Incontinence is defined as involuntary urination or defecation and is quite common in dogs, with urinary incontinence being especially common in spayed females, though these conditions can and does affect dogs of both genders, both spayed/neutered or not.
There are several different defined causes of incontinence, each with their own recommended course of treatment. Estrogen responsive incontinence, commonly called spay incontinence, is the most frequent cause of involuntary urination in female dogs. It can occur anywhere from immediately after spaying up to ten years later, with the average age of onset being around three years. Urinary incontinance can also be caused by bacterial infections, trauma resulting in nerve damage, and anatomical defects.
Fecal incontinance will usually be the result of trauma causing paralysis of the sphincter muscles, megacolon, which generally occurs in cats, though dogs can experience this condition, and in animals that experience irritable bowl syndrome.
Treatment of incontinence is normally managed medically, with drugs and dietary changes. There are many different medications on the market today aimed at relieving the symptoms of incontinence with the choice being fully dependant on the underlying cause.
Phenylpropanolamine (PPA) is a decongestant that helps to tighten the sphincter muscles and is the most commonly used treatment for urinary incontinence in both male and female dogs today. Many dogs are started on a PPA regimen in the beginning, with the success rate being about 50%.
Bulking products such as fiber supplements as well as dietary changes to a prescription diet high in fiber will be prescribed for aniamls with IBD and megacolon, as well as manual stimulation. Dogs that experienced trauma affecting the nerves that control defecation will normally not be able to benefit from medical management and will require surgical intervention.
Surgery is considered a last resort treatment for incontinence. Animals who have not made any appreciable progress on traditional treatments and are experiencing severe incontinence are great are candidates for incontinence surgery.
The tried and true surgical procedure for female dogs consist of surgically tacking the vagina to the belly wall, compressing the urethra. This procedure has been shown to have a 50% chance of success, especially when combined with medical treatments. Many surgical patients will relapse within one year without pharmacological intervention.
For male dogs, there is a surgical procedure similar to the one outlined for females, though it consists of compressing the urethra with other structures.
Incontinence involving defecation in relation to the nerves’ inability to function properly will usually result in having a colostomy bag placed.
Newer treatments involving the injection of collagen into the areas surrounding the urethra have offered a more effective method of surgical intervention to control urinary incontinence in female dogs, with well over half responding positively to the procedure.
Of course, the major drawbacks for these types of procedures are costs and risks. The costs for any of these procedures can run into the $1000’s and there is no guarantee of success, either immediately after or long term. The collagen injection procedure is generally less expensive than the other urinary incontinence procedure, though collagen injections will have to be repeated in the future as the collagen will break down over time. The risks associated with surgery include anesthesia, infection, blood clots, and negative results.