labrador-retriever

Incontinence in Senior Labs: Urinary and Fecal Causes and What to Do

Leaking urine or stool in an older Lab is a medical problem, not a training one. What can cause it, how to manage accidents at home, and when to call the vet.

A senior Lab that leaks urine or stool has a medical problem to investigate, not a training problem. Urinary and fecal incontinence have different causes and treatments, but the first step is the same: a vet exam. This guide covers both.

I'm not a vet, so it leans on the Merck Veterinary Manual, VCA Animal Hospitals and the AKC. It gives no doses, because the right medicine depends on the cause and on your dog's other health problems. If your Lab is straining to urinate and producing little or no urine, or cries out when trying, call a vet or an emergency clinic now and read this later.

Is it incontinence, or something else?

Incontinence means leaking without meaning to. VCA describes the typical urinary sign as urine pooling or spotting under a dog that is sleeping or relaxed. For stool, it describes small amounts leaking without the dog being aware, with fecal balls turning up in the bed or around the house.

Several other things can look like it:

Urgency. VCA says illnesses that increase urine volume, and frequent diarrhea, can create an urgency that leads to accidents.
Pain or stiffness. The AKC says arthritis can make squatting, getting up or walking to the door uncomfortable, so some dogs delay going outside until they can no longer hold it.
Failing senses. Vision loss can make it harder to find the way outside.
Brain changes. VCA says dogs with cognitive dysfunction may forget to eliminate outdoors and then go as soon as they come back in.

The AKC adds that cognitive decline is statistically one of the less common reasons senior dogs begin having accidents, and that physical and medical causes are often more likely. Merck says pain, sensory decline, cognitive dysfunction and any condition that increases urine volume must be excluded first. Accidents that become a pattern, such as two to three times a month in a fully house-trained dog, deserve a vet visit, according to a veterinary behaviorist quoted by the AKC.

Urinary incontinence in senior Labs

The most common cause: a weak urethral sphincter

Merck says urethral sphincter mechanism incompetence, or USMI, is the most common cause of urinary incontinence from failure to store urine in dogs. It is usually attributed to a shortage of sex hormones in neutered animals, particularly female dogs, and it often becomes more noticeable in middle-aged to older dogs. Typically the dog leaks urine without knowing when sleeping or lying down, but urinates normally otherwise.

VCA says urinary incontinence may affect over 20% of spayed female dogs and up to 30% of large-breed dogs, and that it is most common in middle-aged to senior, medium to large-breed females. Merck puts the figure at 11% to 20% for large-breed spayed females, and the AKC says it develops on average 2.9 years after spaying. None of the sources I found single out Labradors. The pattern follows size and spaying, although Merck says it can also occur in intact females and in male dogs.

Other causes your vet will rule out

Urinary tract infection. VCA lists frequent attempts to urinate, straining, blood in the urine, crying out while urinating, licking the genitals and a break in house training. The AKC says UTIs are more common in senior and female dogs.
Bladder stones or tumors. VCA says stones and tumors can cause bleeding, straining and irritation, and a stone that blocks the urethra is potentially life-threatening.
Diseases that increase urine volume. VCA names kidney failure, diabetes mellitus and Cushing's disease. The AKC adds steroid medicines. A dog that drinks and urinates more may not make it outside in time.
Prostate disease in male dogs. VCA lists it among the urethral disorders that cause leakage.
Nerve and spinal problems. VCA lists spinal injuries and disruption of the nerves that control the bladder. Merck says affected dogs often also have weak hind legs.
A partly blocked urethra. Merck says this can make the bladder overflow and leak.

How the vet finds the cause

VCA says urinary incontinence is diagnosed from your dog's signs, history, blood tests and urine tests, with bladder X-rays or ultrasound to look for stones and other abnormalities. A urine culture is how vets confirm infection and choose the antibiotic. Neurological tests are added if a nerve problem is suspected. For USMI, Merck says the diagnosis is often presumptive, based on the dog's profile, history and exam, and on how it responds to treatment.

Treatment

Treatment follows the diagnosis. For USMI, VCA says medicines that tighten the urethral sphincter, or replace hormones, are commonly used alone or together, and that about 70% of cases respond well to medicine alone. Long-term use calls for periodic blood and urine tests. Merck warns that one of the estrogen drugs, diethylstilbestrol, can suppress the bone marrow, which is one reason these medicines are for your vet to prescribe and monitor. For dogs that do not respond, Merck describes collagen injections that bulk up the urethra and a surgically placed artificial sphincter.

An infection needs antibiotics chosen by your vet. Kidney disease, diabetes and Cushing's disease each have their own long-term plans.

Fecal incontinence in senior Labs

VCA divides bowel incontinence into two broad types.

Sphincter incontinence. The muscle that closes the anus cannot stay shut, either because a wound or mass disrupts it or because the nerves that control it are damaged. Dogs leak small amounts of stool without being aware, and may dribble stool when barking or excited. VCA says anal damage may show as redness, inflammation or drainage and extra licking. If nerve damage is the cause, you may also see trouble walking, urine dribbling and changes in how your dog carries the tail.
Reservoir incontinence. Intestinal disease interferes with the rectum's ability to store normal volumes of stool.

Causes worth knowing in an older Lab

Spinal disease at the base of the spine. VCA says lumbosacral disease (cauda equina syndrome) compresses the nerves in the lower back, usually in larger dogs in middle age. Signs include being slow to rise, weak or lame rear legs and, in some dogs, fecal or urinary incontinence. VCA adds that once incontinence has developed, surgery will probably not improve it, because permanent nerve damage is not reversed.
Anal sac problems. VCA says some dogs have loose stools or a lack of bowel control for one to three weeks after anal sac removal, and in rare cases the nerve damage is permanent. Merck calls fecal incontinence a common complication of anal sac surgery.
Intestinal disease. VCA lists intestinal parasites and frequent diarrhea among the physical causes of house soiling.
Pain and stiffness. The AKC lists trouble squatting to eliminate among the signs of arthritis.
Brain changes. VCA lists cognitive decline among the causes of house soiling.

