Ask a Dog Vet and Get Answers to Your Dog Veterinary Questions
I am sorry to hear about your dog's incontinence. I understand how frustrating this can be. Have you ever had a urinalysis performed to rule out a low grade infection? Has she had any imaging done to look for bladder stones or other causes of bladder irritation that can cause urinary incontinence? Have you considered seeing an internal medicine specialist for this issue?
Feel free to answer these while I gather some information for you on alternative treatments.
In looking at the options for refractory urinary incontinence the best recommendation I could make at this time would be to seek the counsel of a board certified veterinary internal medicine specialist. The reason is that about 90% of dogs with incontinence respond to the medications your dog has already been on. This makes me concerned that there may be something else underlying her incontinence besides just having been spayed. In some cases, combination therapy works best and in other cases, novel drugs need to be tried. In the case of trying novel drugs, careful monitoring should be performed and this is where the help of a specialist comes into play because they spend their time managing cases like this. Another reason to involve a specialist is because some of the causes of urinary incontinence require a specific physical exam or diagnostics to discover.
In some cases, the answer is medication and hitting on the right combination and in others surgery may be the answer.
Anatomic issues may lead to urine pooling in the vulva and this can leak out while the dog is laying down or when she moves so vulvaplasty and/or a procedure to lift and support the urethra and bladder similar to a procedure performed in women with this issue may also benefit a dog with refractory urinary incontinence. Other procedures can be performed to bulk up the urethral sphincter with collagen injections or placement of an external inflation device.
Some of the drugs out there that are being used are called imipramine, oxybutynin or deslorelin.
If your vet has reached the end of his ability to treat her, perhaps he would be willing to refer you to an internist in your area.
Does this help with your concern today?