Story at-a-glance

  • There are two types of incontinence: urinary, which is the involuntary leakage of urine, and fecal, which is the inability to control the bowels.
  • Involuntary leaking of urine is most often caused by hormone-induced incontinence after a pet is spayed or neutered. The condition is very common in spayed female dogs and less common in neutered male dogs.
  • Other causes of urine dribbling include trauma to the central nervous system, damage to the pudendal nerve, diseases of the bladder, kidney, or adrenal glands, bladder stones, birth defects, and urethral obstruction.
  • Treatment of urinary incontinence depends on what’s causing it. Any underlying disease must be identified and resolved. Treatment of hormone-induced urinary incontinence can often be accomplished using a combination of natural therapies.
  • Fecal incontinence is almost always due to a communication problem between the colon and brain. Problems with a pet’s lower back can compromise the communication pathway with the result that the animal’s brain doesn’t get the message that nature is calling.



There are actually two types of incontinence -- urine and fecal. Urinary incontinence is the involuntary leakage of urine. Fecal incontinence is the inability of a dog or cat to control his bowels.

Urinary Incontinence

Involuntary passage of urine normally occurs while your pet is asleep or resting. When she stands, you may notice urine leakage. It can be just a small wet spot, or it can be a good-sized puddle.

It's important to understand that your pet is not intentionally leaking urine. She has no control over what's happening. It's not a behavioral problem; it's a medical issue. Trying to correct or punish your pet is a really bad idea. It's very important to treat urine dribbling as a medical problem requiring a medical diagnosis, rather than a behavioral problem.

There are many causes for urine leaking, including trauma to the central nervous system, damage to the pudendal nerve (the nerve that works the neck of the bladder), diseases of the bladder, kidney, or adrenal glands (for instance, Cushing's disease, hypothyroidism, or diabetes), as well as bladder stones, birth defects, and urethral obstruction.

Other known causes of urine dribbling are age-related incontinence, a hormone imbalance, and feline leukemia.

Hormone-Induced Urinary Incontinence

Hands down the most common reason for involuntary urine leakage, especially in dogs, is hormone-induced urinary incontinence.

After a pet is spayed or neutered, the sex hormones estrogen and testosterone (which are necessary to help close the external urethral sphincter) are no longer available.  The result is often urine dribbling.

Hormone-induced urinary incontinence is extremely common in spayed female dogs and somewhat less common in neutered male dogs. These are typically very healthy, vibrant pets that just happen to dribble urine anywhere from multiple times a day to just once or twice a year.

A commonly prescribed drug for hormone-related urinary incontinence called DES, short for diethylstilbestrol, was pulled from the market about five years ago because it was linked to diseases like diabetes and cancer in dogs. Unfortunately, the drug is now once again available. Because of its overall systemic risk to health, I never recommend it.

Another commonly prescribed drug for urinary incontinence is called PPA, which is substantially safer than DES.

The biggest problem with these drugs is that many vets put dogs on them without investigating the cause of the urine dribbling. They just assume that it must be hormone-induced.

I see dogs on these drugs, who, when I run tests on them, have a disease process causing the leakage. Often I find urinary crystals or bladder stones, Cushing's disease, diabetes, or kidney disease in a dog being treated for hormone-induced urinary incontinence.

Treating Urinary Incontinence

The cause of your pet's urinary incontinence should always dictate what treatment she receives. If there's an underlying disease process or structural abnormality causing the problem, it can be corrected through medical or surgical management.

If your pet is diagnosed with hormone-induced urinary incontinence, I strongly recommend you try to treat the problem naturally. Some of the drugs used to treat urinary incontinence, specifically DES, are potentially toxic, with side effects that in my opinion are not worth the risk.

I successfully treat cases of hormone-induced urinary incontinence with glandular therapy, including Standard Process glandulars – Symplex-F for female dogs and Symplex-M for male dogs. I also use natural, biologically appropriate (which means non-synthetic) hormone replacement therapy.

Synthetic hormone replacement drugs can cause some of the same problems in female dogs as they do in women who take them. Natural plant-based hormone therapy is compounded for your pet's specific hormone imbalances based on sex hormone blood test results.

I also use a few excellent herbal remedies, including corn silk, lemon balm, and horse tail. There are some great nutraceuticals specifically formulated to help with incontinence. I also frequently use acupuncture to stimulate the pudendal nerve. And chiropractic can do a great job keeping the central nervous system working appropriately.

Dogs with urinary incontinence that can't be completely resolved can be fitted with belly bands, doggy bloomers or panties with absorbent pads. You can even use human disposable diapers, and just cut a hole out for the tail if that arrangement fits your pet's body shape. Just remember that urine is caustic and should not remain on your pet's skin for very long. It's important if you use diapers to change them regularly and disinfect your pet's skin.

Fecal Incontinence

Fecal incontinence is almost always due to the colon and brain not communicating effectively. The nerves that control the colon are supposed to send a message to the brain when it's time to go outside. If there's a problem with the lower back – for example, degenerative myelopathy, peripheral myopathy, arthritis, muscle weakness, atrophy, a spinal tumor, or a condition such as myasthenia gravis – the communication pathway is compromised, and the animal isn't aware nature is calling.

In older pets, the anal sphincter can lose its ability to hold in feces efficiently.

Parasites can also contribute to fecal incontinence. If you have a pet that has diarrhea for an extended period of time, there can be damage to the muscles of the rectum, which can lead to the problem as well.

Other causes of fecal incontinence can include an abscess or infection of the anal glands, a dietary issue, medications, or a perianal fistula.

