What Causes Some Dogs to Have Accidents When Asleep?
Dear PHP Pete,
My 3 year old dog has recently started having accidents when she sleeps. She is housebroken and does fine when she is awake. What could cause her to leak? Are there medications to treat it?
Urinary incontinence (that is, involuntary loss of urine control) may occur due to a number of reasons, including:
- Anatomical abnormalities
- Spinal cord damage
- Urinary tract infections or stones
- Health conditions that produce excessive urine
The most common cause of incontinence, however, is the loss of function in the urethral sphincter, a muscle that tightens and prevents urine from leaving the bladder. Urethral sphincter dysfunction is most commonly seen in female dogs (particularly larger breeds) that have been spayed. It is also occasionally seen in male dogs and unaltered dogs.
The main symptom is leaking during times of rest, though you might also see staining or redness where the urine has irritated the skin. Symptoms appear within a few weeks to a few years (more likely) after spaying. It is thought that the loss of estrogen decreases how the urethral sphincter responds to signals from the body; this allows leaking when pressure is put on the bladder, such as while resting.
There are several treatment options for this kind of incontinence:
- Phenylpropanolamine (for example, Proin) is often the first line of treatment. This drug directly stimulates the sphincter to tighten. Potential side effects include high blood pressure, increased heart rate, restlessness or irritability, and increased eye pressure.
- Diethylstilbestrol (DES) and Estriol (for example, Incurin) are two estrogen replacement options. These drugs work to replace the estrogen lost after spaying, enabling the urethral sphincter to detect signals more easily and better control leaking. Diarrhea, vomiting, and changes in behavior (such as lethargy and depression) are potential side effects. Other side effects include anemia and unexplained bleeding or bruising, which could be early indicators of bone marrow suppression. These symptoms should be addressed immediately because bone marrow suppression can be caused by high doses of estrogen. To reduce the risk of side effects, these drugs are given at the lowest dose that will control the symptoms.
- Surgical options are also available. Injections of collagen around the sphincter can create pressure or a silicone sleeve can be implanted around the sphincter and filled with saline as needed to reduce flow.
While urethral sphincter dysfunction might be your dog’s issue, it is essential to take your pup to the veterinarian for an accurate diagnosis.
Sincerely, PHP Pete
- Acierno MJ, Labato MA. Canine incontinence. Compendium on Continuing Education for the Practising Veterinarian North American Edition. 28(8):591-600. August 2006.
- Byron, JK. Canine urinary incontinence. American Veterinarian (July 03, 2018.) https://www.americanveterinarian.com/journals/amvet/2018/july2018/canine-urinary-incontinence . Accessed February 2019.
- Chew DJ. Diagnosing and managing urinary incontinence in dogs (Proceedings). dvm360. 2011. http://veterinarycalendar.dvm360.com/diagnosing-and-managing-urinary-incontinence-dogs-proceedings. Accessed February 2019.