Potty Accidents in Dogs: Incontinence versus UTIs

What should you make of it when your dog starts having potty accidents? Do urinary incontinence, and urinary tract infections (UTI’s) look the same?

Urinary Accidents in Dogs: Incontinence versus UTIs

What are the general causes of urinary accidents in dogs?

Emotional causes aside, the two elemental reasons behind your dog’s urinary accidents are that they either

  • could not hold it any longer
  • didn’t know it was happening

The first thing you want to do is to see a veterinarian. Is it a urinary tract infection (UTI)? Does your dog have a condition that causes excessive drinking?

Confirming or ruling out the above conditions is relatively straightforward. If your veterinarian ruled those out, what are the next steps?

  • is your dog’s urethral sphincter (the muscle that guards against leaking) weak and unable to hold urine?
  • is there an anatomical abnormality?
  • do the sphincter and the brain not communicate?

Spay-related incontinence is commonly diagnosed in spayed female dogs. That said, Cookie was diagnosed with it and yet it seems there is more to the picture. Cookie might have a bouncy bladder rather than the typical hormone-responsive incontinence. Her leaks are directly related to how much bouncing she does.

One way or another, Cookie does not know that the pee is on its way out.

While we are doing our best to keep Cookie dry, getting to the bottom of her leaks is still work in progress. You can read more about Cookie’s leaks here.

At the same time, if Cookie got an infection on top of that, would we be able to tell? Which brings up the question – could one tell the difference?

If you already identified one problem, would you miss a new one that looks similar?

For instance, a friend’s dog was sick and treated with steroids and chemotherapy drugs. The side effects of steroids include excessive drinking and, consequently, lots of peeing. Unless you’re always around to let your dog out, some accidents are inevitable.

The dog’s urine was also incredibly stinky. But it was chalked up to the chemotherapy.

Everything they observed seemed to have a perfectly reasonable explanation. I wasn’t until the dog virtually exploded with blood when they discovered she had a massive UTI.

Since Cookie already has potty accidents, would notice if she had an infection on top of it?

I think about that every time I find Cookie lying in a pool of urine. It’s on my mind when because of the black flies she’d rather hold it all day instead of going outside to pee. Because urine sitting in the bladder for too long is one of the risk factors for developing an infection.

Risk factors for getting urinary tract infections (UTI) in dogs include:

  • sex–female dogs are more likely to get UTI than male dogs
  • spay
  • anatomical anomalies
  • suppressed immune system
  • chronic disease such as diabetes or Cushing’s disease
  • reduced mobility such as IVDD
  • incontinence

For example, Cookie is healthy but she is a girl dog, was apparently spayed way too early. As a result, she has issues with incontinence. And who knows whether Cookie’s past pelvic injury plays any role with either of the problems.

So, wait, not only Cookie’s pee accidents could mask a UTI but be a contributing factor too? That’s right–incontinence itself can make it more likely for Cookie to get a UTI. At the same time, a UTI can make potty accidents worse.

Can you see why the subject is on my mind?

Short of having Cookie’s pee analyzed regularly, would I be able to tell that she has a urinary tract infection before it gets bad?

Just now, I had to interrupt my writing because Cookie woke up and got up from a pool of urine. I check on her dryness regularly, but she was playing in the water–it’s hard to tell the difference then until she gets up.

Which brings me to the question what would be the telling difference.

Urinary accidents in dogs–incontinence or a UTI?

And when is it both?

Incontinence

  • doesn’t involve squatting or leg-lifting; urine just comes out
  • accidents without your dog being aware of it happening
  • urine can be dribbling or leak out in copious amounts
  • most likely during sleep or rest
  • happens anywhere, frequently in the bed or other places your dog likes to rest
  • increased drinking contributes to more leaks

Urinary tract infection

  • your dog might squat and strain to urinate
  • urination is painful, and your dog might try to relieve the pain or hold it until they cannot anymore
  • the dog will typically have the urge to urinate frequently in small amounts
  • your dog definitely won’t sleep through that
  • you might find a series of small puddles on the way to the door or a puddle at the door
  • UTI can cause increased drinking

What could you tell from the urine?

Incontinence

  • normal smell or hardly any smell at all
  • it may be light color or clear as increased drinking leads to more leaks
  • clear
  • no blood in the urine

Urinary tract infection

  • cloudy urine
  • blood in urine
  • strong, foul smell

Other potential signs associated with an infection:

  • licking of genitalia
  • fever
  • lethargy
  • decreased appetite

Incontinence in itself doesn’t come with any other signs except the urinary accidents.

At the present time, Cookie doesn’t have any suspicious symptoms other than her leaks. But knowing that her incontinence does put her at a higher risk of UTI, I keep a keen eye on her.

