[Nellizmom]

Looking for ideas on this subject but feel the need to tell the story, so bear with me: My 2 y/o (bday today) chocolate lab has had intermittent incontinence since she was 6 or 7 months old and BEFORE she was spayed at 12 months. It started out every once in a while and not given a whole lot of thought from her vet (great docs) as she was so young and it wasn't that often. About 6 months ago it started happening once a week, so we have been investingating and keeping tract of info since. These are the weird facts:
-only happens when she is at our house. Never at Grandma's and never when the sitters are watching her (at our house). Just recently she leaked a little in my car on the front seat, but otherwise only in the house.
-NEVER happens at night when she is sleeping in her bed or on the floor.
-Always happens when she is recumbant.
-It can happen 5X in one day and then nothing for a week. Usually once a week.
-It's not a UTI...has been checked multiple times.
-Never any blood in the urine
-Was born with a recessed vulva (don't know if this is relational or not, just thought I'd throw it out there) We waited to have her spayed until first heat hoping the vulva would drop...and for the most part it did...but?
-Has been on DES for the past 2 months (originally 0.5mg twice a week and for the past 2 weeks 1mg every other day) during which time she has had 2 more episodes.
-Don't want to start on Proin if we don't have to...sounds pretty dangerous.
-Has tons of energgy, is a beautiful little girl (55 lbs) who loves her mom and dad, and would retrieve all day long if you let her.
**and that's the wierdest part...through documentation, we realized it happens most often on a day when she has pushed herself VERY hard (playing frisbee too long, swimming for retrieves for a hour straight...all things she is completely obsessed with and will go gangbusters until we stop her.
-We will do anything to help her...and if it means cleaning up after her once a week for the next 15 years, so be it. But this isn't right and I and struggling to find an answer for her sake.
-Vet is stumped. Weird symptoms...never at night, days running hard, only at home, ect.
-Have not had her tested for structural issues...seems very invasive.

SO...
-how long do I continue DES at this dosage before declaring it didn't work?
-Can natural remedies help if not hormone related? Leaks No More has been ordered, but not sure if that is safe.
-Can accupuncure or chiropractor help?
-does it even make sense this is hormone related if it started before she was spayed? Might just have been born with weak bladder sphincter?

WHAT TO DO?

[cherylmartin]

Nellizmom,

I am sorry you are having such problems with your baby. Please whatever you decide to do, do not give ProIn. It could kill her. Find a natural remedy that works. Diet information is also available.

At this fourm, under Search, type in incontinence. There are several posts, several threads covering this topic that should help you in your decisions.

Keep us posted as to how she is doing. All of us here care.

[CorkyMax]

For sure no expert here but I am wondering if this is even a physical problem! Sounds almost like she does it because she wants to! And definitely never go on 'killer Proin!!!'
Only at home (Can seem to have control when at someone else's place all day?!)
Not at home when somebody else there and not you! (Doesn't like it that you left her with sitter, etc)
After strenuous, tiring out exercise--(lazy, too tired to go potty outside!?)

How can she go so many days without a problem--Would think it would be happening all the time if a physical thing!

These are links you might want to check out:

1.-- Urinary Incontinence in Dogs
Please ignore all mentions of using phenylpropanolmine (Proin word) in any of these links!
UTI Symptoms in Female Dogs | DailyPuppy.com

Diagnosing and treating urinary incontinence | Dog Time - It's not just a consequence of age --Again please ignore what is being stated about Proin/phenylpropanolmine. The h*ll it isn't dangerous--a lot more than is being acknowledged. Just see the thread in this forum on it!!!

http://www.vshsd.com/For_Veterinaria...ce%20notes.pdf Be sure to see page 3-Detruser instabilities; URGE INCONTINENCE (This sounds like your dog doesn't it!?; ectopic ureter-also page 3. And note all the tables following on page 6,7 and 8.

