5 Dog Incontinence Medications That Could Help

Have you ever noticed drops of dog urine in your home or on your dog’s bedding? It could be due to incontinence. Urinary incontinence in dogs is a medical condition that causes a dog to leak urine. It can happen to dogs of all ages, but is more common in senior dogs. This common issue is estimated to affect 5–20 percent of spayed dogs [1] and around 1 percent of male dogs [2], but dog incontinence medications are limited. 

However, if your dog is diagnosed with urinary incontinence, there are some available drugs and supplements that may help. Here are some options to discuss with your veterinarian.   

Why Your Dog Might Need a Dog Incontinence Medication

Your veterinarian will prescribe incontinence medication both for your pet’s benefit and your benefit. Keep in mind that we are specifically talking about dogs who leak urine with no knowledge or control, not dogs who excessively urinate due to a condition like diabetes or who feel the urge to urinate repeatedly due to something like a urinary tract infection (UTI).

Your female dog leaking urine is more likely to get urine scalding around her vulva or to excessively lick at her vulva, which might result in a UTI. If you put a diaper on an incontinent dog (male or female), they’re more likely to get urine scalding, skin infections, and UTIs. Urinary incontinence medications for dogs can help prevent these health issues.

As much as we love our pets, we also don’t want small puddles of urine on the carpets and furniture. Controlling urinary incontinence will help keep your home cleaner (and smelling better, hopefully).

Types of Incontinence Medications for Dogs

Medications for urinary incontinence can help with incontinence that’s due to sphincter incompetence. However, canine incontinence medications are unlikely to help pets with urinary incontinence due to neurologic diseases (spinal injury or congenital malformations like ectopic ureters).

In some cases, your veterinarian may recommend more than one medication to maximize control of urinary incontinence. 

Hormonal Medications

Most cases of urinary incontinence in dogs occur in spayed females. There is a sphincter around the urethra (tube from bladder that takes urine out of the body) which keeps urine from leaking. In spayed dogs, this sphincter may become incompetent, meaning it doesn’t keep all the urine in.

For these dogs, hormonal therapies are recommended. These medications replace the action of estradiol, a natural estrogen that decreases in concentration after spaying.

In male dogs, testosterone injections may treat urinary incontinence. This is less effective than hormone therapy for female dogs, and it may result in undesirable behaviors (marking and humping). This is not routinely recommended by veterinarians.

Non-Hormonal Medications

The main class of non-hormonal medications for urinary incontinence is alpha-adrenergic agonists. These medications act on the receptors of the urethral sphincter in dogs to increase urethral tone. The tightening of the sphincter improves the ability of the bladder to hold urine.

The antidepressant medication imipramine may also help with urethral tone while potentially relaxing the bladder.

In some cases, anti-anxiety medications and muscle relaxants may be prescribed to help with bladder relaxation, especially in male dogs who are unresponsive to the usual therapies.

Supplements

Supplements are not routinely prescribed for urinary incontinence, but there are a couple options which may promote urinary tract health when used in conjunction with other medical therapies.

5 Dog Incontinence Medications and Supplements 

Incurin (Estriol)

Incurin is the brand name for the active ingredient estriol. Estriol is an estrogen that can treat estrogen-responsive urethral sphincter mechanism incompetence (USMI) in spayed females, the most common form of urinary incontinence seen in dogs. The FDA-approved medication enhances urethral sphincter tone.

An important note is that Incurin is not dosed by weight. All dogs will originally receive 2 mg by mouth once per day. If effective, the dose is systematically tapered to the lowest effective dose. You must follow your veterinarian’s instructions precisely to ensure you are tapering this medication correctly.

Incurin and its active ingredient estriol is only a treatment option in spayed female dogs who are over a year old. The most common side effects include gastrointestinal issues like vomiting or estrogen-related changes like a swollen vulva. Estrogens carry the risk of bone marrow toxicity, but this is uncommon when following your veterinarian’s dosing recommendations. Caution is recommended in dogs with liver disease or who are on steroids like prednisone.

Proin (Phenylpropanolamine HCl)

Proin is a dog incontinence medication made from the active ingredient phenylpropanolamine HCL. Phenylpropanolamine is an alpha-adrenergic agonist used to treat dogs with urinary incontinence due to decreased muscle tone in the urethral sphincter. By stimulating alpha-adrenergic receptors in the urethral sphincter, the medication increases urethral sphincter tone, preventing leakage from the bladder.

There are multiple formulations available, so some dogs will receive phenylpropanolamine by mouth once daily and others will receive the medication twice daily. Some cases may require administration every 8 hours.

Phenylpropanolamine is an option both for female and male dogs. Caution is recommended in pets with heart disease, glaucoma, enlarged prostate, hyperthyroidism, diabetes, Cushing’s disease, liver disease, kidney disease, and high blood pressure.

Negative side effects could include increased blood pressure, heart rhythm abnormalities, vomiting and loss of appetite, anxiety and irritability, diarrhea, and increased thirst. These are more likely at high doses or with overdose.

