps the bladder locked until the animal decides to urinate and voluntarily releases that lock. That is why most of these little accidents happen when the animal is resting or asleep, and they wake up in a little puddle. This type of incontinence is, in the majority of cases, very successfully treated with oral medications of oestrogenic compounds which increase the sensitivity of the internal urethral sphincter to the naturally occurring catecholamines in the body. If oral treatment does not achieve control of urinary incompetence, surgical options may be considered. These surgical options are usually the domain of specialists and involve equipment and techniques outside the scope of general practice. These solutions are costly, but can be very successful as well.
Another form of urinary incontinence is one that we see in young puppies. It is caused by a congenital defect known as an ectopic ureter. The ureter is the tube that leads from the kidney to the bladder. Since mammals have two kidneys and two ureters, there are two dedicated entry points into the bladder. Meanwhile, the urethra is a single duct out of the bladder and ends in the vulva or the penis. An ectopic ureter comes from the kidney but does not enter the bladder in a standard fashion. It can, for example, enter straight into the urethra, thereby bypassing the bladder and its sphincter completely. This condition requires surgical correction and again is a specialist procedure that quite often is out of the financial scope of clients or excluded from insurance as a pre-existing condition. Your veterinarian will, as a matter of routine, investigate all possible causes for urinary incontinence to distinguish between behavioural, anatomical, and neurological aspects that influence normal urination. This may include an investigation of underlying diseases that led to an increase in fluid uptake, urinary tract infections or inability to concentrate urine.
But rest assured that the older spayed, large-breed female dog, that has a history of leaving puddles after sleeping, is very likely suffering from urethral sphincter incompetence, which can be successfully treated by your local vet.