Senior dog incontinence: solutions that help

Most incontinence in old dogs can be treated, or managed well enough that the dog stays comfortable and the house stays livable. The first step is a vet visit, because many causes respond to prescription medicine. The second is a practical kit: waterproof washable bedding, diapers or belly bands used with care, pads, more trips outside and good skin care.

Incontinence or accidents: which is it?

Incontinence means urine or stool leaks out without the dog knowing. You find a wet patch where the dog was lying, or a dribble as they walk, and the dog seems unaware or surprised.

Accidents are different. The dog knows they need to go but does not make it, cannot get up in time, or has forgotten where to go. They squat or lift a leg in the usual way, just in the wrong place.

The difference matters because the causes and the fixes are not the same. Leaking points toward the bladder outlet or the nerves that control it. Accidents point toward drinking more, an irritated bladder, sore joints or confusion. The second group is covered in why an old dog has accidents in the house. If confusion seems likely, go through the dog dementia signs checklist.

Dog incontinence while sleeping

A wet bed after a nap, in a dog who pees normally when awake, is the classic picture of a weak bladder outlet. The muscle that holds urine in relaxes during sleep and a little escapes. It is most often seen in older spayed females, and it is one of the forms that commonly responds to prescription treatment. Only your vet can confirm that is what is going on.

Common causes in old dogs

These are possibilities for the vet to work through, not a way to diagnose your dog at home.

• A weak urethral sphincter, the muscle that closes the bladder
• A urinary tract infection or bladder stones
• Conditions that make a dog drink and pee far more, such as kidney disease, diabetes and Cushing's disease
• Spine or nerve problems, which often show up alongside weak or wobbly back legs
• Prostate problems in male dogs
• Growths in or near the bladder
• Side effects of some medicines
• Arthritis pain or dementia, which cause accidents rather than true leaking

Start with the vet, not the pet store

Take a fresh urine sample if you can, and notes on when the leaks happen. Expect an exam and a urine test, and often blood tests. Many of the causes above are treatable, and treating the cause can stop the leaking altogether.

Is there an over-the-counter medication for dog incontinence?

No. There is no over-the-counter medication proven to treat incontinence in dogs. The medicines that work are prescription only. Some tighten the bladder outlet and some are hormone-based, and each has side effects that rule it out for certain dogs. Your vet chooses the medicine and the dose. Where medicine is not enough, some dogs are offered a procedure.

Bladder supplements sold without a prescription have thin evidence behind them. Never give a dog human bladder medicine or any other human drug unless your vet has specifically directed it.

Does apple cider vinegar help dog incontinence?

There is no good evidence that it does. Apple cider vinegar does not strengthen the bladder outlet or clear an infection, and it can upset the stomach. The real harm is delay. An untreated infection, stones or diabetes gets worse while you wait to see if a home remedy works. See the vet first.

Do not cut back your dog's water to reduce leaking. Thirsty old dogs are often thirsty for a medical reason, and restricting water can make them seriously ill.

Incontinent dog solutions: the practical toolkit

Waterproof, easy-to-clean beds

A good dog bed for incontinence keeps urine out of the filling and survives a daily wash. Look for:

A raised mesh cot is another option. Urine passes through to a pad or tray below, so the dog is not lying in it. Check that your dog can step up onto it easily.

Diapers and belly bands

Belly bands wrap around a male dog's middle and catch urine only. Full diapers cover the rear and suit females, and males with bowel leaks. Fit matters: snug enough not to slip, loose enough for two fingers underneath.

The risk with both is urine scald, a raw rash from skin sitting in urine. To avoid it:

• Check often and change as soon as it is wet or soiled
• Clean and fully dry the skin at each change
• Give diaper-free time every day, on a washable pad
• Keep the hair around the rear and belly trimmed short
• Ask the vet before using any cream. Dogs lick, and some human diaper creams are harmful if swallowed

Pads, floors and more trips out

• Washable pee pads under and around the bed, on the sofa and in the car. Disposable ones work too but shift and shred more easily.
• Floor protection: washable rugs or runners with a waterproof backing in the places your dog rests. They also give grip.
• An enzymatic cleaner for accidents, so the smell does not draw the dog back to the same spot.
• More frequent trips outside: first thing, after meals, after naps and last thing at night. An emptier bladder leaks less.
• An easier route out. Ramps, traction and treated pain all help a dog who cannot get up in time. See what you can give a dog for arthritis pain.

Skin care

Look at the skin on the belly, inner thighs and under the tail every day. Rinse or wipe urine off with plain water or a dog-safe wipe and pat dry. Red, damp, smelly or broken skin needs a vet, because scald gets infected quickly.

Bowel incontinence

Dogs with bowel incontinence drop stool without noticing, often while walking or asleep. It commonly traces back to nerve or spine problems, or to bowel disease, and it needs its own workup. There is more in why an old dog poops in the house.

• Feed at fixed times so the bowels become more predictable, then walk soon after each meal
• Ask the vet whether a change of diet would firm things up. Do not add fiber or supplements on a guess
• Full dog diapers will contain stool, but change them at once. Stool damages skin faster than urine
• Keep the hair under the tail clipped short, and wash and dry the area after each leak
• Use wipe-clean or washable surfaces wherever the dog rests

When to call the vet today

• Straining to pee with little or nothing coming out. This is an emergency
• Blood in the urine, or crying when peeing
• Leaking that started suddenly along with weak, wobbly or dragging back legs, or a limp tail
• Sudden loss of bowel control
• Drinking far more than usual, vomiting, or not eating
• Raw, bleeding or foul-smelling skin
• Black or bloody stool

Is incontinence a reason to put a dog down?

On its own, usually not. A dog who leaks urine but still eats, moves around, enjoys company and is comfortable in their skin has a problem you can manage, and often one a vet can treat. Many dogs live for years this way.

It becomes part of the bigger picture when:

• It cannot be controlled after the vet has tried what is available
• The dog is distressed by it, or by the cleaning and diapering it takes
• The skin keeps breaking down or getting infected despite good care
• It comes with loss of mobility, so the dog lies in urine or stool and cannot move away
• It is one sign among several of a disease that is taking over

Your own capacity is a fair part of this too. Constant laundry and broken nights wear people down, and a vet would rather hear that than have you struggle in silence. Scoring the whole dog helps more than judging one symptom: use the quality-of-life scale for senior dogs, and read when to say goodbye if the answers are sliding. The decision is one to make with your vet. Euthanasia is only ever carried out by a veterinarian, and it is never something to attempt yourself.

This article is general educational information about incontinence in older dogs and is not veterinary advice. Leaking urine or stool can point to several different conditions, some of them urgent, and only an examination and tests can show which one your dog has. Decisions about medication, supplements, diet and end-of-life care for your dog should be made with your veterinarian.