Proin is classified as a controlled substance in some states due to potential abuse as a precursor to methamphetamine. Extra verification of the prescription with your veterinarian may be required. If you live in a state where Proin is controlled, there may be special instructions for destruction of unused medication. Please check with your veterinarian.

Imipramine Hydrochloride

Imipramine is a tricyclic antidepressant that indirectly stimulates alpha-adrenergic receptors, increasing tone in the urethral sphincter. The medication may also help with bladder relaxation. In humans, this medication is commonly used to reduce bed-wetting in children.

Imipramine is given by mouth twice daily. Controlled studies regarding efficacy of imipramine for urinary incontinence in dogs are currently lacking.

This medication is an option for both male and female dogs. The medication should not be used in dogs who are on another form of antidepressant called a monoamine oxidase inhibitor (MAOI), such as selegiline. Caution is also recommended in dogs with seizure disorders, heart disease, thyroid disease, kidney disease, liver disease, and glaucoma.

Negative side effects include constipation, hyperexcitability, tremors, seizures, vomiting, diarrhea, and sedation.

VetriScience Bladder Strength Supplement

VetriScience Bladder Strength Supplement aims to improve bladder control, strengthen bladder muscles, improve bladder emptying, and prevent urinary tract infections. Active ingredients include pumpkin seed powder, Rehmannia glutinosa root powder, wild yam extract, soy protein extract, corn silk powder, saw palmetto extract, olive leaf extract, and vitamin B6.

The supplement is given by mouth either once or twice daily.

The supplement is mostly aimed towards spayed female dogs and senior dogs but is an option for both male and female pets. With any medication or supplement given by mouth, stomach upset that could result in vomiting, diarrhea, and loss of appetite is possible.

In the United States, supplements are regulated by the Food and Drug Administration (FDA) as food, not as drugs. This means there is no regulatory guarantee regarding the quality or efficacy of ingredients. VetriScience products do have the quality seal of the National Animal Supplement Council (NASC) which identifies products from companies committed to creating quality supplement products.

PRN Pharmacal CranMate Chew Tabs

CranMate is a supplement for supporting a healthy urinary tract. This supplement isn’t necessarily going to improve urinary incontinence but may support the urinary tract of dogs who are on long-term medications for incontinence, including those who are prone to urinary tract infections. CranMate is made with American Cranberry purified fruit extract. Other active ingredients include sorbitol, dicalcium phosphate, microcrystalline cellulose, whey powder, liver powder, soy protein concentrate, iron oxide, silicon dioxide, and magnesium stearate.

The supplement is given by mouth once daily but may be given twice daily during UTI occurrence. 

The supplement is an option for both male and female dogs. With any medication or supplement given by mouth, stomach upset that could result in vomiting, diarrhea, and loss of appetite is possible.

As previously mentioned with other dog urinary supplements, there is no regulatory guarantee regarding the quality or efficacy of ingredients. However, PRN Pharmacal follows Current Good Manufacturing Practices (CGMP) and standards. 

Other Medication Options for Urinary Leaking in Dogs

In some cases, especially for male dogs who aren’t responding to the usual medication treatments for urinary incontinence, your veterinarian may recommend medications geared towards incomplete bladder emptying. These dogs may actually have overflow incontinence rather than issues with their urethral sphincter. 

Medications that help with muscle relaxation – such as prazosin or methocarbamol – may be recommended in these cases. Anti-anxiety medications like diazepam may also be prescribed. 

If your pet is not responding to the usual medications, make sure to speak with your veterinarian about bladder-emptying disorders.

Dog Incontinence Medications: Tips and Safety

Make sure to discuss any pre-existing conditions with your veterinarian before starting a prescription incontinence medication, especially if your pet has heart, kidney, liver, thyroid, or eye issues.

If your dog experiences significant side effects, contact your veterinarian before continuing the medication.

Some of these medications, such as Proin, are designed to taste good to your pet. This means there is a risk that your dog might decide the medication is a nice treat and accidentally overdose if they get access to the bottle. Keep these medications out of reach of children and pets.

If your dog’s incontinence does not improve despite medications, it’s possible that they have another less common cause of urinary incontinence, so follow up with your veterinarian for additional diagnostics. Dogs under one year old with incontinence should have congenital defects of the urinary tract ruled out before starting medications.

References:

1. Forsee, Kara M., Garrett J. Davis, Emily E. Mouat, Katharine R. Salmeri, and Richard P. Bastian. “Evaluation of the prevalence of urinary incontinence in spayed female dogs: 566 cases (2003–2008)”. Journal of the American Veterinary Medical Association 242.7 (2013): 959-962. doi.org/10.2460/javma.242.7.959. Web. 12 Feb. 2024.
2. Pegram, C et al. “Associations between neutering and early-onset urinary incontinence in UK bitches under primary veterinary care.” The Journal of small animal practice vol. 60,12 (2019): 723-733. doi:10.1111/jsap.13072