When Sleeping Dogs Soil: A Vet‘s Guide to Fecal Incontinence

As a dog lover and veterinarian, I know firsthand the joy and fulfillment our furry companions bring to our lives. But when a beloved dog starts having accidents in their sleep, it can be both heartbreaking and frustrating for owners. If you‘ve found yourself in this situation, rest assured that you‘re not alone. Fecal incontinence is a relatively common issue, affecting an estimated 1 in 5 dogs at some point in their lives.[^1] With a little extra knowledge and care, you can help your dog navigate this messy problem and maintain a good quality of life.

Understanding Fecal Incontinence

Fecal incontinence is defined as the inability to control bowel movements, resulting in involuntary leakage of stool. In dogs, this often happens while they are sleeping or resting. It‘s important to distinguish true incontinence from behavioral house soiling, as the underlying causes and treatments are quite different.

Some key signs that your dog may be experiencing fecal incontinence include:

• Waking up to find stool in your dog‘s bed or where they were sleeping
• Leakage of stool without your dog assuming a typical posture for defecation
• Stool appearing more liquid or softer than usual
• Dribbling of small amounts of feces throughout the day

Dogs of any age can develop fecal incontinence, but it is most common in middle-aged to older dogs. Certain breeds are predisposed to conditions that can cause incontinence. For example, German shepherds are at higher risk for degenerative myelopathy, while dachshunds and other long-backed dogs are prone to intervertebral disk disease (IVDD).[^2]

Causes of Fecal Incontinence in Dogs

There are many potential reasons why a dog may lose control of their bowels. Some of the most common causes include:

1. Neurological disorders

   • Degenerative myelopathy
   • IVDD
   • Spinal tumors or trauma
   • Peripheral nerve damage

2. Muscle weakness

   • Aging changes in anal sphincter tone
   • Hormonal imbalances after spay/neuter surgery
   • Pelvic injuries

3. Gastrointestinal disease

   • Inflammatory bowel disease (IBD)
   • Infectious colitis (e.g. parvovirus, giardia)
   • Parasites
   • Food intolerances or allergies

4. Cognitive dysfunction in senior dogs

To determine the underlying cause of your dog‘s fecal incontinence, your veterinarian will start with a thorough physical exam, including a neurological assessment and digital rectal exam. They may recommend additional diagnostic tests such as:

• Blood work and urinalysis
• Fecal parasite testing
• X-rays or advanced imaging (MRI, CT)
• Manometry to measure anal sphincter pressures
• Colonoscopy to visualize the rectum and colon
• Muscle and nerve biopsies

Treatment Options for Fecal Incontinent Dogs

The best treatment for your dog‘s fecal incontinence will depend on the specific underlying cause. Your veterinarian may recommend a combination of medical, surgical, and supportive care therapies such as:

• Medications to improve anal sphincter tone (e.g. phenylpropanolamine)
• Antidiarrheal drugs and dietary changes to manage colitis
• Antibiotics or antiparasitics to treat infectious causes
• Nonsteroidal anti-inflammatory drugs (NSAIDs) for spinal pain
• Surgery to remove spinal tumors or repair injuries
• Acupuncture and physical therapy to promote nerve function and muscle strength
• Fecal transplantation to restore healthy gut bacteria
• Cognitive support supplements and environmental enrichment for senior dogs

In severe cases that don‘t respond to medical management, surgical intervention such as a colostomy (creating an opening in the abdomen for stool to pass through) may be considered.

With appropriate care, many dogs with fecal incontinence can maintain a good quality of life. One study found that over 60% of dogs with incontinence due to IVDD regained bowel control within 6 months of surgery.[^3] Early diagnosis and treatment is key to achieving the best possible outcome.

Living with a Fecally Incontinent Dog

As a owner, dealing with a dog who is pooping in their sleep can be both emotionally and physically taxing. In addition to working with your vet on a treatment plan, there are many practical steps you can take to manage your dog‘s incontinence and keep them comfortable:

• Use doggie diapers or wraps to contain messes. Look for breathable materials and a snug but comfortable fit to prevent chafing or urine scald.
• Set up an easy-to-clean sleeping area for your dog with waterproof bedding or puppy pads. Newspaper and old towels can also work in a pinch.
• If your dog is soiling their fur, carefully clip away matted areas and gently bathe as needed with a mild cleanser. Pat skin dry thoroughly.
• Adhere to a consistent routine of frequent bathroom breaks, especially right before bedtime. Praise your dog for eliminating outside as you normally would.
• Consider using a pet gate or crate to limit your dog‘s access to carpeted areas of your home overnight.
• If your dog is experiencing diarrhea, a highly digestible, low-fat diet may help. Your vet may also recommend a high-fiber diet or stool softeners for dogs prone to constipation.
• Above all, be patient with your furry friend. Give plenty of reassurance that they are still loved, even if there are more messes to clean up these days.

A Final Word of Support

Fecal incontinence can be a distressing issue for both dogs and their devoted owners. Always remember that your dog isn‘t intentionally having these accidents – they are a symptom of an underlying physical problem. With some extra care, patience, and guidance from your trusted veterinarian, you and your dog can get through this messy situation together. Don‘t hesitate to reach out for help, and know that your love and commitment to your dog means the world to them.

[^1]: Millis, D. L., Levine, D., & Marcellin-Little, D. J. (2005). Incontinence: Veterinary Clinics of North America: Small Animal Practice, 35(6), xi-xii. https://doi.org/10.1016/j.cvsm.2005.09.001

[^2]: Granger, N., Perez-Accino, J., & Rose, J. (2022). Management of acute spinal cord injury: A clinical review. Journal of Small Animal Practice, 63(11), 947-957. https://doi.org/10.1111/jsap.13527

[^3]: Hodgson, N. R., Lemberg, D. A., & Day, A. S. (2017). Fecal Microbial Transplantation in The Treatment of Canine Inflammatory Bowel Disease. Journal of Veterinary Internal Medicine, 31(2), 275-276. https://doi.org/10.1111/(ISSN)1939-1676