Written by Shannon Fujimoto Nakaya, DVM
Yes, incontinence can and does happen in a percentage of the aging population, humans and animals. Like other muscles in the body, sphincter muscles can get weak in older (and sometimes not so old) animals and "accidents" happen. It usually evolves slowly -- like occasional bed wetting episodes or dribbling when the pet is excited. Fecal incontinence can similarly develop, but not as often, and usually even later in life.
It is important to remember that this is not the pet's fault; scolding the animal will not improve the situation. There are, however, a number of ways to manage these bodily functions, preserve your pet's dignity, and maintain cleanliness and hygiene.
First, it is important to make sure that the incontinence, especially if it is something that seems to develop overnight, is not a symptom of some other medical condition. Urinary tract infection, for example, can cause the bladder to spasm and leakage can occur, but a ten day course of antibiotics usually cures the condition. Medical conditions like diabetes or kidney disease can cause patients to be more thirsty and when they drink more, they will urinate more. Early detection increases the options for supporting these patients. Simply assuming that they are old and incontinent animals may be inappropriately depriving them of care for a treatable condition. A urinalysis is a simple test that can screen for urinary tract infections, kidney disease, and diabetes. It will also be helpful to your vet to know how much water your pet consumes in a 24 hour period. Measure the volume of water that you put out and then subtract how much is left the following day.
Older dogs, like puppies, can become more susceptible to intestinal parasites and GI distrubances, which can manifest as "poop accidents." Again, in order to be fair to our animal companions, it is worth a fecal test and an examination to make sure that the incontinence is not an indicator of a more serious problem.
It is not appropriate to deprive an aging or an older pet of food or water because they are having accidents.
Tips for managing incontinence:
- Scheduled potty breaks. Remember when your animal companion was a puppy that needed to go out 20 minutes after every meal and every couple of hours in between meals? Hopefully it won't be that bad initially, but resuming a regular schedule often helps. An empty bladder or a smaller bladder is less likely to leak than a full one, particulary overnight or before some kind of excitement. Ditto with the bowels.
- Some people have fenced in yards and dog doors provide freedom for the pet to go in and out according to need. Keep in mind that even with a dog door, pet's don't always think to empty themselves before going to bed or falling asleep. Getting them out before they go to bed, or gently waking them to do a potty break before you go to bed, can help keep the bedding dry overnight.
- For pets with fecal incontinence, walking and exercise often stimulates defecation, which allows you to empty your pet's colon on a schedule.
- Actual incontinence due to weak spincter muscles is less common in cats than dogs. However, some older cats just seem to "forget" to go the the potty and then go wherever they happen to be the need arises. Escorting these cats to the potty on a schedule can serve as gentle reminders about proper elimination etiquette.
- Some older cats take to eliminating next to the litter pan rather than inside of it. It seems that for some of these cats, it is just not worth the effort of lifting their arthritis legs over the edge of the litter pan. Cutting down one of the edges of the pan or using a flatter tray, and/or talking to your veterinarian about pain management can encourage them to resume going into the pan.
- Little dogs that were paper trained as puppies can be re-trained to utilize "pee and poop stations" overnight or when you can't be there to let them out. If newspapers aren't absorbent enough (or if you've gone electronic for your news), there are washable and reusable Pish Pads (www.pishpad.com), or a variety of indoor potty trays with washable artificial turf.
- Unwashable bedding like mattresses or foam or large stuffed beds can be wrapped with vinyl covers. Vinyl table cloths work okay for little dogs. Fabric stores will sell heavier duty vinyl by the yard. You can also purchase a roll of Tyvek® HomeWrap® from Home Depot.
- Fleece can be purchased by the yard at fabric stores. If you don't care about color or print, there is usually something cheap in the clearance section. Fleece is great because you don't need to finish the edges. You just cut to whatever size you want; the edges will not ravel and come undone. Fleece is soft. Several layers of fleece makes a decent bed that can be put in the washing machine and thoroughly washed. And it dries almost instantly.
- Laundry. Between disposable diapers and diaper services, very few younger people know how to launder dirty diapers or dirty bedding. First, remove the solids. Second, run it under faucet to rinse off the remainder of the solids and dilute the urine -- use lots of water. Then put it in the washing machine. Add detergent and a cup of white vinegar. Best laundry secret ever.
- Acupressure at CV2 can help to "exercise" and strengthen urethral spincter muscles. The point on the midline, under the dog, between its hind legs, on the front edge of the pelvic bone. You can do this with your dog standing or lying down, whichever your pet is more comfortable with. How much pressure? One way that I have heard it described is as much pressure as would be comfortable were you to close your eye and press on your eyeball. The pressure should stimulate your pet to contract or squeeze its spincter muscles and you should be able to feel that. A few minutes daily for a couple of weeks should help to strenghten those muscles. Maintenance very few days thereafter.
- Acupuncture and Chinese herbals can be very effective at managing incontinence. You can learn more about veterinary acupuncture and search for a veterinary acupuncturist in your area at www.ivas.org.
- Phenylpropanolamine (PPA) is a prescription drug that is generally effective in alleviating urinary incontinence and generally well tolerated. Talk to your veterinarian about whether this is an appopriate option for your pet.
- Some female dogs have what is called an Estrogen-responsive urinary incontinence. These dogs usually improve with a form of hormone replacement therapy, specifically DES or diethyl stilbesterol. As with other prescriptions, you should talk to your veterinarian about whether this is an appropriate therapy for your pet or not.
- For pets with fecal incontinence, diets that are highly digestible or low residue can minimize stool volume.
- Sometimes pee pads and diapers become necessary for overall cleanliness and hygiene. More on this in the chapter on Improving Qualtiy of Life When Your Pet Is Incontinent.