In conclusion, things can get complicated.

If you’re dealing with only one or the other–urinary incontinence or UTI– the differences are usually obvious. In the vast majority of cases, one is puddles while at rest while the other is an increased frequency of attempts to urinate producing only small volumes at a time.

Always pay attention to your dog and make sure that a new problem doesn’t hide behind an existing one.

When in doubt, arm yourself with a home urine test kit such as Petnostics or PawCheck. If your dog’s urine doesn’t contain any traces of blood or protein, it is unlikely that your dog has a UTI.


Bladder stones and urinary crystals can come with the same symptoms as a urinary tract infection:

  • urinary accidents
  • painful urination
  • frequent urination
  • straining to urinate/difficulty urinating
  • discolored or bloody urine

The two most common types of bladder stones in dogs are struvite or calcium oxalate stones. If your dog has struvite bladder stones or crystals, and underlying chronic UTI is likely. If that is the case, you should also ask for urine culture because there is an increased chance of resistant bacteria.

Conversely, calcium oxalate stones are a predisposing factor to bladder infections.

If your dog is straining to urinate they require medical attention as soon as possible. Male dogs are particularly susceptible to this medical emergency.

As you can see, nothing happens in isolation.

Fortunately, you don’t have to try and diagnose your dog–you do need to know when you might have a new problem on the top of the old one.

Related articles:
Symptoms to Watch for in Your Dog: Changes in Urination/Urinary Accidents

Further reading:
Urinary Incontinence in Dogs
Urinary Tract Infection, Lower (Bacterial) in Dogs

Categories: ConditionsDog health advocacySymptomsUrinary accidentsUrinary incontinenceUrinary tract infection (UTI)

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Jana Rade edited by Dr. Joanna Paul BSc BVSc

I am a graphic designer, dog health advocate, writer, and author. Jasmine, the Rottweiler of my life, was the largest female from her litter. We thought we were getting a healthy dog. Getting a puppy from a backyard breeder was our first mistake. Countless veterinary visits without a diagnosis or useful treatment later, I realized that I had to take Jasmine's health care in my own hands. I learned the hard way that merely seeing a vet is not always enough. There is more to finding a good vet than finding the closest clinic down the street. And, sadly, there is more to advocating for your dog's health than visiting a veterinarian. It should be enough, but it often is not. With Jasmine, it took five years to get a diagnosis. Unfortunately, other problems had snowballed for that in the meantime. Jasmine's health challenges became a crash course in understanding dog health issues and how to go about getting a proper diagnosis and treatment. I had to learn, and I had to learn fast. Helping others through my challenges and experience has become my mission and Jasmine's legacy. I now try to help people how to recognize and understand signs of illness in their dogs, how to work with their veterinarian, and when to seek a second opinion. My goal is to save others the steep curve of having to learn things the hard way as I did. That is the mission behind my blog and behind my writing. That is why I wrote Symptoms to Watch for in Your Dog, which has turned out being an award-winning guide to dog owners. What I'm trying to share encompasses 20 years of experience. Dr. Joanna Paul BSc BVSc is our wonderful sponsor and has been kind to edit and fact-check my important articles.

15 Comments
  1. As always, I learned something new. I don’t think any of my cats have ever had issues with either, but Truffle did develop bladder stones which made it difficult to pee.

  2. This is good information! Every now and then Sophie will have an accident. It is good to know the signs of a UTI.

  3. Marjorie Dawson

    A really helpful post. I like the comparison chart. People might be sat there saying how do I tell the difference YIKES!!! You have just made a worried dog parent’s life easier. Great job!

  4. After having two cats with urinary issues I’m always wary of any accidents- plus cats communicate by peeing in places. I spend a lot of time worrying about whose peeing and where

    • It seems to be that urinary accidents in cats are more reflective or things such as arthritis than actual urinary tract issues.

  5. I watch Layla like a hawk so anything unusual I run to the vet but thank goodness have not had this problem although she is getting older

  6. Great post. My senor boy was injured recently and on steroids. He had a few accidents on the kitchen floor which is VERY unusual for him. I took him in for a check up and, luckily, it turned out to be a side effect of one of the medications he was on – no infections. Since he healed up and got off the medications the accidents have stopped. He’s getting older now, so it really made me wonder what the cause of the accidents were – the medications, age related issues, an infection, something else? I’m totally a regular at the vet’s office, but I usually go in at the first sign of something being off just so I can make sure there’s not something more I could do to help them feel better faster.

  7. This is really interesting! It is just one of the ways that cats and dogs differ. Cats rarely have true UTIs, more often, they develop crystals in their urine (which is painful and can block the flow). Also, male cats are far more likely to develop urinary issues than females.

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