A dribble, spray, puddle, or a lake, urinary ‘accidents’ in the house can be frustrating for you and your pet. There are a whole host of reasons and underlying causes that can contribute to why your pet regresses on their house training. This article is not focused on those pets who were never completely house broken as that is an entire subject of its own.
This month Maki, a lovely 5-year-old female spayed Akita, as agreed to share her story. As Pet of the Month, her story is somewhat common; the good news is there is help, so don’t despair.
Maki was adopted in October of 2023 through one of the local shelters, and was spayed at 4 years of age, just before going home. So, she had been an intact female dog for a number of years, going through several heat cycles. There is some thinking that ‘early’ spaying may predispose female dogs to urinary incontinence; however, that is not always the case, and there are more factors involved as we’ll outline below.
Maki settled in well to her new home, and it wasn’t until July of this year that the owner began to notice some urine puddles where Maki had been sitting in the house. Maki seemed completely unaware. Initially it was once or twice, then it became such that there were multiple episodes in the same day. Obviously, this was concerning to her owner. Maki’s appetite, water intake, activity, and attitude all seemed normal.
For any patient that has urinary symptoms – increased urination, straining to urinate, a change in the color of the urine, inappropriate urination, difficulty urinating, painful urination etc. – a medical work up with your veterinarian is needed.
Here’s a list of some of the more common causes for urinary issues:
- Urinary infections, most often bacterial
- Metabolic changes that contribute to increased thirst and increased urine output, such as
- kidney disease
- thyroid disease
- diabetes
- Addison’s disease
- Hormonal changes – more common in female vs male dogs
- Bladder changes
- Cystitis or inflammation of the bladder lining
- Urinary crystals or bladder stones
- Ectopic Ureters – physical defect in the bladder
- Bladder polyps
- Bladder cancer
- Physical Issues
- Arthritis
- Spinal cord diseases/injuries
- Behavioral or Access Issues
- Not providing adequate ‘potty’ breaks or access to appropriate places to urinate
- Failure to teach your pet cues so they can alert you when they need to go out, or failure to notice their cues in time. Again, lack of consistent and effective house-training for dogs can create situations where pets are eliminating in the house because they never learned that going outside was preferred
- Getting your pet ‘in trouble’ or ‘scolding’ for elimination in the house generally has the opposite effect – it makes them more nervous and anxious. Urinating can be a sign of appeasement, so it is better to give them praise when going in the correct locations
- Pets who have urinated in the house, can still detect the prior episodes, and may continue to urinate in those areas unless the behavioral aspect is addressed and the area thoroughly cleaned, sometimes removing the carpet and carpet pads
- With cats, not providing ‘Five-Star’ litter boxes can lead to your cats choosing their own spots. In public restrooms, we generally prefer the cleanest, nicest options – give your cats the same. If there are multiple cats, providing access to several cleaned and sanitized boxes daily is essential.
- In older dogs, we need to consider age-related cognitive changes too
To get a proper diagnosis for Maki, the doctors as Hawthorne Hills Veterinary Hospital started with evaluating blood work and submitting a urine sample for testing. In some situations, additional testing with radiographs, abdominal ultrasound and/or special dye studies of the urinary tract might be needed to arrive at a correct diagnosis. Fortunately for Maki, there was no indication of kidney, liver or thyroid disease, and her blood glucose was normal, ruling out diabetes. A urine sample showed excellent concentration with no signs of bacteria, blood, crystals, or abnormal cells. She did however, have a surprisingly low resting blood cortisol level, suggesting that she might have Atypical Addison’s disease. This was excluded when her ACTH Stimulation Test came back as normal.
All of this was great news. With very normal lab results, and no history of behavioral issues, we concluded that Maki was suffering from a hormonal deficiency which contributed to her inappropriate urination. In female dogs after they are spayed, their body estrogen levels drop and this can contribute to a decreased strength of the urethral sphincter. The consequence is when the dog is relaxed, the sphincter relaxes and allows urine to flow out of the bladder. Depending on how full the bladder is at any given time, the amount of urine can be drop-drop, all the way to a full urine ‘lake.’ In most cases, the dogs are completely unaware that this has happened. When we question pet owners, they will often tell us their dogs ask to go outside, urinate outside when prompted, yet they find urine spots where their pet spends time sleeping or relaxing.
Getting a proper answer is important. Dogs who suffer from urinary incontinence that is untreated, are at risk for chronic skin infections, bacterial urinary infections, and urine scald when the urine collects in the fur. This is uncomfortable and unnecessary. Fortunately, for Maki and other female dogs, this condition is quite treatable. Some dogs respond to a medication called phenylpropanolamine (Proin® or Proin ER®) which is well tolerated and generally very effective. A few dogs need estrogen supplementation (Incurin®) to obtain complete continence. There are some potential side effects to either of the meds, but those can usually be managed well. Improved quality of life for both the dogs and their owners is significant.
We are happy to report that Maki responded very well to Incurin® and follow-up lab work shows her body is tolerating the medication without any worrisome side effects. This will be a lifetime medication for Maki and has significantly improved her health, and her relationship with her family.
