Urinary incontinence is the involuntary leaking of urine. The most common cause of urinary leaks in female dogs is spay incontinence.
To me, however, the theory isn’t adding up.
Cookie’s urinary leaks started when she was about two years old. There seemed to have been little rhyme and reason to them. We’ve gone through several theories and treatments–what we got to show for all that were mixed results.
First things first, we made sure Cookie didn’t have a UTI or anything else going awry in her urinary tract or bladder. All of that checked out.
Because she was so young, we checked for anatomical abnormalities. Cookie’s labs were all good, and there was no reason to suspect something sinister. The conclusion was that she has estrogen-responsive incontinence.
Cookie never leaked consistently
One thing that never added up to me was that Cookie could go weeks or months without leaking and then leak like nobody’s business. And then stop again. I was told that incontinence could work that way. But it didn’t make sense to me.
However, not having found anything else wrong, we decided to treat it as such. I opted for a treatment that seemed more natural to me–estrogen therapy. It kind of, sort of, worked. Maybe. Certainly not in such a way that I would be satisfied that we had the right diagnosis.
What else could it be?
Spay incontinence? Following the spay surgery, the strength of the urethral sphincter, the muscle that keeps urine from leaking, decreases–and continues to weaken with age. Many female dogs develop incontinence within three years post spay. The timeline would fit. The presentation, in my opinion, does not. If the muscle was weak, wouldn’t it mean that Cookie should leak every time there was enough urine in the bladder? Which has not been the case.
Cookie also has not been drinking abnormally and whether or not she’d leak has not been directly dependent on how full her bladder was.
Neurological? Cookie’s spine looks healthy on radiographs. She does have some anatomical issues in her pelvic region. Could it be that a nerve that controls the sphincter gets pressed and that’s what is causing the leaks?
We tried chiropractic care
Cookie does see a chiropractor and does usually need some adjustments. However, sometimes she’d stop leaking after an adjustment, sometimes not. We continue with chiropractic care for her but how that may or may not affect Cookie’s incontinence remains debatable.
Because Cookie has abnormalities with her lumbosacral and sacroiliac joints, I was wondering whether that might be at the root of the problem. We implemented a holistic treatment that is meant to address just that. And again, sometimes it looks like it works and sometimes not.
Why it only happens now and then? Why she can have a full bladder and not leak one day and leak the next?
What I observed
Over time, a pattern started emerging. It seemed that Cookie’s incontinence had been preceded by two things – full bladder and a lot of bouncing. Bouncing through deep snow or bouncing through tall grass. Naturally, bouncing could affect the nerves controlling the sphincter as well. Was that it, though?
One way or another, the more I keep track of it, the stronger the connection seems to be.
Bouncy bladder?
During Cookie’s last wellness exam, the vet asked about how it’s been with her incontinence. I explained how it is sporadic and described my observation. The vet was taking in the information and processing. I could see her think, putting it together.
Then she turned to me and started explaining how the bladder isn’t solidly attached to anything and pretty much just “hangs” there. Which can make it bounce with a portion of it hung over a bone, out of proper position. Hmm … I remembered how at the beginning of our incontinence journey, Jasmine’s vet believed that there might be urine pooling where it shouldn’t be. We thought it was an anatomical problem, but that got ruled out.
What if the displacement was only a temporary thing–a bouncy bladder?
When I asked Jasmine’s vet about it, he agreed it was possible. Well … did we solve the mystery of Cookie’s leaks?
Update and further thinking
Armed with the new theory, I kept even a keener eye on when Cookie leaks and when she doesn’t. What is the verdict?
There definitely is a connection between bouncing and the urine leaks.
While an empty bladder wouldn’t leak, a full one doesn’t leak just because it’s full. That is confirmed. And Cookie’s bladder gets full often because the entire outdoors is one giant ice cream buffet.
How do we know when Cookie’s bladder was full?
That’s quite simple to determine. Typically, when we take Cookie out, she’ll eat some snow, sniff the air, walk around, stick her head in the snow … and then, eventually, she’ll pee a moderate amount. When her bladder is full, she’ll pee as soon as she hits the ground and a substantial volume.
The other way of telling her bladder was full when she finds herself lying in a puddle of urine.
What is making the difference?
Cookie has never leaked at night, regardless of how full her bladder was. Not once. She’ll only leak during the day, typically about half an hour after a walk.
After she’s done a bunch of bouncing. Right now, the snow is about three times as deep as Cookie is tall. Maybe more. When she decides to get off the trail which we keep making for her, the snow literally swallows her. It takes a lot of effort for her to bounce herself out of it, even though I am right there trying to stomp it down around her to make it easier.
Bouncing definitely plays a role
That, I believe, leaves two theories. One is that all that violent exertion might affect the nerves that control the bladder. Given Cookie’s issues in her pelvic area, this would be a reasonable assumption.
Case in point to the contrary: yesterday, we were out, and Cookie strayed from the trails more than often enough. After that, she leaked like a faucet. But after we went out the next time, and she did exactly the same stuff, she did not leak at all. She rested for several hours and then when she asked to go out, her bladder was quite full, but it did not leak.
It would almost seem that she bounced things out of position the first time around and then back where they belong on the next walk.
I am slow to draw conclusions, but given all the observations to date and the available theories from Cookie’s veterinarians, bladder displacement does seem to be what the cause behind Cookie’s off and on incontinence is.
Related articles:
Urinary Incontinence in a Dog: Cookie’s Mysterious Leaks
Further reading:
Diagnosing and Managing Urinary Incontinence in Dogs