Many of the causes of inappropriate urination are treatable with the help of your veterinarian. If there is an underlying condition, that must be dealt with first in order to get the urinating issue under control. Treatment for common causes include the following:
Hormone-related incontinence (USMI) is treated with medications that improve urethral strength and compensate for the loss of hormone driven control of the “switch off” valve out of the bladder.
Phenylpropanolamine (PPE) is the most effective treatment option controlling over 80% of USMI cases, however, it must be given three times a day initially and dogs often don’t like the taste of it. Because of these issues, a hormone supplement with estrogen (typically diethylstilbestrol (DES)) is used.
Hormone supplements controls 50-60% of USMI cases, so it’s not quite as effective as PPE, and is given once daily for 5 days, then once weekly long term (or as needed to control the accidents). If high doses of either are used, bone marrow issues can develop, so it’s important to be aware and monitor the situation.
If these medications are unsuccessful at controlling the incontinence, collagen injections into the urethra may be considered as an additional treatment option. Doing urine tests periodically to look for signs of concurrent bladder infections is important because dogs with incontinence are more prone to developing UTIs.
Arthritis, Trauma and Tumors
Incontinence related to arthritis can be managed by treating the arthritis pain. Talk to your veterinarian about the many options for addressing this common issue, especially in older dogs.
Trauma and tumors causing incontinence will need to be treated specific to their individual causes.
Bladder stones may need to be surgically removed. Some can be dissolved with a special prescription diet, but repeated x-rays and urine tests, and often long courses of antibiotics are needed in order to do this successfully.
Either way, when a dog is prone to developing bladder stones, it will likely need to be fed a diet that prevents crystals from forming in the future. This often provides a cure to the problem, but it has to be strictly adhered to. There are many prescription diets now available for dogs with this condition, which your vet can recommend.
Urinary Tract Infections (UTIs)
UTIs are typically cured with the use of an appropriate antibiotic. Recurrent infections will need more investigating about the underlying cause. These can be more complicated to treat.
Behavioral inappropriate urination will require a reintroduction of house training. Going back to the basics like when your dog was a young puppy, positively reinforcing urinating outdoors, using crate training or other measures to make it very difficult or impossible for them to urinate inside. Be patient and consistent, and you should get a resolution over time!