Question: Our nine-year-old neutered Border Collie, Poppy, has been leaking urine, and we find that her bed is wet quite often. She does still ask to be let out to urinate. Our vet has suggested some hormonal therapy. Is this going to be a permanent issue? Do you have any holistic alternatives to this?
K.L., via email
Answer: Urinary incontinence is a common problem in middle-aged to elderly pets, and especially neutered female dogs like Poppy. Defined as the involuntary or unintentional leakage or passage of urine, urinary incontinence indicates the loss of voluntary control over the bladder.
In humans, incontinence has a variety of causes, and this is very likely the case for dogs and cats, too. In many cases, it may not be possible to determine all the factors leading up to the condition. It seems to affect medium to larger dogs more than toy or small breeds, and obesity can also be a factor.
A common form of incontinence in neutered female dogs like Poppy is acquired urethral incompetence. This condition is caused by low estrogen levels and is an example of hormone-responsive urinary incontinence.
Developmental disorders of the urinary tract, lesions in the brain or spinal cord, lumbosacral disc disease, urinary tract infections (UTIs) and bladder cancer are other possible causes. Overflow incontinence due to an over-distended bladder is seen in traumatic fractures of the spine or pelvis.
Symptoms and diagnosis
Young dogs may urinate in excitement inside the house, especially when they are still training. A neutered female dog may have little accidents around the house, or owners may find their dog's bedding and legs damp and smelly from urine leakage, often overnight. Elderly dogs or those with spinal injuries will dribble or leak while just standing.
With a thorough exam and full history, a vet can determine whether a pet is exhibiting voluntary but inappropriate urination, such as spraying in cats; temporary incontinence, such as may be caused by infection or a female being in heat; or has longer-term involuntary urination.
The vet will check the animal's urinary bladder for its size and ability to express urine, as well as the genitals and, in the case of male dogs, the prostate.
Testing a pet's urine will provide clues to infections, stones, cancer, diabetes and kidney disease, so it is a good idea to get a urine sample before your pet's visit.
Blood tests may be needed if the pet is urinating a lot and drinking too much (polyuria and polydipsia), in order to check for any underlying diabetes, kidney or liver disease. Radiographs or ultrasound scans may also be necessary to rule out stones, congenital problems, cancer and kidney problems.
It is not easy to treat incontinence. There is quite a bit of variation in the response of each animal to the same treatment. What's more, in many cases, there are multiple causes, so it may not be possible to completely stop Poppy's incontinence even if it can be reduced.
Incontinence in neutered female dogs is often responsive to estrogen therapy. I've had good success with estriol, which is a synthetic, short-acting estrogen, as it increases the muscle tone in the lower urogenital tract and improves the function of the bladder and urethra.
The drug phenylpropanolamine can also be successful if the incontinence is caused by the bladder sphincter muscle.
If anatomical disorders are diagnosed, surgery may be required, and your vet will then refer your pet to a specialist. Prosthetic sphincter implantation is now possible.
However, these treatments can come with side-effects and risks. Phenylpropanolamine, for example, can cause restlessness, irritability, increased heart rate and high blood pressure.
Here's a variety of natural, holistic methods that can help to support Poppy's recovery from incontinence.
Homeopathy. A remedy called Leaks No More from HomeoPet (www.homeopet.com), containing Plantago, Gelsemium, Cantharis, Causticum, and Alumina 6c and 30c, is available for dogs with urinary incontinence. It can be dosed directly into the mouth or added to water. Another product that may be useful is Prana Pets UTI Support for dogs and cats (available at www.pranapets.com). Follow the label instructions for the correct dosage.
Traditional Chinese medicine. In traditional Chinese medicine, incontinence is thought to stem from weakness in the kidney yang and qi. The treatment involves increasing heat in the animal's body by using warming foods, herbs and acupressure. It's important to have your dog checked by a holistic vet trained in traditional Chinese veterinary medicine (TCVM) before embarking on this type of treatment, but a typical diet to warm or balance kidney yang would include the following:
• Oats, rice, barley
• Vegetables, especially carrots, kale and beans
• Chicken, salmon, lamb and rabbit.
A TCVM practitioner may also prescribe Chinese herbal formulas, which can be very effective for incontinence in dogs.
Herbs. Astringent herbs such as lotus seed and Schisandra can help. Nettle can also be beneficial. As well as having astringent properties, it's a rich source of vitamins A and C, iron, sodium, chlorophyll, zinc, silica, protein and dietary fiber (the high vitamin C content enables the iron to be absorbed more efficiently by the body).
Nettle is also an excellent balancing tonic, general blood cleanser, and whole-body conditioner and booster. Giving Poppy nettle biscuits (see recipe, above) is a great way to get her to consume the herb.
Herbs that are natural sources of estrogen are also worth a try and may help Poppy stay off the synthetic form. Wild yam root, dong quai and wild oats contain plant steroids that are precursors in the synthesis of estrogen.
Suggested dosage: lotus seed and Schisandra: small dogs: ¼ tsp daily; medium dogs: ¼ to ½ tsp daily; large dogs: ½ tsp daily; other herbs: follow the product label instructions
Acupressure. Acupressure can help dogs to regain bladder control, and it's something you can do yourself. Apply gentle pressure on the following points 2-3 times daily for 1 minute.
• BL 67 (Bladder 67): Located on each hind leg on the outer aspect of the outer toe
• BL1: Located in the little dip on the inside or corner of each eye (medial canthus)
• SP 6: Located on the inner (medial) side of the back leg just above the hock joint or ankle
• SP10: Located on the knee of the hind leg at the bend or crook on the inner side
For detailed instructions on how to give acupressure to your pet, see my book, You Can Heal Your Pet.
Glandular supplements. These are extracts from ovaries that help stimulate natural estrogen production. There are special formulations made for animals that can only be obtained from a holistic vet. A human version called Solaray is a useful alternative.
Suggested dosage: small dogs (5-15 lbs or 2-7 kg): ¼ of the human dose; medium dogs (16-55 lbs, 8-25 kg): 1⁄3 of the human dose; larger dogs: ½ the human dose
Animal healing. Try regular pet reiki sessions with a focus on the sacral chakra, which controls the bladder and emotions associated with it. See You Can Heal Your Pet for guidelines.
Nettle K9 biscuits
1½ cups (175 g) self-rising flour
1 free-range egg
2 Tbsp nettle-infused sunflower oil (you can make your own by combining 1¾ oz (50 g) dried nettle with 18 fl oz (500 mL) sunflower oil and leaving in a sealed jar for four to six weeks)
1 tsp unset (runny) honey
1 handful finely chopped nettles
1) Preheat oven to 375°F/190°C. Grease an 8 × 11-inch (20 × 29-cm) baking sheet.
2) Combine all ingredients in a large bowl to form a soft dough. Spread mixture ½-inch (1 cm) deep on the baking tray. Bake 25-30 minutes until just firm.
3) Remove from the oven and let cool. Cut into bite-sized squares.
4) Keep in an airtight, labeled container in the fridge for up to five days, or freeze for up to one month.
Rohini Sathish, DVM, MSC, MRCVS, MHAO, MCIVT
Dr Sathish is an award-winning holistic vet with 22 years of experience. After training in acupuncture, acupressure, energy healing, Emotional Freedom Technique (EFT), animal communication and herbal medicine, she now actively integrates conventional veterinary treatments with complementary therapies and is co-author of You Can Heal Your Pet (Hay House UK, 2015). You can contact Dr Sathish at her website: www.rohinisholisticvetcare.com