Leaking middle-aged dogs Print E-mail
News - Rubrieke
Tuesday, 22 December 2015 12:27
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Dr Liesel van der Merwe is a small animal medicine specialist. Send her your questions: This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

Dr Liesel van der Merwe

Older sterilised female dogs often develop urinary incontinence. This can vary in severity from mild and intermittent to really large amounts, causing a big mess.

The hormone oestrogen, mainly made by the ovaries, amplifies the effect of the nerves to the muscular region at the neck of the bladder to cause contraction and “hold the urine in”.

In a proportion of sterilised dogs, especially larger breeds, the loss of oestrogen from the ovaries can cause urine leakage months to years after the sterilisation. Most bitches will only leak when they are lying down as the bladder will hang forward into the abdomen when standing. These dogs can still pass urine normally.

The anatomy of the female urinary tract with its short wide urethra makes the bitch prone to urinary tract infection. If she is incontinent on top of this, the risk of cystitis increases.

So, if we know this why do vets still recommend sterilisation? Well, the complications of not sterilising your female dog can be a lot worse.

The presence of oestrogen in the system can trigger hormone sensitive cancers in susceptible individuals. The risk of mammary cancer (breast cancer) if the dog is sterilised before the first heat is miniscule. If you wait until after the second heat, the risk is the same as if you hadn’t sterilised at all.

In practice I hardly ever see mammary cancer because most bitches are sterilised. I compare this to when I was a student and just starting out over 20 years ago – mammary cancer was a lot more common in dogs as they were not always sterilised.

Additionally, every time your bitch comes into season and isn’t mated, she will go into a state of “false pregnancy” for about three months. The hormones are the same as if she were pregnant, and even if she isn’t showing behavioural or physical changes, the uterus had developed extra blood supply and glands as if she were.

Eventually, after many false pregnancies, the lining of the uterus becomes cystic and may develop a life-threatening infection called pyometra.

Treatment starts off medically in incontinent bitches whereas dogs which are incontinent from an early age, before sterilisation usually have an anatomical fault which may require surgery.

Our most effective drug, phenylpropalonamine, is off the market, even in raw form, due to its use in making recreational drugs. We now rely on low doses oestrogen hormone supplementation.

This obviously has side effects and may cause signs of “heat”. If it works – that is good – and you can find out the dose which is right for your dog. However, in some cases it is just not very effective.
Because of the medication not being very effective there are a lot more surgical procedures being performed on incontinent bitches to try to alter bladder position and increase tone in the bladder neck and urethra.

These are very similar to the procedures performed in women who develop a similar problem due to pelvic muscle weakening with ageing – even without having had children. In fact, we use the same “stitch” material and introducers used for women in one of the techniques. These procedures are not without slight risks themselves though, as post operatively the bitch may actually struggle to urinate if the “tacking” is too tight.

I have two incontinent bitches at home. Luckily both are mild and are managed with low dose intermittent hormone supplementation. The inconvenience of wet urine patches on yours and their bedding and the carpets is a real problem practically. If they were not controlled on pills I would consider surgery.

So, ask your vet, and find out which surgeons are able to perform these operations.


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