Bladder Incontinence in Dogs: What Causes Leaks and How to Manage Them

Urinary incontinence happens when a dog involuntarily loses bladder control, and it is not your dog being spiteful or acting out.¹ If your dog's back end is also going, the two are often connected: with a ruptured disc, dogs that lose the use of their hind legs usually lose the ability to urinate and fully empty the bladder at the same time.² Our wider guide to caring for a dog with weak back legs covers the mobility side.

What's actually causing the leaks?

A weak bladder, or urethral sphincter mechanism incompetence (the ring of muscle that holds urine in doesn't close properly), is often responsible for incontinence in spayed females.¹ Owners often report an older spayed female leaking unexpectedly while asleep, caused by lower estrogen levels weakening the urethral muscles, though this hormone-responsive incontinence can occur in both sexes.¹

Age plays a part too: the urethral muscles weaken over time, so dogs struggle to hold their urine and incontinence often begins in middle age as the bladder weakens.¹ Two other everyday causes are a bladder infection, and conditions like diabetes, kidney disease or Cushing's disease that make a dog drink much more water.¹ In seniors, cognitive dysfunction syndrome (canine dementia) can also explain why a dog forgets where to pee.¹

Why weak back legs and bladder incontinence in dogs go together

The same spinal injury tends to knock out both functions at once, which is why complete loss of hind leg movement usually arrives at the same time as losing the ability to urinate and to empty the bladder completely.² If paralysis is higher up the spine, it can affect the nerves that control urination and defecation.³ In a high-risk breed with a sudden onset of paralysis and no severe trauma, there is roughly a 95% chance a ruptured disc is behind the signs.⁴ A fibrocartilaginous embolism, where a tiny piece of disc blocks a blood vessel to the spinal cord, causes sudden-onset paralysis.⁴ Degenerative myelopathy, a spinal cord disease causing progressive muscle weakness and loss of coordination,⁵ has no treatment and ultimately leads to loss of urine and bowel control.⁴ Sudden weakness or paralysis is an emergency: go to a vet the same day.

Two bladder patterns worth learning to tell apart

A dog with an overfull bladder posturing and straining with little or nothing coming out needs urgent care, because retained urine backs up and a dog with signs of a blocked urethra (the tube urine passes through) needs veterinary care immediately, as a complete blockage can be fatal without treatment.⁶ There is more detail in our guide on a dog with IVDD who isn't passing urine.

The other pattern is a floppy bladder that dribbles when the dog moves, stands up or lies down. Dogs that lose the use of their hind limbs often cannot urinate well, and owners will need to express their bladders several times a day so urine is voided.² Ask your vet or rehab tech to teach you how to express your dog's bladder hands-on, and go back to them if the bladder still feels full afterwards.

Accidents that aren't incontinence at all

Plenty of indoor puddles come from a dog who simply can't get into position or can't get outside in time. A wobbly dog braces instead of squatting, slips on tile, or holds it until it spills. Rugs, carpets or yoga mats on hard floors, pet ramps, a sling or harness to assist with walking and standing, and a wheelchair to support the hind limbs are all standard management steps.⁵

The OldPal Rear Support Dog Wheelchair holds the back end up so your dog can walk out, turn around and toilet on a predictable schedule instead of dragging. Dogs can squat and go to the bathroom while in the chair, and the padded harness carries weight through the hips and chest rather than the spine. It comes in five sizes covering rear leg heights from 3 to 27 inches; measure from the top of the hip straight down to the toe pad using the sizing guide and fit finder, or email a photo and your measurement to help@oldpalpets.com.

Before the vet visit, and what happens there

Keep a simple diary. Note when and where your dog urinates in the house, when you first noticed, whether they are drinking more than usual, and whether urination seems painful.¹ Add whether leaks happen asleep or awake, and whether they strain. Your vet will usually run a urine test and blood tests to rule out a bladder infection or an underlying condition, and may also use imaging.¹ If the legs are involved, expect a neurological exam too, and testing for spinal cord disease may add blood work, X-rays or scans.⁵

Keeping skin and bladder healthy

Dogs who can't void normally are at higher risk of chronic urinary tract infections and urine scald, and without motor function they cannot turn themselves and may develop bed sores, so keeping them on a soft, well padded area helps.² Urine scald lesions show up around the genitals and can also involve the abdomen, groin and upper legs.⁷ Clip damp fur short, wash and dry fully, use a barrier cream your vet suggests, and rotate washable bedding that handles leaks. Diapers or belly bands may save serious cleanup if your dog tolerates them, pads or washable bedding help overnight, and above all maintaining hygiene avoids skin infections.¹ Change a diaper as soon as it is wet, never leave one on a damp coat, and read our notes on toileting and hygiene around a wheelchair.

What to expect over time

There is no cure for degenerative myelopathy, though routine physical therapy may delay its progression.⁵ After intervertebral disc disease (disc damage in the spine), the road to recovery is usually a long one, spanning weeks to months.² Either way, clean skin, a dry bed, a set potty schedule and support for the back legs keep daily life good.

Frequently asked questions

Related guides

• Hind leg weakness with incontinence
• Incontinence in older female dogs
• When your dog pees the bed

Sources