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Dr. Ellie
Dr. Ellie, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 304
Experience:  emergency and critical care resident
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My dog is a female yorkie mix that was rescued from a puppy

Customer Question

My dog is a female yorkie mix that was rescued from a puppy mill. She is about 4 years old and weighs 9lbs. She began to have urinary incontinence--she did not do this when I got her in May but started in June. I know that she was spade in February right after they rescued her. WE tried DES ( 5 days then once per week) It became less during the five days (on day 3-5) but when I stopped it for seven days, on the second day without it she began to leak again. We added in Proin (4 weeks ago)(14/tab B id) but there was no change. We moved to DES every other day plus the Proin- all this did was make her seem like she was in heat and if anything increased the leakage. My male dogs were trying to mount her and she was just miserable. My vet basically said he didn't know what to do next. I'm not giving up on this little lady but not sure what other options are out there.
Submitted: 2 months ago.
Category: Dog Veterinary
Expert:  Dr. Ellie replied 2 months ago.

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.

Expert:  Dr. Ellie replied 2 months ago.

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?

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