Ask Hopeful Henry: Can spaying lead to incontinence?

Dear Henry,

My question for you is: does spaying contribute to and/or cause urinary incontinence. I understand it can. What is your opinion?
Thank You

Thank you Bruce for the question. Simply put, yes dogs that have been spayed (spay is term for female dogs and neuter is for male dogs) can become incontinent. About 20% of female dogs will become incontinent within three years of spay surgery. This is known as estrogen-responsive or spay incontinence. Most of the time this happens with older dogs, it has been proven that if a dog gets spayed before her first heat but no earlier than three months old have a lower incidence of spay incontinence. That being said there are several other potential reasons that could cause canine urinary incontinence:

• Bladder infections, stones, polyps or tumors
• Overflow incontinence, which occurs when a dog is affected by a medical condition that causes her to drink excessively, such as diabetes and Cushing’s disease.
• Spinal cord disease
• Developmental urinary tract abnormalities, including ectopic ureters and vaginal strictures.

The first thing you should do if you suspect canine incontinence is see you veterinarian for advice. Veterinarians will usually recommend a urinalysis and a urine culture. If the urinalysis reveals evidence of a medical disorder that may be causing your pet to over-consume water, your veterinarian will likely recommend complete bloodwork in order to make a definitive diagnosis. The urine culture is used to identify the type of bacteria growing in the urine.

There are treatment’s for your dog’s incontinence, here are some of them you can discuss with your veterinarian:

• Urethral sphincter strength can be improved with medication — some 50 to 60 percent of incontinent spayed female dogs will respond to estrogen therapy, which works to increase the sensitivity of the closure receptors in the urethra.
• Estriol (Incurin) is a new, natural estrogen therapy option that will be available to veterinarians this fall. Although other estrogen formulations have been used for spay incontinence, estriol is the only FDA-approved estrogen for the condition. (FDA approval ensures drug safety and effectiveness, as well as quality and consistent manufacturing and monitoring processes.)
• Another course of treatment is phenylpropanolamine (PPA), which is a nonhormonal medication that directly stimulates closure receptors in the urethra. About 85 to 90 percent of spayed female dogs will show an excellent response to PPA. The FDA has also recently approved a PPA product called Proin for the treatment of spay incontinence.
• If incontinence fails to respond to either estrogen or PPA alone, it is recommended that both therapies be used simultaneously, since they often work better together.
• Medication works for most dogs with spay incontinence, but when it fails or a dog experiences adverse side effects from the medications, there are other procedures that can be considered. These include collagen or bulking injections around the urethral sphincter, surgical implantation of a urethral occluder and certain bladder and urethral tacking surgeries.
• While some of these therapies have proven successful, these techniques will not necessarily provide lifelong continence, and a combination of surgical and medical options are often used jointly for the best outcome.

Hoping this answered your question.
Hopeful Henry

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