Speaking of Healing Pets

Posted by Dr. Randy Aronson on September 24th, 2007 in urinary problems in dogs and cats

Urinary Incontinence in Dogs
Your Pet’s Health

Urinary issues are a frequent concern I hear from pet owners in my examination rooms, as well as from callers to my radio show. Take for example, “Pookie,” an otherwise well-behaved and healthy dog who wakes up in the morning and finds an unusual wet spot on her new cedar-chip bed.

She is noticeably upset and when she goes outside to relieve herself she strains and attempts to urinate numerous times, only producing small amounts of urine.

This is not an uncommon problem in dogs. Incontinence, which must be differentiated from inappropriate urination, can have multiple causative factors and may be a sign of a serious medical problem in your pet.

Diagnosing Incontinence
Incontinence is defined as an uncontrollable leaking of urine due to a malfunction of the sphincter of the bladder. Inappropriate urination on the other hand is a behavioral condition in which your pet chooses to urinate in the house, instead of an accepted area outside, or for some dogs, on potty pads or newspaper.

Let’s pick up Pookie’s story at my veterinary hospital. I obtained a medical history from Pookie’s pet guardians and we discussed urinary incontinence and its ramifications.

I then outlined a diagnostic plan, which included a blood profile and urinalysis. One key question asked during my history taking is whether there is a significant increase in water consumption. The importance of this lies in the fact that there is a set of medical conditions that cause polydipsia, or increased water consumption, and this increased load on the bladder may lead to incontinence.

Examples of the diseases implicated in the excess drinking are diabetes mellitus, diabetes insipidus, and Cushing’s disease or hyperadrenocorticism. The blood profile will identify these abnormalities if they are present.

I obtained the urine for analysis by performing a cystocentesis, which is the physical extraction of urine using a needle inserted into the bladder. This may sound painful, but in actuality, it is far superior to using a urinary catheter, which may introduce bacteria and spasming of the urethra (the tube that urine uses to exit the bladder), and is a painful procedure. A sterile urine sample is needed to assure an accurate culture of any bacteria present when we send the sample to our clinical laboratory.

Pookie’s blood results showed an increase in her white blood cell count (WBC) with the predominate cell being granulocytes. These cells are present in infection. Her urine test was positive for blood, bacteria and crystals with an elevated pH of her urine (the measure of acid or base, a marker for certain types of urine problems).

This urinalysis pointed to an infection called cystitis and actually was directly attributable to the infection and dental disease in Pookie’s mouth. The accumulation of tartar, plaque and gingivitis often result in the blood vessels of the gums carrying this bacteria to the organs in the body, many times, landing in the kidneys resulting in a urinary tract infection.

Pets’ Dental Health is Vital
I have seen many occasions in my 25 years of medicine in which a urine culture yields the exact same bacteria in the urine as in the mouth of my patients. This emphasizes how important a good preventative dental program is with our pets.

To finish up with Pookie’s case, I started her on a broad spectrum antibiotic and Imm-Power, a immune stimulant for the urinary tract infection and set up an appointment to perform a dental prophy, a deep tooth cleaning and polishing, while she was still taking the antibiotics. I started a cranberry product with marshmallow root and vitamin C (Pet-C) to address the increase in the pH of the urine, which renders the urinary tract more susceptible to bacterial infections (I like to see the urine pH stay between 5.5 and 7.0). I will discuss dental disease and prevention in an article at a later date.

Help for Dogs - and Cats, Too
Finally, incontinence may result from other problems intrinsic to your dog or cat. We will often see older females leaking. This is due to a lack of the hormone estrogen, which then causes the sphincter of the bladder (the trigone) to not function properly. This may be treated with acupuncture, Chinese herbs and phytoestrogens or plant replacements. Bladder stones or cystic calculi may also be a potential cause for incontinence, as may nerve dysfunction. Cancer is also on my list of items to rule out.