Urinary incontinence in dogs: treatments compared
Checked against FDA labels and veterinary references: October 2026
Short answer
Most dogs that leak urine while resting or asleep have a weak urethral sphincter, common in spayed female dogs as they age. It usually responds well to phenylpropanolamine (Proin, or once-daily Proin ER) or estriol (Incurin), with improvement over several days. Your vet will first rule out other causes, such as a urinary infection, bladder stones, diabetes or Cushing’s disease, which can look the same.
Urinary incontinence treatments for dogs at a glance
- Proin (phenylpropanolamine)FDA-approved chewable, 2011How it is given: Twice a dayWhat to watch for: Restlessness, higher blood pressure; can mask a urinary infectionWhere to get it: Vet or veterinary pharmacy
- Proin ERFDA-approved extended-release, 2019How it is given: Once a dayWhat to watch for: As for ProinWhere to get it: Vet or veterinary pharmacy
- Incurin (estriol)Estrogen for spayed femalesHow it is given: Once a day, then the lowest dose that worksWhat to watch for: Changes like being in heat, such as a swollen vulva, or reduced appetiteWhere to get it: Vet or veterinary pharmacy
- Both togetherWhen one medicine is not enoughHow it is given: As your vet directsWhat to watch for: Effects of bothWhere to get it: Vet
- Surgery or urethral bulkingSpecialist proceduresHow it is given: One-time procedureWhat to watch for: Anesthesia risk; results varyWhere to get it: Specialist referral
| Treatment | How it is given | What to watch for | Where to get it |
|---|---|---|---|
| Proin (phenylpropanolamine)FDA-approved chewable, 2011 | Twice a day | Restlessness, higher blood pressure; can mask a urinary infection | Vet or veterinary pharmacy |
| Proin ERFDA-approved extended-release, 2019 | Once a day | As for Proin | Vet or veterinary pharmacy |
| Incurin (estriol)Estrogen for spayed females | Once a day, then the lowest dose that works | Changes like being in heat, such as a swollen vulva, or reduced appetite | Vet or veterinary pharmacy |
| Both togetherWhen one medicine is not enough | As your vet directs | Effects of both | Vet |
| Surgery or urethral bulkingSpecialist procedures | One-time procedure | Anesthesia risk; results vary | Specialist referral |
What urinary incontinence looks like
True incontinence is leaking without meaning to, typically wet spots where the dog has been lying or sleeping, rather than deliberate urination indoors. The most common cause is urethral sphincter weakness, especially in spayed female dogs and larger breeds as they get older.
Other causes to rule out first
A urine test and sometimes blood tests or imaging come first, because several conditions look like incontinence: urinary infections and bladder stones, and conditions that make dogs drink and urinate much more, such as diabetes, Cushing’s disease and kidney disease. Spinal problems and, in puppies, misplaced ureters are other causes that medicine will not fix.
What to expect
Phenylpropanolamine tightens the urethral sphincter, and it may take several days of treatment before accidents improve. Estriol works by restoring the effect of estrogen on the urethra, and the dose is gradually lowered to the smallest that keeps your dog dry. Many dogs stay dry on one medicine for years; some need both.
Cautions
- Phenylpropanolamine can raise blood pressure and heart rate, so your vet will check blood pressure and use care with heart disease, high blood pressure, kidney disease or glaucoma.
- Never give two doses at once to make up a missed dose.
- Because these medicines can hide the signs of a urinary infection, report any change in urine color, smell or straining.
- Estriol is for spayed female dogs and is not used in intact or pregnant dogs.
Keep the bottle out of reach
Proin chewables are flavored, and dogs that get into the bottle can eat many at once, which can cause dangerously high blood pressure. Store them securely, and if your dog eats extra, call your vet or an animal poison control center straight away. See poison control contacts.
Home care
Waterproof, washable bedding, more frequent walks, and gently washing and drying the skin around the genitals prevent urine scald and skin infections while treatment takes effect.
Frequently asked questions
Is it normal for older dogs to leak urine?
It is common, especially in spayed female dogs, but it is not something to accept: most dogs respond well to treatment once other causes are ruled out.
How fast does Proin work?
It may take several days of treatment before accidents decrease. Your vet will adjust the plan if it does not help.
Can male dogs get urinary incontinence?
Yes, though it is less common, and they may respond less well to phenylpropanolamine. Your vet will look for other causes, including prostate problems.
Is Proin safe long term?
Many dogs take it for years. Your vet will check blood pressure and watch for side effects such as restlessness, especially in dogs with heart or kidney disease.