Signs of Female Incontinence After Spaying
You will most likely notice that your dog dribbles while walking or lying down, so you will probably find wet spots on the bedding or areas where she sleeps. This may be side effects of the anesthesia but if it lasts longer or re-occurs months after the surgery and your dog seems to not be getting better from the leaking, consult your vet as it may be spay incontinence. You may also notice your female dog is licking the area of skin that has become irritated by urine. These are symptoms of spay incontinence.
Your vet will diagnose spay incontinence through your dog’s medical history, clinical signs, blood tests, and urine tests. They may also perform a bladder radiograph (X-ray) and ultrasound on your dog to make sure their diagnosis is not confused with other diseases.
Can spaying cause incontinence in dogs? Unfortunately, yes, it can be one of the side effects of spaying a dog. Incontinence after spaying appears on your furbaby first before it actually appears on your floor.
You will occasionally notice and wonder why your female dog is leaking urine when lying down or while resting. Or, you might notice some of these common signs of dog incontinence after spaying:
Each of these can be considered a spay incontinence symptom. Incontinence after spaying typically develops immediately or some months after the actual spaying procedure. According to the National Center for Biotechnology Information, urinary incontinence occurred on average at 2 years and 10 months after surgery and occurred each day, while the dogs were awake or during sleep.
Sadly, many of these dogs will develop a urinary tract infection because of the constant licking of the vulva and its constant exposure to urine, which can make the situation worse. Since the sphincter is weak, it allows bacteria to travel inside the bladder. And all of that licking is creating a breeding ground for bacteria. It’s the perfect storm of sorts and makes incontinence even worse.
If your dog has recently been spayed and has any of the symptoms mentioned, you should schedule a follow-up appointment with your vet, who will want to do a urinalysis and blood work, and perhaps even culture to determine the kind of bacteria that is present if an infection is occurring.
“Will my vet know if my dog will develop incontinence after spaying?”
Your vet cannot predict if your dog will be the one to develop incontinence, but according to Dogs Naturally Magazine, obese dogs and pets that are spayed under the age of six months are more at risk. This is because of the common cause that is a hormonal imbalance that occurs after spaying.
For the urinary tract tissues of your furbaby to function well, it greatly depends on the amount of estrogen that its exposed to. After your pets ovaries are removed, her estrogen levels become too low to supply proper function of the tissues in the urinary tract, thus exposing pets who are spayed early to the possibilities of incontinence.
What is Spaying?
Spay surgery sterilizes a female dog and prevents her from getting pregnant. Usually, both the ovaries and the uterus are removed. Another option is to remove only the ovaries or only the uterus.
Unspayed female dogs go into heat about once every six to eight months and it lasts for as long as three weeks each time. During this time, a female dog is receptive to mating with males. She may appear nervous, easily distracted, and more alert than usual. She may also urinate more often than she normally does and produces a vaginal discharge. Unless they’re spayed, female dogs regularly go into heat for their entire lives. In addition to eliminating the odor and behaviors associated with being in heat, spaying is thought to have several additional benefits.
The spay procedure has its equivalent in human healthcare and is known as a complete hysterectomy (ovaries and uterus removed) or an oophorectomy (removal of the ovaries). This procedure is sometimes referred to as “surgical menopause.” As with a human hysterectomy, spay surgery leaves a dog without her full complement of sex hormones, such as estrogen.
Since spaying is done when pets are quite young, they will experience a lifetime of essentially being in menopause. Some veterinarians are starting to question this practice and are looking at the long term health consequences of a lifetime without sex hormones. Bone cancer, ligament tears, and incontinence tend to be more common in spayed dogs.
Some veterinarians suggest removing only the ovaries because this surgery is simpler and reduces the risk of damage to a pet’s lower back. While the immediate risk to the pet may be less, sex hormone production is not preserved when the ovaries are removed. Dr. Michelle Kutzler, who specializes in animal reproductive health, recommends removing only the uterus. Leaving the ovaries intact allows them to continue to produce sex hormones. The pet will still go into heat, but will be sterile, and will not produce uterine spotting and other secretions.
One problem that may be associated with spaying is urinary incontinence or the unintentional leaking of urine. Veterinarians recommend that pets with urinary incontinence be evaluated by a professional, as urinary incontinence has a number of potential causes. One common cause is hormone imbalance following spay surgery. The proper function of urinary tract tissue is dependent upon adequate exposure to estrogen and after a pet’s ovaries are removed, her estrogen levels are low. Lack of estrogen may cause the urethral sphincter (a muscle used to control the exit of urine) to relax and release urine involuntarily. Incontinence is most common during rest as muscles are relaxed and urine tends to seep out.
