Hello and thanks for researching this important question!
Recovering from cystotomy (incising the bladder to remove stones) can take quite a bit of time...the muscles and nerves in the bladder and abdominal wall must heal in order for complete urinary control to resume. Loss of control during sleep can occur during this process. Complications from scar tissue can occur when multiple surgeries have been performed on the bladder, although this is a pretty "forgiving" muscle.
***Using the steroid treatment will increase her kidney output, thus filling her bladder more quickly...this can certainly contribute to the control problem that she is experiencing post-op. Please let your vet know that you are using this medication--steroids can interfere with healing of surgical incisions.***
***However, it is not uncommon for a female dog to have bladder sphincter control problems when her estrogen source (her ovaries) are surgically removed (humans also experience this!). This is also more often reported as a dog ages. Urinary accidents do occur in the sleep of pets affected in this way...if your dog has been spayed (has had her ovaries and uterus removed), this is something to consider discussing with your veterinarian.***
A medication called phenylpropanolamine (say it "fen-ill-pro-pan-ole-ameen") is often prescribed for simple urinary incontinence. Sometimes a dog will not be completely helped by the phenylpropanolamine (often abrev. PPA for short!), and a compounding pharmacy is contacted to make a dose of estrogen replacement therapy!! Just as in people, this is not always safe and should be considered by you and your vet with her size and health history in mind. What is commonly used is called "Diethylstilbesterol", or DES (say it: die-eth-ill-still-best-er-ol).
***Please contact your vet's office to report this slow recovery. A veterinary surgeon would certainly want to be made aware of any problems a patient is having after surgery.***
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