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Urinary Incontinence

By: Dr. Debra Primovic

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Urinary incontinence is the loss of voluntary control of urination. Normal urination requires that the nerves and muscles of the bladder are working properly. Urinary incontinence sometimes may be confused with inappropriate urination. Inappropriate urination often is a behavioral problem. Diagnostic tests may be needed to distinguish between urinary incontinence and inappropriate urinations.

Probably the most common form of incontinence in cats is called "primary sphincter mechanism" incontinence and is thought to be caused by weakness of the urethral muscle. It is most common in middle-aged medium- to large-size spayed female cats.

Urinary incontinence can have neurogenic and non-neurogenic causes.

  • Neurogenic causes of incontinence include those that are caused by abnormalities of parts of the nervous system involved in regulation of urination.

  • Non-neurogenic causes of incontinence include congenital problems (abnormalities present at birth) such as a misplaced ureteral opening (ectopic ureter), over-distension of the bladder due to partial obstruction, hormone-responsive incontinence, and incontinence associated with urinary tract infection.

    What To Watch For

  • Dribbling of urine
  • Finding of wet spots where the pet was sleeping
  • Irritated skin from contact with urine

    Finding wet spots in the house does not necessarily imply that the pet is incontinent. Pets with increased thirst and increased urination may urinate in the house due to increased urine volume and not being able to get to the litter box in time.

    Straining while urinating and blood in the urine suggest other disorders such as bacterial cystitis or bladder stones.

    Diagnosis

    Diagnostic tests must be performed to confirm the diagnosis of urinary incontinence and exclude other diseases that may cause similar symptoms such as urinary tract infection or urolithiasis (stones or calculi). Tests may include:

  • Complete medical history and physical examination, including palpation of the abdomen

  • Urinalysis to evaluate for presence of white cells, red cells, and bacteria

  • Urine culture and sensitivity to evaluate for presence of bacterial urinary tract infection

  • A complete blood count and serum biochemistry tests to evaluate the pet's general health and function of other body systems

  • Plain abdominal X-rays to evaluate for stones

  • Contrast dye studies to evaluate for congenital abnormalities and bladder position

  • In difficult cases, special physiologic studies of urination (urethral pressure profile, cystometrogram) may be recommended. These tests will require referral to a specialist.

    Treatment

    Whenever possible treatment for urinary incontinence will be determined by the underlying cause. Definitive treatment involves elimination of the underlying cause of the urinary incontinence. Examples include correction of an anatomic defect, removal of a neurologic lesion, relief of partial obstruction, effective treatment of a urinary tract infection.

    In many cases, the cause of incontinence remains unknown after all diagnostic tests have been performed. In this instance, urinary incontinence must be treated symptomatically. The drug phenylpropanolamine is commonly used to treat urinary incontinence thought to be caused by weakness of urethral muscle ("sphincter mechanism incompetence").

    Home Care and Prevention

    Administer medications prescribed by your veterinarian to your pet as directed. Allow your pet free access to fresh clean water and frequent opportunities to urinate. Make sure the bedding is clean and dry.

    Follow-up with your veterinarian for examinations and urinalysis. If your pet has an inadequate response to treatment, additional tests may be necessary to identify the cause of the incontinence.

    Contact your veterinarian if you notice any signs of urinary tract infection (e.g. straining, blood in the urine) or urinary obstruction (e.g. painful urinations, frequent unsuccessful attempts to urinate).

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