Ask the Vet: Senior Dog Urinary Accidents

The Problem: I have a small dog who will be 16 in June. She is no longer able to "hold it" through the night and I wake to puddles on my floor. She doesn't seem to be interested in the potty patch. I hate to isolate her or crate her at her age since she is unfamiliar with these things. -Angel Williams Orechovesky

The Solution: 

Angel, this problem is not unusual for older dogs but can be difficult to manage without medical help. When I am presented with this situation, my first step is a comprehensive health screening to pinpoint the medical condition behind the problem. Age alone is not a sufficient explanation for her problem.

After a physical exam, a routine lab screening which includes blood work and urinalysis is indicated. The exam can help me determine if there are stones forming in your old girl’s urinary bladder, if she is actually leaking urine, and if there are health problems outside the urinary system which could be contributing to her inability to hold urine through the night like she used to do.

The lab work will indicate whether or not a urinary tract infection is developing, how well her kidneys continue to work, and if other organ systems are involved. These services (exam and senior lab screen) cost about $150 in most veterinary hospitals and give us the majority of the information we need to be able to treat the problem effectively. Sometimes other tests are indicated, but this investment in diagnostics is sufficient for most cases.

If a urinary tract infection is indicated, antibiotics to clear the infection will help your sweet girl feel better and reduce her urgency to void during the night. Antibiotics won’t help her if she does not have a urinary tract infection, but may be the only treatment she needs if she does have one. In older dogs, the typical signs of straining to urinate, blood in urine or licking behavior may not be present; the only clinical sign of an infection is often urinary accidents.

Sometimes, with age, dogs lose the muscle tone required to hold urine in the bladder effectively. We can prescribe medications to increase that muscle tone, allowing her to go longer between voiding. This might be the answer for her if she does not have a urinary tract infection, or if she still has accidents after a urinary tract infection is cleared.

Older dogs need to drink more water than younger dogs in order to keep their kidneys healthy, and as they age their kidneys become less efficient at concentrating the urine (retaining water in the body), so the frequency and amount of urine produced increases with age. Your older dog will need to go out regularly, but should be able to maintain a schedule without indoor accidents. Older dogs who have urinary accidents usually have one of the medical conditions I’ve described and will benefit from a visit to the veterinarian – and so will you when you have fewer puddles to clean up in the morning!

Lynne M. Flood, DVM
Daniel Island Animal Hospital
291 Seven Farms Dr Ste 103
Daniel Island, SC 29492
843. 881.7228
www.danielislandvet.com