Incontinence in Dogs After Bladder Stone Surgery

Name: Incontinence in Dogs After Bladder Stone Surgery
Creator: Dr. Zubair Khalid

By Dr. Zubair Khalid, DVM, MS, PhD · 2026-10-03

Incontinence in dogs after bladder stone surgery means urine leaks without your dog choosing to urinate. It is common in the first days to weeks after surgery and often improves as swelling settles and bladder function returns. Sometimes it points to a complication or a separate problem that needs treatment.

This article is educational and is not a substitute for veterinary diagnosis or treatment.

Quick Answer

Mild leaking right after surgery is usually temporary and linked to bladder inflammation, anesthesia, or catheter irritation.
Leaking that starts weeks later, or that never improves, may mean sphincter weakness, a urinary tract infection, or a stone left behind.
Call your surgeon the same day if your dog cannot urinate at all, strains with no urine, or has a hard, painful belly.
Most dogs are rechecked within 7 to 14 days after stone removal, and sooner if leaking continues.
Never restrict water to stop leaking. Your dog needs free access to water during recovery.

What Post-Surgical Incontinence Actually Is

Urinary incontinence means involuntary leakage of urine during the storage phase of urination [1]. In plain words, the bladder is supposed to hold urine until your dog decides to go. When the sphincter or bladder muscle does not do its job, urine dribbles out.

This is different from urgency or accidents caused by pain. A dog with post-surgical incontinence often leaks while resting, sleeping, or walking. Some dogs leave a wet spot where they were lying and do not seem to notice.

After bladder stone surgery, the bladder wall has been cut and sutured. The lining is inflamed. The nerves and muscles that control urination can be irritated for a while. That combination makes leaking more likely in the early recovery period.

Dog Leaking Urine After Surgery: What Owners Notice

Owners usually describe one or more of these signs:

Wet spots on bedding or the floor, often after sleep
Damp fur around the vulva or prepuce
A urine smell on the hind legs or tail area
Licking at the belly or genital area
Straining to urinate, or urinating in small amounts often
Blood-tinged urine in the first day or two
Restlessness at night

Some of these signs overlap with a urinary tract infection or with bladder stones that were not fully removed. Urolithiasis and cystitis can look alike, with abdominal pain, difficult urination, blood in the urine, and urinary retention in dogs with stones [2]. That is why your surgeon needs to examine your dog instead of guess from the symptoms alone.

If your dog is also straining to pass stool after surgery, that is a separate issue covered in Dog Constipation After Surgery: Causes and Safe Relief.

Causes and Risk Factors

Temporary causes in the first days after surgery

Anesthesia relaxes the urethral sphincter. A urinary catheter, if one was placed, irritates the urethra. Surgical swelling in the bladder wall reduces its ability to stretch and hold urine. Pain medication can also affect how well your dog empties the bladder.

These effects usually fade within several days to a couple of weeks. Leaking that is mild and improving is a good sign.

Urinary tract infection

Bacteria in the bladder cause inflammation, urgency, and sometimes leaking. Infection is a common reason for ongoing incontinence after stone removal. Urinalysis and urine culture are part of the standard evaluation for any dog with confirmed or suspected stones, because they help identify complicating bacterial infections [3].

Stones left behind

If a stone or fragment remains in the bladder or urethra, your dog may keep straining, leaking, or having accidents. A newer technique uses a thin needle scope during open cystotomy to look inside the urethra and retrieve stones that would otherwise be missed [4]. In that report, the needle scope allowed complete visualization of the urethra in only three of the animals, so this approach has limits [4]. Ask your surgeon whether all stones were removed and whether follow-up imaging is planned.

Urethral sphincter mechanism incompetence

This is the most common cause of leaking in spayed female dogs. The sphincter that holds urine closed becomes weak. It can appear or worsen after bladder surgery. In an international survey of veterinarians, urethral sphincter mechanism incompetence was the leading reason for a medication trial when incontinence was suspected [1].

Ectopic ureters

Ectopic ureters are uncommon congenital abnormalities that cause urinary incontinence, and female dogs are affected more often than males [5]. If your dog has leaked since puppyhood and the stone surgery did not fix it, this may be the real problem. Surgical options include neoureterostomy, nephroureterectomy, and ureteroneocystostomy, and minimally invasive versions of these procedures are now described [5]. You can read more in Ectopic Ureters in Puppies: Diagnosing Incontinence and Surgical Fixes.