Owners of pets with fecal incontinence might find accidents around the house. Or the pet could inadvertently pass feces when he uses his abdominal muscles to go from a lying position to a standing position, or when he jumps up on the couch, or in similar situations requiring use of the abdominal muscles.

Your dog or cat may also poop while walking without knowing she's doing it. It can also happen during sleep. Excessive gas and swelling of the abdomen are common in cases of fecal incontinence.

It's important to find the underlying cause of your pet's fecal incontinence. Your vet will want to do a complete blood profile – including a chemistry profile, CBC, urinalysis, and a fecal analysis – to check for the presence of an infection or parasites. Sometimes, additional diagnostics such as X-rays may be required to check for spinal arthritis or a bone tumor.

Both chiropractic and acupuncture – I use electroacupuncture in my practice – can be very helpful in these cases. Aligning the vertebral bodies and stimulating the nerve fibers that communicate between the colon and the brain can help reduce incidences of fecal incontinence.


What is perivulvar dermatitis?  

Have you noticed your dog licking her genitalia often?  Is this area red and quite swollen?  Then your pet may have perivulvar dermatitis.

Perivulvar dermatitis is inflammation of the skin surrounding the vulva. The outside of the female genital area is called the vulva. 

Inflammation of a dog's vulva can be caused by an infection, irritants, a recessed vulva and redundant skin folds, allergens, or trauma. 

Your dog is licking because of pruritus (itchiness) due to irritation probably caused by an infection. The more she licks the more inflamed (red) her vulva becomes. Resolution requires identification of the underlying cause and appropriate antibiotic treatment.

Early spaying can sometimes increase the risk of recessed vulva, vaginal dermatitis, and vaginitis, especially for female dogs spayed before puberty. Canine puberty is usually between 6 and 12 months of age.

I recommend you have your dog examined in person. She may require a vulvoplasty.

Here's the deal. A female dog's genitalia consists of her vulva (the external female genitals), the vestibule (the space between the labia/lips containing the orifice of the urethra), and then the vagina which leads to the uterus. 

Your dog's urinary orifice leads to her bladder and this is located at the base of her vagina. Urine is eliminated through the vestibule therefore any infection in the vestibule can have an effect on the female's urinary tract and vice versa - any urinary tract infection can also infect the mucus membranes of her vestibule/vulva. 

When a female dog is spayed before her genitalia are fully-developed and especially if the dog becomes obese then the outer vulvar folds of skin will become floppy because the inner vestibule is immature (small) so that the outer large folds of the floppy vulvar skin will retain urine in the dog's vestibule or it may become infected by yeast or bacteria. This causes the dog's genitalia to itch and then the dog licks her genitalia to try to alleviate the itching. The more she licks the more irritated and inflamed (red) her skin becomes which is called perivulvar dermatitis. The pathogenesis of perivulvar dermatitis is similar to other mucocutaneous and skin fold pyodermas with the presence of excessive moisture, warmth, secretions, and exudates providing a suitable region and substrate for bacteria to proliferate. 

The complication of urine and urine scald is also present in this location. 

Urine scald is due to the irritating chemicals in urine which soaks into the fur around her vulva and vestibule.

Warm, moist areas on the skin, such as vulvar folds often have higher bacterial counts than other areas of skin and are at an increased risk for infection. The primary treatment of superficial vulvar infections is with appropriate antibiotics for approximately 3 weeks.

Just like humans who occasionally have a mild superficial bacterial infection and don't receive antibiotic treatment, a dog can eventually overcome a mild bacterial infection without antibiotic treatment unless the dog's immune system is weak. 

If your dog is eating a healthy diet, she is eliminating normally, isn't behaving lethargically, and she doesn't have any other signs of a weakened immune system then her inflamed vulva will eventually heal on its own. This is not to say that it could "possibly" go the other way and her vulva "might" become more infected. I cannot predict the future.

If you'd like to treat your dog at home then I recommend that you clip any excessive or long hairs surrounding her vulva because excessive hair can trap debris and bacteria. 

Bathe her 2 to 3 times a week during the next 2 weeks and then 1 to 2 times a week until the inflammation (redness) and licking of her vulva resolves. 

Medicated shampoos should be prediluted 1:2 to 1:4 prior to application to facilitate lathering, dispersal, and rinsing. 

Appropriate antibacterial shampoos include benzoyl peroxide or chlorhexidine.

Benzoyl peroxide: http://www.nextag.com/Pets -zzben~oyl+peroxidez2702000z0zBeez5---html

Chlorhexidine: http://www.petplace.com/drug library/chlorhexidine/page1.aspx

After her bath you can gently massage a thin layer of Neomycin Ointment inside the skin folds of her vulva.

Gently massaging the Neomycin Ointment allows it to be absorbed through the mucus membrane. Don't apply too much and don't massage too vigorously. She will most likely lick to remove the Neomycin so if she does lick it off then don't apply more Neomycin because this might increase the inflammation.

Improvement may not be evident for at least 3 weeks.


Finally, a complete work-up for vaginitis in dogs, especially those with adult-onset disease, includes performing serologic testing for canine brucellosis, which may be exhibited as persistent mucopurulent vulvar discharge, and ruling out systemic disease by performing a complete blood count and serum chemistry profile.

Canine herpes virus infection in prepubertal bitches or spayed adult female dogs is associated with vesicular or firm lesions on mucosal surfaces, including the vagina, and no other clinical signs.

Posted on 17 Oct 2014

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