Diabetic dog peeing in the house again: UTIs and other causes

Why is my diabetic dog peeing in the house again?

New accidents after things had settled are upsetting, but they aren't bad behaviour. Something has changed, and your vet can help work out why.

High blood sugar or a urine infection could be involved. There are other causes too, from kidney disease to a leaky bladder in a spayed female. Most of them can be treated, and a urine test is usually where your vet starts.

Before you call, watch what's actually happening. Is he passing big puddles more often, or straining to pass a little? Is he leaking while he's asleep, or squatting on purpose? Those point to different problems, and your vet will want to know which one you're seeing.

When accidents are urgent

If he repeatedly tries to pee but little or no urine comes out, go to an emergency vet now. Don't wait to collect a sample. A blocked bladder can become life-threatening quickly. It's more common in male dogs, where a bladder stone can get stuck in the narrow tube that carries urine out.

Straining, blood in the urine, a new smell or painful peeing need a call to your vet. When a diabetic dog needs a vet the same day lists the other signs that shouldn't wait.

If the accidents come with vomiting, not eating, or being very tired or weak, it can be diabetic ketoacidosis, a life-threatening complication of diabetes. The signs often come together: vomiting, not eating, being very tired or weak, fast or deep breathing, and breath that smells sweet. Call your vet or an emergency clinic now. There is no safe way to treat ketoacidosis at home.

If your vet has asked you to test urine for ketones, follow their instructions. Do not wait for a test, or let a negative strip delay a call about an unwell dog. If a urine strip shows ketones, call your vet now, even if he seems well. If he also vomits, won't eat or is unusually tired or weak, go to a vet or emergency clinic now. Call ahead on the way if you can, but don't delay travel for a reply or another test. What if a urine strip shows ketones? has what to have ready when you call.

If he collapses, has a seizure, is very weak, can’t stand, won’t respond or is struggling to breathe, go to an emergency vet now. The emergency page has what to tell them, and no emergency vet nearby helps if your clinic is closed.

Urine infections (UTIs) in diabetic dogs

Diabetic dogs are more prone to urine infections, and some get one after another. When his blood sugar runs high, sugar spills into his urine, and bacteria grow well in it. Diabetes can also weaken the body's defences against infection.

Some diabetic dogs have bacteria in their urine without signs of a urinary infection. This is called subclinical bacteriuria and usually should not be treated with antibiotics. Diabetes alone is not a reason to treat it. Your vet may consider treatment if there is concern that an infection is affecting sugar control or another specific reason to treat.

The signs to watch for: asking to go out more often, straining or squatting for a long time, passing small amounts often, blood or pink-tinged urine, a strong or different smell, licking around his genitals, whining or crying when he pees, and accidents in the house.

When his sugar is running high again

When his blood sugar is higher than it should be, sugar spills into his urine and pulls water out with it. He pees more, so he drinks more, and a bladder that fills faster can't always wait for the next walk. These are the same signs of diabetes you may have noticed before he was diagnosed.

Sugar can run high again for lots of reasons: an infection, another illness, a change in his food, a problem with how the insulin is stored or given, or other medicines. Glucose stays high even on insulin goes through them, and high blood sugar in dogs explains the signs and when it turns urgent.

Infections and high sugar feed each other. An infection can make his insulin work less well, and high sugar makes infections more likely. That's why your vet may want to check both at the same visit.

Never give extra insulin because he's peeing more, and don't change anything about his insulin yourself. Call your vet.

Other reasons a diabetic dog has accidents

Kidney disease. It's more common in older dogs, and it makes a dog drink and pee more, sometimes with a poorer appetite or weight loss. Diabetes and kidney problems explains what the tests can and can't tell you.

Cushing's disease. The body makes too much of the stress hormone cortisol. It causes thirst and peeing of its own, and it can make insulin work less well. Diabetes and Cushing's has more.

A leaky bladder. Some spayed females leak urine while they're lying down or asleep, because low levels of sex hormones after spaying can weaken the muscle that keeps the bladder shut. She won't know it's happening, and it can often be treated, so mention damp patches where she sleeps.

Bladder stones. Stones can irritate the bladder and cause straining, blood and accidents, and they're one of the things vets look for when infections keep coming back. A stone that blocks the way out is an emergency, especially in male dogs.

Medicines. Some medicines, steroids in particular, make dogs drink and pee more. Tell your vet about anything new, including creams, eye drops and supplements, and don't stop a prescribed medicine yourself. Other medicines and your dog's diabetes explains why.

Getting older, cold weather and a changed routine. An older dog may need to go out more often, and a shorter last walk on a cold night or a later dinner can be enough for a dog who drinks more than he used to. These are worth sorting out, but only once your vet has ruled out the medical causes.

In a female who hasn't been spayed, heavy drinking and peeing can be a womb infection called pyometra, which can become life-threatening quickly. Call your vet now, or an emergency clinic if your vet is closed.

What the vet will do

Your vet will ask what you've seen, examine him, and almost always test his urine. A urinalysis checks the urine for sugar, ketones, blood, protein, crystals and signs of infection, and shows how concentrated it is. It often comes with blood tests to look at his sugar control and his kidneys.

If an infection is likely, a urine culture is the test that matters most. The lab grows any bacteria in the sample, identifies them and checks which antibiotics work against them. That way he gets the right medicine rather than a guess, which matters even more for a dog whose infections keep coming back.

The best sample for a culture is taken straight from the bladder with a fine needle, which vets call cystocentesis. It sounds worse than it is: it's quick and routine, and it keeps bacteria from his skin or the ground out of the result. Vet guidelines on urine infections recommend it for culture whenever it's safe to do.

If he does have an infection, your vet will prescribe an antibiotic. Give it exactly as prescribed, for as long as your vet says, even if he seems better. Ask whether they want to recheck his urine afterwards. Dogs whose infections keep coming back usually need more tests, to look for stones or another cause.

Because an infection can upset his sugar control, your vet may want to look at his readings again once it's treated. Home testing, glucose curves and notes for your vet explains what that can involve.

What not to do

Don't take his water away. A dog who is losing water in his urine needs to drink to replace it, and cutting it back can make him dangerously dehydrated. Signs of dehydration in a diabetic dog lists what to look for.

Don't give antibiotics left over from last time or from another pet. Your vet chooses the medicine and duration. Follow their latest instructions if the prescription changes.

Don't rely on cranberry. Cranberry products are popular, but vet guidelines on urine infections say there isn't enough evidence to recommend them, so don't use them instead of your vet's diagnosis and prescribed treatment. Ask your vet before you give any supplement.

Don't change his insulin because he's peeing more, and don't punish him for accidents. Neither fixes the cause. Clean up with an enzyme cleaner so the smell doesn't draw him back to the same spot, and keep a note of each one instead.

What to write down and bring

Before you call, jot down when the accidents started and how often they happen, whether he's straining or passing big puddles, any blood or new smell, whether he leaks while asleep, how much he's drinking compared with usual, his appetite and energy, when he last had insulin, and any medicines he's on.

Only bring a urine sample if the clinic asks for one, and ask them how they want it collected. Usually that means a fresh sample, ideally the first pee of the morning, caught in a clean container and brought in soon. An old or badly stored sample isn't much use for a culture, and the clinic may prefer to take one themselves.

Take any readings and notes you have. What to record for your diabetic dog's vet has a simple list, the questions for the vet sheet helps you remember what to ask, and why a dog suddenly drinks a lot and pees more shows an easy way to measure his drinking.