Senior Dog Health: How Do I Care for an Older Dog With Fecal or Urinary Incontinence?
Aging can be as problematic for dogs as it is for their pet parents. In addition to developing lots of graying hair as well as decreasing vision and hearing, many pets also lose their ability to control their bowel moments. In clinical terminology, they develop fecal and/or urinary incontinence.
Senior dogs with bowel incontinence problems are a common part of Dr. Cathy Alinovi's clientele, and she shares her expertise on how to diagnose, treat and care for the two types of incontinence: fecal and urinary.
Question 1: In general, what causes either type of incontinence in dogs?
Dr. Cathy: In general, it is an inability to feel when the feces or the urine are ready to come out. Not being able to feel often relates to arthritis as the stiff joints and little information going through the nerves from the back end means the waste product just comes out.
Q3: What is the prognosis for dogs with incontinence issues?
Dr. Cathy: Once the issues start, they are harder to reverse than to prevent. Some pet owners don’t mind using diapers, or confine their dog to smaller spaces so there is less mess to clean up.
Q2: What roles do diet and exercise play in treating incontinence?
Dr. Cathy: Arthritis is inflammation. Great food (real food) is anti-inflammatory. Exercise and movement blocks pain directly at the spinal cord, before the information gets to the brain. So together, diet and exercise are extremely important in addressing inflammation and the pain of arthritis.
If dogs eat great food and have reasonable exercise their whole lives, they will be less likely to have incontinence issues. Also, talking your dog for a walk stimulates elimination behavior naturally; so, a good long walk before bed should get the poop and the pee out for a cleaner night.
Q4: How can pet parents know if behavior problems or medical problems are causing the incontinence?
Dr. Cathy: It is incredibly common for older dogs to have bladder infections and no one to know – their immune system is weaker and doesn’t feel the infection/irritation. So, first thing is to bring a urine sample to the vet; second thing is to take x-rays of the back end.
Q5. Let's get specific: what is fecal incontinence?
Dr. Cathy: Fecal incontinence is the Inability to hold feces inside the rectum. A strong, healthy anal region has strong muscles to hold feces in place and will only evacuate the bowels when the dog says the time is right.
Q6: What symptoms would alert the owners?
Dr. Cathy: Typically, they would observe the presence of feces in the bed or “walking poops", where the fecal matter just plunks out while your dog is walking.
Q7: How would you diagnose fecal incontinence?
Dr. Cathy: Mostly by observation: does the dog hunch to poop?
Also, a finger probe in the rectal region should lead to increased anal tone (butt pucker,) so no pucker means your dog can’t feel well. A limp tail that just hangs down also suggests fecal incontinence.
Q8: What are the Western medical treatment options?
Dr. Cathy: The usual treatment is laxatives so the feces do not build up and become constipation.
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Q9: What types of alternative medical treatments are there?
Dr. Cathy: Because fecal incontinence is often related to weak peri-rectal (around the rectum) muscles – specifically the levator (lifter) ani (anus) muscle, therapy to strengthen these muscles can help.
Acupuncture in the tail region directly stimulates muscles and nerves, to help with sensation in the back end. Chiropractic, which is veterinary spinal manipulation therapy (VSMT), restores motion and blood flow so the brain has a better idea there is a back end, and can really help with overall arthritis, as well as the sensation to lift the tail, hunch, and poop.
Q10: What tips do you have for caring for dogs with fecal incontinence?
Dr. Cathy: Homework type options include tickling your dog’s rear end, even pinching it – whatever creates a pucker helps the reflex to keep the poop in until the time is right for it to come out. Additionally, I recommend exercise because that movement helps waste products to move, outside, where they belong.
Your veterinary chiropractor can also show you how to do safe, gentle tail pulls/traction, to help stimulate the back end. If the feces are well formed, and you don’t step in it in the middle of the night, it really is a minor inconvenience to clean up.
Q11. Next, what is urinary incontinence?
Dr. Cathy: This is the inability to feel urine when it needs to come out. These dogs seem just like puppies/babies – when the bladder is full, it will empty by reflex, just as babies of many species do.
Q12: What signs would alert pet parents of this problem?
Dr. Cathy: In the morning, there will be a puddle on your dog’s bed, or in the afternoon, or any time your dog is relaxed and half-asleep. It can also happen when the dog is walking and the urine comes out involuntarily.
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Q13: How do vets diagnose urinary incontinence?
Dr. Cathy: A few things have to be figured out, as there are other conditions that seem like incontinence but are other health problems.
Diseases such as anal gland disease, gastrointestinal dysfunction, Cushings disease, or injuries can also cause bowel incontinence, so if an elderly dog that is otherwise well house-broken starts having unexplained accidents, it's time to get him to the vet for a check-up.
Q14: What are the common treatments for it?
Dr. Cathy: A hormone meant to help with sphincter control (the valve that is supposed to keep the urine in). The drug most commonly used is called Proin; it’s made with phenylpropanolamine.
Q15: Are there nontraditional or alternative treatments for urinary incontinence?
Dr. Cathy: Very similar to fecal incontinence, acupuncture and VSMT can help with urinary incontinence. Because the muscles are a bit different for urination than defecation, the exact things treated will be a bit different, but the principles are the same: stimulate the muscles and nerves to have better feeling for the back end.
Q16: What are the best coping techniques for owners with incontinent dogs?
Dr. Cathy: Use diapers or potty pads on the dog’s bed at night.
You do have to watch for diaper rash if you leave diapers on a dog all the time because they get wet, which breeds yeast and bacteria, and your dog may develop a rash.
© 2014 Donna Cosmato
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