How back injuries can lead to accidents in the night
If you have a dog with urinary incontinence (a leaky bladder), you most likely know how frustrating this problem is.
This problem is not fun for your dog either. Dogs are quite fastidious and get very embarrassed when they have an accident.
Neither is it fun to clean carpets and floors and who wants their house smelling like pee?
The main cause of urinary incontinence in dogs is commonly understood to be low estrogen levels in spayed females. It is true that some female dogs with urinary incontinece respond to estrogen hormones however, this theory falls short because male dogs suffer from this problem too.
Story of Caz
It was the year 2002 when I met Caz, a lovely Rhodesian Ridgeback female who lived with my friend Pat. Her previous owner gave her up after she accidentally fell off the back of a truck. She was dragged behind the truck but, fortunately, recovered from this horrible accident.
Pat loved Caz. She brought her to me for treatment of urinary bladder incontinence that had not responded to traditional treatment. For several months we tried non-traditional approaches and saw no change. It was a frustrating situation and we were all at our wits end.
However, I was stubbornly determined to solve the mystery and after a brief conversation, Pat allowed me to take Caz home for a few days of observation.
To our surprise, Caz showed no signs of incontinence for three days! I started to think that her incontinence was somehow connected to the walks and exercise she did with Pat. I decided to join them on their walk to see if I could get any clues.
As soon as we started walking, Caz was completely obsessed with chasing her ball. Pat, being the “good dog mom” threw Caz’s ball over and over because she wanted to make her happy. Thirty minutes later, her tongue was hanging out like a big pink yo-yo and she finally looked like she had enough.
When we got back to the car and Caz hopped in and - bingo - a big puddle of urine appeared on the blanket almost immediately.
Now we knew Caz’s incontinence was related to her exercise, muscle strain and back injury. After a few weeks of gentler walks, no ball chasing, a specific homeopathic treatment and a few physiotherapy sessions, the problem was solved for good. The good news was that we didn’t use any carcinogenic estrogen hormones.
To date, I have treated many dogs for incontinence and only two needed estrogen. Now I understand this condition can be reliably treated with gentler and safer methods and without a drug prescription.
Why excessive stretching on the surgery table can cause urinary bladder incontinence
If the connection between lumbar spine injuries, over-exercise and urinary incontinence was a complete surprise to you, you are not alone. Most people, including many veterinarians, are not aware of this relationship. It is as if the most simple connections, the easiest treatments are the hardest to see in medicine.
How are back injuries and exercise related to incontinence?
Physiologically, urine leaking is caused by weakness of the urinary bladder sphincter. This sphincter receives its nerve supply from the caudal lumbar area of the spine.
It appears that when the lumbar muscles get injured or overexerted, they get tight and the bladder sphincter nerves get impinged. This leads to the sphincter “numbing out” and involuntary urine leakage.
Most people do not believe this until they see the practical results of treatment for the lumbar spine and muscles in the area. Failures are very rare unless there is a bladder polyp, tumor, infection or another underlying cause. Another issue could be the client is not following the treatment instructions.
Why do female dogs become incontinent after spaying?This the next logical question. It is natural to ask why estrogen treatment is effective if lumbar injuries are the most frequent cause.
It is true that the drop in estrogen levels is one of the factors in urinary incontinence. However, there is another cause that often plays a role when female dogs are spayed.
Many dogs going through the spay procedure are excessively stretched on the surgical table with their legs being pulled back by ties. The table is often insufficiently padded and this can generate excessive stress on the lumbar sacral spine and cause urinary incontinence.
My intention is not to discourage you from spaying or neutering your dog. In fact, I believe that it is an important part of addressing dog homelessness and unnecessary suffering.
All you need to do is to discuss this issue with your veterinarian prior to the surgery. Just be ready, because practitioners may not be aware of the connections described above. I encourage you to politely ask that your dog is not stretched excessively on the surgical table and that the table is well padded.
So far you have learned:
- a large number of incontinent dogs leak urine because of injuries to the lumbar sacral area and the resulting reduced nerve supply to the bladder sphincter.
- it is important not to stretch dogs on the surgical table when they get spayed or neutered because it can lead to lumbar-sacral subluxations (injuries) and incontinence.
First, you need to rule out the following problems that can lead to urine leaking:
Urinary tract infection by running a urine sample test and possibly a culture.
- Polyp or growth that can impede the function of the bladder sphincter.
- Ectopic ureter that attaches to the bladder in an anatomically incorrect location.
- Urinary bladder stones, which can cause inflammation, irritation and incontinence.
- Excitement or submissive urination. This is a behavioural issue and has to do nothing with true urinary incontinence.
- Sometimes hyperactive adrenal glands or the administration of corticosteroids can also cause incontinence.
Every incontinent dog should go through the following:
- Physical examination
- Blood test – chemistry, complete blood count and thyroid test
- Urinalysis to evaluate kidney function
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If you dog doesn’t respond, ask your veterinarian to perform further examinations, such as a bladder ultrasound to rule out other possible problems.
If all tests come back normal and you have treated your dog for three to nine months without any change, it is possible that your dog will need estrogen medication such as Stilbestrol or Proin. I personally prefer Stilbestrol.
© Dr. Peter Dobias, DVM