How the vet finds the cause

VCA says your vet will examine the anal area, do a rectal exam to rule out internal lesions, and check the nerves of the hind limbs, anal sphincter and tail. If a nerve problem is suspected, spinal X-rays come first, then CT or MRI if needed. If intestinal disease is suspected, the first tests are usually a fecal parasite exam and blood tests, followed if needed by abdominal X-rays, ultrasound, endoscopy or biopsies.

Treatment

Treatment follows the cause. VCA says an anal wound or mass may need surgery, and surgery may be advised for a herniated disk or other nerve lesion. In some dogs with nerve damage there is no definitive treatment and the focus shifts to management. VCA says a low-fiber diet may reduce the amount of stool produced, while a high-fiber diet may make cleanup easier, so ask your vet which suits your dog.

Managing accidents at home

A woman sitting on a wooden bench next to a dog

Home care supports your vet's plan. It does not replace it.

More trips outside. VCA says senior pets may need more frequent access to a suitable bathroom area, and that if a medical condition raises your dog's thirst you may need to keep up the extra trips or provide an indoor toilet area. Merck says a dog that can no longer be relied on to signal should be taken out more often and kept to easily cleaned areas when you cannot supervise.
Make getting outside easier. Merck suggests ramps and nonskid flooring for slippery steps. If stiffness is part of the picture, our guide to signs of pain in senior dogs can help you spot it, and your vet can advise on pain control.
Absorbent gear. The AKC says pee pads, diapers, belly bands, litter boxes and artificial grass areas help some dogs, especially at night or when outdoor access is limited. Diapers and bands must be changed regularly to keep things hygienic and prevent skin irritation.
Protect the skin. Merck says constant dribbling of urine can inflame and scald the skin around the vulva or penis. Keep the area clean and dry, and tell your vet about redness or sores. See our guide to skin conditions in senior Labs.
Do not scold. Merck advises avoiding punishment for house soiling in dogs with cognitive decline because it causes anxiety, and suggests rewarding your dog for eliminating outside.
Keep a simple log. This is my own suggestion, not a medical test. Note when accidents happen, how big they are, and whether your dog is drinking more. It gives your vet something concrete to work with.

When to call the vet

Go now if your Lab is straining to urinate and producing little or nothing, or crying out when trying. Merck says complete blockage of the urethra is a medical emergency, and the AKC says difficulty urinating or an inability to urinate can lead to a ruptured bladder. Merck adds that vomiting, dehydration and severe depression follow quickly.

Book a visit soon if you notice:

Blood in the urine, which the AKC says to report immediately
Lethargy, loss of appetite or vomiting along with the accidents (AKC)
A change in how often your dog urinates, or in the color or volume of the urine (AKC)
Frequent attempts to urinate, straining, or crying out while urinating, which VCA lists as signs of a urinary tract infection
Trouble walking, weak hind legs or changes in how your dog carries the tail with incontinence, which VCA links to nerve damage
Redness, inflammation or drainage at the rectum, or extra licking there (VCA)
Accidents that keep happening in a dog that was fully house-trained (AKC)

Quality of life

Incontinence is a symptom, and what it means depends on the cause. VCA says the outlook for urinary incontinence from sphincter weakness is generally good. Nerve damage, kidney disease and diabetes have different outlooks.

When a cause cannot be fixed, VCA's seven-category quality-of-life scale (known as HHHHHMM) counts hygiene as one category, alongside pain, hunger, hydration, happiness, mobility and having more good days than bad. For hygiene, the question is whether your dog can be kept clean and away from soiled areas. Our guide on how to know when it's time to put down an elderly dog explains the scale. No single symptom should settle the decision, so talk it through with your vet.

Questions owners ask

How can I help a senior Lab with incontinence?

Start with a vet exam to find the cause, because urinary and fecal incontinence are treated differently. Then combine the treatment your vet prescribes with more frequent bathroom trips, absorbent bedding or diapers, skin care, and help getting outside.

Why is my 13 year old dog having accidents in the house?

Common reasons include urinary incontinence, a urinary tract infection, kidney disease, diabetes or Cushing's disease, arthritis pain that makes it hard to get outside in time, fading vision and cognitive decline. The AKC says physical and medical causes are often more likely than cognitive decline, so book an exam.

Are Labs prone to incontinence?

In what I found, size and spaying matter more than breed. VCA says urinary incontinence may affect over 20% of spayed females and up to 30% of large-breed dogs, and Merck puts it at 11% to 20% of large-breed spayed females. The sources I found give no figure for Labradors specifically.

Can incontinence be cured?

Often it can be controlled. VCA says about 70% of cases of urethral incontinence respond well to medicine alone, and surgical options exist for those that do not. Incontinence from nerve damage is harder, because VCA says permanent nerve damage is not reversed.

Should I put my dog down for incontinence?

That is a decision to make with your vet, looking at the whole picture. The cause matters: sphincter weakness is often treatable, while advanced nerve disease may not be. VCA's quality-of-life scale counts hygiene as one of seven categories, so incontinence is one factor and not the whole story.

Sources

VCA Animal Hospitals

Merck Veterinary Manual

American Kennel Club

Incontinence in Senior Labs: Urinary and Fecal Causes and What to Do

Is it incontinence, or something else?

Urinary incontinence in senior Labs