Hey Lesley.
I will share my thoughts. Would be interesting to hear Jenny’s thoughts too!
You are right… Male dogs with urinary incontinence pose a more difficult challenge. Although a less common problem in males, less than 50% of male dogs respond to medical therapy, and the most successful treatment is phenylpropanolamine. One possible reason for this is a misdiagnosis of dogs with USMI when in fact they have overflow incontinence from urethral sphincter dyssynergia or functional urethral obstruction. Testosterone cypionate has had some anecdotal use in males with USMI and may provide some improvement. Urethral bulking agents may be placed antegrade through a cystotomy incision; however, there has not been a formal evaluation of this procedure and its overall success rate is unknown. Surgical placement of an artificial urethral sphincter appears to have some success in male dogs that fail medical therapy.
I think it is important to work up these male incontinent dogs as much as possible. I would definantely consider urine analysis and possible culture. An abdominal ultrasound would be helpful. The problem in male dogs is a visualisation of the lower part of the urinary tract. If clinical signs are suggestive of any urethral disease I would consider a retrograde urethrogram or possibly CT.
In short, the first line medication trial would be phenylpropanolamine.
Hope that helps.
Scott 🙂
