Faecal Incontinence in Old Dogs
Incontinence in dogs: a common complaint I hear from the owners of old dogs is fecal incontinence – normal looking bowel movement or stool “accidents” that get left somewhere in the house by a dog who knows better, and who didn’t do it on purpose. Often the owner finds them where the dog sleeps, or they see them come out when the dog first struggles to stand after a nap. But is this really dog incontinence?
What Causes Incontinence in Dogs?
In most cases, this is not true incontinence. True incontinence in dogs stems from a lack of anal sphincter control, and I think in most cases that is only a small part of the problem.
This problem seems to almost exclusively affect dogs with very weak or debilitated hind ends. These dogs have difficulty standing, and most importantly, they have difficulty assuming a proper “defecation posture”. Although these dogs may have a weaker than normal sphincter, in most cases it is still strong enough to prevent incontinence as long as the colon is not overfull.
However, because these dogs lack the strength to comfortably squat and defecate, they do what I refer to as the “walk & drop” – rather than crouch, they keep stepping forward while defecating.
Presumably, because defecating is so awkward and potentially uncomfortable for these dogs, they never fully evacuate their colon; they seem to defecate just enough to relieve any immediate urge, but not much more. As a result, they spend most of their day with a mostly full colon.
Sometimes this catches up with them when they sleep, when a mostly full colon becomes an over full colon. Combine that with the reduced muscle tone of a deep sleep and suddenly you have the recipe for a soiled bed. Alternatively, as they engage their abdominal muscles to stand, pressure in the abdomen increases, causing them to have an accident while first getting up from a nap.
What can I do to help?
Sometimes increasing the amount of non-digestible fibre in the diet helps (1 ice cream scoop of canned pumpkin with each meal for a large sized dog). There are prescription medications available that improve colon motility, but I’ve not found them particularly effective. Giving plenty of opportunity to defecate outside before bedtime is definitely helpful.
The treatment with which I have seen the best results is to address the underlying lower back pain – increase the dog’s comfort and hind end strength so that it can hold a better defecation posture and therefore better evacuate its colon. Using combined acupuncture and manual therapy (CAMT), as well as a comprehensive arthritis treatment protocol, yields the best results. Manual therapy is an umbrella term for chiropractic and/or physiotherapy style adjustments and mobilizations, as well as massage techniques. This protocol has an excellent prognosis for improving quality of life, and in most cases reduced the number of “accidents” as well.
Having said that, by the time the dog is at the “walk & drop” stage, they are usually quite debilitated, and the more advanced a condition is, the harder it is to turn around. But by being aware of earlier signs and responding when you first see them, the chance of preventing this problem in the first place is much better.
Some of the more common earlier signs include:
- Hesitation or reduced ability to jump up (e.g.: into the car)
- Body shakes that don’t reach from head to tail
- Stiffness or difficulty standing (e.g.: pulling from front legs instead of pushing from the back)
- Fatiguing earlier on walks
- Stumbling or scuffing hind feet
- Altered head, back or tail posture
What about urinary incontinence?
Although that is a blog topic unto itself, lower back pain is a common cause of dogs leaking urine in their sleep. Treating that underlying pain often resolves urine leakage issues. Resolving back pain can be a effective treatment for both urinary and fecal incontinence, but is also an important goal unto itself. Less pain is a good thing.