Loss of bladder control in beloved pet

Question
QUESTION: I adopted a Cairn terrier mix four and a half years ago and she is the most wonderful dog!  She was a stray, so I don't know her exact age but it is estimated to be anywhere from 10 to 13 years old.  She has always been extremely well behaved and until a couple of months ago she had only peed a handful of times inside the house.  About 3 months ago she started to have accidents more frequently inside, and then about 3 weeks ago she started to pee in the house several times a week.  Occasionally I will find small puddles where she had been lying down, but more often it is a heavy stream that she just cannot seem to hold in.

I became concerned when she started to pee in the house after having peed outside only three or four hours earlier (just a few months ago she had no problem holding it 10 hours while I was at work).  I took her to my vet, who is great, and she did a urine test and a full blood panel, both of which came back completely normal with no sign of diabetes, bacterial infection, etc.  The vet then did a urine culture where she took urine directly from my dog's bladder, and again it came back normal.  So we still don't have a reason for my dog's loss of bladder control and the vet has recommended an ultrasound as the next step.  I am currently unemployed and would like to hold off on that for a while if possible.  A few days ago I started her on *******, giving her a quarter of a pill every twelve hours.  The first couple of days this seemed to be helping, and she even went six hours without peeing inside or outside.  Then a couple of days ago the accidents came back.  She has been on ***** for less than a week, so I know it's too soon to tell if it will work, but I think that I will end up springing for the ultrasound sooner rather than later.

I should also mention that she is able to hold it overnight for up to 12 hours.  When she does have an accident, I don't yell at her because I know it's not her fault and she definitely knows that she's not supposed to do it (based on how upset she acts).  Since I'm not working I can usually take her out every 4 hours or so, but it still isn't frequently enough.  I have been monitoring her water intake and I try to make sure that she doesn't drink too much at one time.

I've been thinking that instead of leaving water out for her all day I could give her measured amounts of water at specific times throughout the day, and then take her out based on when that water will go through her system.  Do you know how long it takes for a dog's body to process water or have any recommendations for this?

Again, she is a wonderful wonderful dog who I love dearly, but this problem is becoming very inconvenient.  If I lived in a house with a doggie door and a gated back yard, it might not be an issue, but I live in an apartment building on a fairly busy street and she cannot be outside by herself.  I also live with two roommates who are very understanding of the situation, but it makes it harder when my dog's habits inconvenience them.  

I thought about putting her in a crate while I am out, but since she knows she is not supposed to go in the house I have to believe she would just pee in the crate.  Additionally, I have never had to crate her and she HATES being in a crate (I think it goes back to her life before I adopted her) and I really think it might traumatize her.  

I apologize for the long and convoluted back story, but I am hoping that you'll be able to give me some suggestions based on her specific behavior and my specific situation.  Do you have any suggestions about how to curtail the incidents from happening aside from taking her out every 3 hours (which I will not be able to do for much longer)?  Thank you in advance!

ANSWER: First of all, what is this:A few days ago I started her on *******, giving her a quarter of a pill every twelve hours.??? what are these stars supposed to be and why are they in this letter?

I have no clue what ******* is supposed to mean. Did your vet happen to mention bladder stones to you? They are not uncommon in dogs at all.

They can cause a great deal of bladder tone loss. Another thing is just age and hormonal issues. Incontinence of this type is very common in older spayed dogs. Most vets prescribe phenylpropanolamine for it.

It is basically a decongestant that has shown to help with urinary incontinence in most dogs. There are many forms of it.

Xrays are cheaper than ultrasound and will show bladder stones, even small ones, if done correctly. A good vet will palpate the bladder also and feel them in there. Small stones feel like sand in the bladder and larger ones feel like you are holding a bag of marbles.

There are many approaches to bladder stone issues also. One of course is direct surgery to remove them. If the bladder is full of them this is usually the best course of action. If not, then a diet to dissolve the stones works well also. Most vets use Hill's S/D which is Stone Diet, and it will dissolve the most common struvite stones. If she has calcium oxalate crystals, those require a different food.

The vet should have been able to detect crystals of some sort in the bladder if there were stones unless all she was looking for was infection. So it's hard to say what is going on here.

If the vet is suspecting something else, like a mass of some sort in the bladder, she should have found some evidence of that in the bladder stick she did.

I would approach the vet about xrays first and then ask about getting her on some phenylpropanolamine to start with. Drug therapy should always be the first modality used and then onward to more invasive and inexpensive procedures.

So let me know what the stars are for. I cannot read them.
Hope this helps some and that you find an answer soon.

Here is an article on bladder stones for you:
Just click on the links

http://www.peteducation.com/article.cfm?c=2+1634&aid=400


http://www.bladderstonesindogs.com/bladder-stones-in-dogs-signs.php

http://www.bladderstonesindogs.com/

Please let me know how it goes. I love Cairn terriers myself!


---------- FOLLOW-UP ----------

QUESTION: Whoops, sorry about the ****s.  I temporarily forgot the name of the medicine and entered the **** to remind myself to look it up which of course I failed to do.  In any case, the medicine she is on is Proin (PPA).

Today I was taking her outside after she had gone out two hours earlier because I noticed that she drank a significant amount of water.  I was locking the door to my apartment when she peed all over the doormat.  I still had to take her down a flight of stairs and through the vestibule before getting her outside, and she has never done this before.  I find it hard to believe that she had to pee so badly that she couldn't have waited to get outside, especially when she had been sleeping peacefully just minutes before and did not act like she needed to go out at all.  I'm beginning to wonder if some of this could be behavioral?

Thank you for the information about the bladder stones and the X-Rays -- I have not discussed that possibility with my vet but will be sure to do so!

Answer
Kate,
if it is behavioral, it has to do with a lack of nerve impulses in her brain or in her spine firing off. Often geriatric dogs lose muscle and nerve control of their bowels and bladder due to the spine getting old and stiff and not broadcasting the signals as well.

Sometimes Cholodin can help with this. It is an amino acid supplement that most vets carry over the counter. We used it for years with good results. Some dogs, of course have no change, some noticeably so.
It is certainly worth a try.

I am sure she isn't doing this to be a bad dog. Most likely she doesn't even know when she feels the need to go. That would explain her waiting too long or letting it go like she did. Maybe she has zero control over it. The 6 hour span was probably due to the PPA. That is the drug I was referring to myself. Make sure you don't skip days or doses with it. The longer you use it the better it works- if it caused by something like hormones or bladder tone.

I would certainly investigate the stone connection and also have her spine and nerve impulses checked. A simple check that can be done is to see how much feeling she has in her back feet and how she plants them when they are touched on top.

Just ask the vet- it is easier to show then tell you!
I hope this doesn't get complicated for her. Please let me know when you find out what it is. Poor, sweet girl!