The following are some commonly used treatments for incontinence in dogs:
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5 Possible Complications After Spaying Your Dog
One of the more common problems veterinarians see that not many people are aware of is urinary incontinence in female dogs. This is also referred to as spay incontinence or hormone responsive incontinence as it tends to happen mostly in dogs who have been spayed.
First, let’s review what it means to be “spayed.” The common spay procedure is an ovariohysterectomy–surgical removal of the dog’s ovaries and uterus. There are many reasons why we recommend spaying female dogs. We spay dogs to prevent unwanted breedings and overpopulation, but also to help prevent reproductive organ disease when dogs grow older. Mammary (breast) cancer, uterine infections, and ovarian cysts are very common, if not expected, in older non-spayed female dogs. These diseases are all related to the effects of estrogen and progesterone that occur with each heat cycle. Of course, spaying female dogs also prevents their owners from having to deal with the messy discharge that occurs with each heat cycle, typically lasting for several weeks.
Interestingly, when we spay and neuter dogs, they still very much maintain male and female dog characteristics. This is because testosterone and estrogen are also produced from the adrenal glands, although in much smaller amounts than in the testes or ovaries. Now, back to incontinence…
I grew up a big fan of Wayne’s World on Saturday Night Live and they always got a big kick out of saying the word “sphincter”! But we should all be thankful for our sphincters, especially those at our bladder and rectum! When we are asleep, awake, at work, or at play, our bladder sphincter is closed tight, keeping urine from leaking out until we’re ready to go to the bathroom. It’s the same for dogs and cats. Urinary incontinence occurs when the sphincter muscle is not closed tightly enough, allowing some urine to leak out when it’s not supposed to. In spayed female dogs, this is thought to be due to a lack of estrogen hormone in the body, which helps to give that muscle more “tone.”
The classic case we see is a middle-aged to older spayed female dog who is brought in for having urinary accidents in the house. When we inquire about when the accidents occur, they always happen when the dog is sleeping, taking a nap, or resting. They may leak a small amount, or leak the entire bladder–not very fun on your couch cushions! Usually, the dogs have no idea they did it and they wake up wet and a little confused.
It doesn’t take too many of these leaking episodes for an owner to call wanting to find out what’s wrong. The first thing we recommend is to test their urine to rule out any infection or diabetes, both of which can also cause incontinence. If the urinalysis is normal, the history alone tells us it’s female urinary incontinence.
We always recommend treating urinary incontinence. Obviously, no one wants their dog leaking urine everywhere they sleep. But also, urinary incontinence puts these dogs at a high risk for developing a urinary tract infection. Often the infections that occur secondary to incontinence are not very obvious, except for worse-than-usual-smelling urine.
Fortunately, treating urinary incontinence is generally easy and successful. There are two medications available, estrogen and phenylpropanalamine (PPA).
I usually recommend estrogen supplementation because it clearly goes at the underlying cause of the problem–lack of estrogen. Estrogen supplementation is very safe and dogs who are responsive, often end up only needing one pill, once a week to maintain a tight sphincter. The challenge with estrogen supplementation is finding the right dose, as some dogs are more sensitive than others.
The other appropriate medication that is often used is PPA, often called Proin. This is actually a type of stimulant, which acts on receptors in the sphincter muscle to cause it to tighten up a little. This medication has to be given twice daily, long term, but is also generally safe and effective.
So you might ask, “Should I just not spay my dog?” Well, no. Although you will certainly decrease her risk of getting urinary incontinence, you will dramatically increase her risk of getting mammary tumors or a uterine infection. I would argue that easily more than 90 percent of non-spayed female dogs will eventually get mammary tumors or get a uterine infection that requires an emergency spay when they get older. Also you’ll have to deal with heat cycles and puppies. So risk/benefit: I’ll take the risk of incontinence, easy.
There is a group of folks out there who recommend letting dogs go through one heat cycle before spaying them, and I think this is a reasonable consideration. The “pros” are that their lower urinary tract gets some estrogen exposure that will decrease their risk of incontinence. Also, their body gets to naturally develop to maturity. The “cons” are that the prevention of mammary cancer is reduced (but still there), their owners have to deal with a messy heat cycle, and the spay surgery itself is more painful in an adult dog than a six month old puppy. Also, although the risk of urinary incontinence is reduced, it is not gone!
I recommend spaying dogs between six and nine months of age. The majority of dogs spayed at this age do NOT go on to become incontinent and the surgery is less complicated and offers a quicker recovery when they are still puppies. For some dogs that have a recessed vulva or puppy vaginitis (ask your vet), I recommend waiting for a heat cycle so these problems can resolve.
I do think that spaying at 12 to 16 weeks is too early and may be associated with a higher rate of incontinence as they get older, and there’s really no reason to do this surgery that early.