Managing Urinary Incontinence and Oestrogen in Bitches

Urinary incontinence in dogs is an involuntary loss of bladder control, causing leakage or accidents. While it can affect both sexes, it is particularly common in female dogs (bitches), especially after spaying or in older age. This article explores urinary incontinence in bitches, focusing on the critical role oestrogen plays, how to distinguish medical causes from behavioural issues, and practical management strategies.

Understanding The Difference: Incontinence vs Behavioural Issues

Often, inappropriate urination is mistaken for incontinence, but these are distinct issues. Inappropriate urination is under the dog's physical control and can result from behavioural causes such as stress, anxiety, changes in routine, or boredom. In contrast, true urinary incontinence is a medical condition where the dog cannot control urination and may be unaware of urine passage or physically unable to prevent leakage.

Behavioural issues typically arise suddenly after events like house moves or extended periods alone without stimulation. Incontinence most commonly occurs in bitches either as they age or shortly after being spayed, linked to changes in hormone levels, particularly oestrogen.

The Role of Oestrogen in Urinary Continence

Oestrogen is a crucial hormone that supports the strength and function of the bladder muscles and urethral sphincter in female dogs. When oestrogen levels decline, these muscles weaken, diminishing the dog's ability to hold urine, resulting in leakage and accidents.

Natural ageing reduces oestrogen production in bitches, which explains why urinary incontinence is more prevalent in mature and elderly dogs. Additionally, spaying—especially if performed before a dog’s first heat cycle—can significantly reduce oestrogen production, leading to an increased risk of urinary incontinence, often within six months post-procedure.

Rarely, tumours affecting the bladder or hormonal regulation may impair oestrogen's function, so veterinary tests may include tumour screening to rule this out.

Urinary incontinence is more frequent in large and giant breeds; breeds such as the Weimaraner puppies, Springer spaniel puppies, and Boxer puppies are at higher risk compared to smaller breeds where behavioural causes are more common.

Diagnosing Urinary Incontinence in Bitches

Veterinarians typically begin diagnosis by distinguishing true incontinence from behaviour-based urinary issues. This involves a thorough clinical examination, history taking, and often hormone level testing to assess oestrogen status. Additional tests may be conducted to exclude infections, bladder stones, or tumours that could contribute to urinary issues.

Treatment and Management Options

Currently, no treatment can restore natural oestrogen production permanently. However, urinary incontinence due to oestrogen deficiency in bitches is effectively manageable with hormone replacement therapy.

Hormone Replacement Therapy: Synthetic oestrogen medications such as Incurin® (estriol) are commonly prescribed. Estriol is a short-acting, natural oestrogen that helps strengthen urethral sphincter muscles, increasing urinary continence.

Treatment usually involves lifelong medication, with dosages tailored individually through veterinary monitoring. Most dogs show significant improvement within days to weeks. Side effects are generally mild and may include occasional loss of appetite, vomiting, or vulvar swelling.

Costs for long-term treatment are typically affordable, amounting to only a few pence per day.

Supporting Your Bitch at Home

Alongside medication, practical care measures can help manage incontinence:

• Provide easy access to suitable toilet areas frequently to reduce accidents.
• Keep your dog clean and dry to prevent skin irritation or infections.
• Use washable bedding and protection mats in favored resting places.
• Maintain regular veterinary check-ups to monitor ongoing health and treatment effectiveness.

Preventive Considerations for Responsible Owners

For owners considering spaying, it is advised to await full sexual maturity (after the first heat cycle) to reduce the risk of oestrogen-related urinary incontinence. Responsible breeders and owners should prioritise the health implications of early spaying.

If you notice your previously healthy bitch developing urinary leakage within months of spaying, consult your vet promptly for assessment and management.

Summary and Next Steps

Urinary incontinence in bitches is closely linked to decreased oestrogen levels due to ageing or early spaying. Recognising the difference between medical incontinence and behavioural problems is essential for effective management.

Hormone replacement therapy with synthetic oestrogens like Incurin® offers an effective treatment option, restoring muscle tone and improving your dog's quality of life. Combined with compassionate home care, many affected bitches can lead comfortable, happy lives.

If you suspect urinary incontinence in your bitch, schedule a veterinary consultation to explore diagnosis, treatment, and management tailored to your dog's needs.