http://www.entirelypets.com/urin.html

This info below is from this site: http://www.sinervia.com/library_file...00_INCURIN.pdf ---It is very long and I just copied what I thought was important but if you want to see the rest!--(This is 25 pages long)
Estriol
Estriol is the only safe estrogen to be administered long term in dogs. Fatal bone
marrow depression has been reported with all other estrogen preparations. Due to
the interaction of hormones and their receptors in target tissues, duration of treatment
before effect and individual dose requirements must be considered. It may
take weeks or months before a full effect is achieved, and the dose must be titrated
to the individual’s needs. If high doses (exceeding 2 mg/dog/day) are administered,
side effects in the genital system may be observed, as seen in intact female dogs in
heat. Estriol may be useful in dogs with side effects from application of sympathomimetics
and, interestingly, may improve the overall condition of female dogs with
behavior changes after neutering. Furthermore, estriol will improve the action of
sympathomimetics by sensitizing the adrenergic receptors in the urethral smooth
muscle, so it can be used in combination therapy. Many dogs that do not respond to
PPA or ephedrine alone are continent when estriol is given as an adjunct. Estriol also
has positive effects on bladder storage function and can be used if these problems
are detected or suspected.
Imipramine
Tricyclic antidepressant agents may be used in rare cases, when a dog is hyperactive
or nervous and will have problems with administration of sympathomimetics. Effects
on the urethra and bladder are comparable to that of sympathomimetics.
Gonadotropins
Recently, administration of gonadotropins, such as GnRH analogs, has been shown
to be effective in some female dogs with refractory urinary incontinence. Pending
further research, these drugs may be considered alternative treatment options for
selected patients.
Information about endoscopic treatments
When conservative treatments fail or side effects become unacceptable, endoscopy
and surgery become options. Endoscopic injections of collagen into urethral tissue
have been shown to be effective in approximately 60% of cases. The long-term effect
is less favorable than surgical treatments; however, a great advantage is minimal
invasiveness and low complication rate. For older female dogs, this is the author’s
treatment of choice. However, special equipment and expertise are required to perform
the procedure properly. The treatment can be repeated, takes no more than
22 • Urinary Incontinence
20 minutes, and the author has never observed relevant complications. Other
implants may reduce cost, but pose more problems during application.
Surgical treatments for urinary incontinence
Colposuspension
Colposuspension is probably the most common procedure in management of female
dogs with urinary incontinence. Colposuspension is easy to perform, and some
surgeons may do this as a laparoscopy-assisted procedure. The complication rate
is low—approximately 12% show signs of dysuria and even fewer have stranguria,
which responds to diazepam administration and catheterization is not necessary.
The long-term success rate is approximately 55% and even more dogs show some
improvement. The author considers this procedure first choice in young dogs with
USMI and pelvic bladders based on x-rays or ultrasonography.
Urethral sling procedure
For severe USMI, when all other treatments fail, a transpelvic urethral sling, which is
currently the most successful incontinence procedure in women, can be applied and
has a success rate similar to colposuspension. It also can be used as a combined
treatment. Response to drug treatment may be improved and allows control of incontinence
in about 75% of cases. However, more severe complications may occur,
requiring catherization in the first two days and in some dogs the sling has to be
removed.
Cystourethropexy
Some surgeons prefer suturing the uretha and bladder to the abdominal wall, which
is a simple procedure and has been used historically in humans. The success rate is
lower compared to the other treatments, but cystourethropexy may be an alternative
when other treatments fail.
Vasopexy
In male dogs, the overall response to drug treatment and surgery is much lower
than in female dogs. Vasopexy has been the most common surgical treatment with
a success rate of approximately 20–30%. It can be applied as a minimally invasive
procedure.
In conclusion, there are many options to treat urinary incontinence in female dogs
with USMI. Only a few dogs have no options to improve their condition. Artificial
sphincters, the last option in human incontinent patients, are not considered
applicable for dogs from an ethical point of view; however, for a motivated owner,
this may be a solution to discuss in the future.

[CorkyMax]

[B]The above info by: Intervet Symposium • 23
SCOTT A. BROWN, VMD, PhD, DACVIM
Dr. Brown received his veterinary degree from the University of Pennsylvania,
completed an internship and residency at the University of Georgia and is boardcertified
by ACVIM in internal medicine. He earned a PhD in renal pathophysiology
from the University of Georgia and completed a post-doctoral research fellowship
at the University of Alabama School of Medicine. Since 1989, Dr. Brown has been a
faculty member of the University of Georgia, where he is currently the Josiah Meigs
Distinguished Professor of Physiology and leads the Department of Small Animal
Medicine and Surgery. He has been recognized for teaching and research excellence,
having received the National Norden Distinguished Teaching Award and the AVMA
Research Excellence Award. His research interests are urinary tract diseases and
systemic hypertension.
RAfAEl NICKEl, DVM, Dr Med Vet, PhD, DECVS
Dr. Nickel graduated from Hannover Veterinary School in 1983 and completed his Dr
Med Vet degree in laser spectroscopy in 1986. He conducted an externship at Tufts
Veterinary School in 1987, then entered private small animal practice in Germany
in 1988. Dr. Nickel then joined the University of Utrecht, in 1989, where he was
an Assistant Professor and Lecturer in Small Animal Surgery and Urology. He
received a PhD from the University of Utrecht in 1998, writing his thesis on urinary incontinence.
He has served as president of the European Society of Veterinary
Nephrology and Urology and is a board member of ECVS. Dr. Nickel is a veterinary
and human health industry consultant and a frequent guest lecturer on urology topics.
Symposium

[CorkyMax]

See you have read my posts now. Lol, was still going to add more but haven't had time to look up more stuff. Was going to put these words in my browser: dogs/submissive incontinence;<-(good one to check I think)----dogs/overdistension of bladder;-----dogs/kidney failure;----dogs/postoperative pelvic adhesions <-(Esp. this one!); dogs/intermittent incontinence; Maybe you can try them yourself? So guess I am done looking. Hope you find the answer to the problem but again, I have to say Please stay away from the Proin. Better a peeing dog than a dead one!

[adoptpaws4love]

SOme dogs have been born with something not right in their backs, It causes incontinence under different situations. Forgive me if I missed that the dog was x-rayed and checked for that, the reason I know is my friends dog has the same issues once in ahwile she will wake up from sleeping a have a few drips, other times she will be playing and have the same results. After having her urine checked two times with no signs of UTI she was x-rayed and they found the problem. She is on meds , he gradually cut dosage to the least amount possible to stop the problem and she is fine. My understanding is it is heridatary. It is one of the many things dogs should be checked for before breeding them from what the vet has stated. The dog I speak of was a adopted mix breed. So try maybe to talk to the vet and ask if he is familiar wiht something like that or try another vet possibly who is knowledgable on that subject. I cannot remember what he called it, sorry.

[CorkyMax]

Animal Health Issues: Incontinence

[Nellizmom]

Thank you SO much for your replies. All have been helpful and make me feel a little bit better. So grateful for this community and everyone in it!

Jean and Nelli