Urinary incontinence can profoundly impact quality of life for dogs and their caretakers. This article provides an overview of the common causes of urinary incontinence and outlines a logical approach for evaluation and management of dogs with this condition.<\/p>\n
Take-Home Points<\/strong><\/p>\n Urinary incontinence (UI), defined as the passive and involuntary leakage of urine, must be differentiated from periuria (the conscious voiding of urine in inappropriate locations).1<\/sup> In some instances, complications related to UI such as urinary tract infection (UTI) can cause confusion, and care must be taken to establish a reliable clinical picture. The prevalence of UI in dogs is unclear, although it is well established that spayed female dogs are predisposed.2-6<\/sup> The severity is variable, with clinical signs ranging from an occasional damp spot on bedding to persistent dripping throughout the day and night. However, even low-grade UI can impact patient wellbeing and cause substantial distress to caretakers2,3,7<\/sup>; it is therefore important to promptly identify the cause and offer appropriate management options.<\/span><\/p>\n Control of urination is complex; it includes a storage phase during which the bladder relaxes as it slowly fills and a voiding phase in which urine is deliberately released.1<\/sup> Considered simplistically, the bladder acts as a reservoir for urine and the urethra functions as a sphincter; normal voiding requires coordinated contraction of the former and relaxation of the latter and is controlled by both local reflexes and inputs from higher centers. In dogs with UI, these normal processes are disrupted by mechanical or functional disorders. <\/span><\/p>\n Differentiating storage disorders from voiding disorders relies on determination of the postvoid residual volume (PVRV; i.e., the amount of urine remaining in the bladder after voluntary<\/span><\/p>\n urination). This is routinely calculated using 2D ultrasonographic measurements of bladder size (<\/strong><\/span>BOX 1<\/span><\/strong>)<\/strong>. A normal PVRV is defined as <\u20091 mL\/kg, while a PVRV >\u20093 mL\/kg indicates urine retention; intermediate values are regarded as inconclusive.1<\/sup> It can be helpful to determine PVRV immediately after a routine walk with the owner, as (in the authors\u2019 experience) the stress of being in the clinic and observed by strangers may inhibit normal voiding behaviors.<\/span><\/p>\n\n
Normal Voiding<\/h2>\n
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