Other risk factors

Stone type matters. Calcium oxalate and struvite are the most common stone types in dogs [6]. Struvite stones can often be dissolved with a prescription diet instead of surgery, so some dogs that go to surgery have oxalate or mixed stones that tend to come back [6]. Recurrence raises the odds of new bladder irritation and more leaking.

How Incontinence After Bladder Stone Surgery Is Diagnosed

Your veterinarian will start with the history you provide. Write down when the leaking started, how often it happens, whether your dog seems aware of it, and whether urination is otherwise normal.

The next steps usually include:

Physical exam, including palpating the bladder and checking the surgical site
Urinalysis to look for blood, crystals, and signs of infection
Urine culture and susceptibility to confirm infection and choose the right antibiotic
Blood work to check kidney values and overall health
Abdominal ultrasound or radiography to look for remaining stones

Urinalysis is an important part of evaluating any animal with confirmed or suspected stones, and urine pH and specific gravity can hint at the stone type or help monitor prevention plans [3]. If your dog had a stone analyzed, bring that report to the recheck.

More advanced testing is sometimes used. Urethral pressure profiles measure how well the sphincter holds pressure, and one study looked at whether these measurements predict long-term continence in female dogs with ectopic ureters [7]. This testing is uncommon in general practice. In the same international survey, urethral or bladder pressure measurement was rarely used, reported by 0.2% of veterinarians in Spain and 2.4% in Italy [1].

If infection and stones are ruled out, your veterinarian may consider whether the problem is a weak sphincter or another cause. The article Dog Incontinence: How to Tell If It's a Bladder Infection or Weak Sphincter walks through that distinction.

Treatment Options

Treatment depends on the cause. There is no single fix for every dog.

Cause	Typical approach	What to expect
Post-surgical swelling or catheter irritation	Time, pain control, monitoring	Often improves within days to a few weeks
Urinary tract infection	Antibiotic chosen from culture results	Leaking usually improves as infection clears
Retained stone or fragment	Repeat imaging, possible second procedure	Depends on stone location and size
Weak urethral sphincter	Medication trial, often started before advanced testing	Many dogs improve, some need dose adjustments
Ectopic ureter	Surgical correction	Continence rates after surgery range widely

For suspected sphincter weakness, veterinarians often start a medication trial. In the international survey, the first-choice medical treatment was phenylpropanolamine [1]. Your veterinarian calculates the dose from your dog's weight and health, so do not use a dose from another pet or an online chart.

Surgery is an option for some causes. Ectopic ureters require surgical correction, and reported continence rates after surgery range from 22% to 72% [7]. That range is wide, which means some dogs still leak after a technically successful repair.

For dogs with stones that keep coming back, prevention matters as much as treatment. Struvite stones can be managed with a prescription dissolution diet that lowers protein, magnesium, and phosphorus, promotes acidic urine, and adds sodium to increase water intake [6]. Calcium oxalate stones are not dissolved this way. You can read about that in Calcium Oxalate Stones in Dogs: Surgical Removal and Prevention Diet.

Recovery, Outlook, and Long-Term Management

Most dogs go home within a day or two of bladder surgery. Expect a quiet week or two with leash walks only, no jumping, and no rough play. Keep the incision clean and dry.

Leaking often peaks in the first few days and then gradually improves. If your dog is still leaking at the recheck, your veterinarian will decide whether to test for infection, reimage the bladder, or start medication.

Long-term management may include:

A prescription diet matched to your dog's stone type
More water intake, which lowers the concentration of stone-forming minerals in urine [6]
Scheduled potty breaks every few hours
Doggy diapers or waterproof bedding for management at home
Routine urine testing every few months

Some dogs need medication for life. Others stop leaking once inflammation resolves. Your dog's outlook depends on the cause, so ask your surgeon for a clear plan at the recheck.

Prevention

You cannot prevent every case of post-surgical incontinence, but you can lower the odds of stones returning and reduce bladder irritation.

Follow the prescription diet exactly. Do not mix in table food unless your veterinarian approves it.
Keep water available at all times. Adding moisture to food helps dilute urine [6].
Take your dog out often during recovery so the bladder does not overfill.
Finish all antibiotics as prescribed, even if leaking stops.
Bring your dog to every recheck. Stone size on repeat imaging is compared with earlier images, and stones that fail to shrink after 1 to 2 months of medical treatment are probably not struvite and need a different plan [6].
Ask about monitoring. Urine pH and specific gravity can help track dissolution or prevention protocols [3].

If your dog has a history of stones, ask your veterinarian about the full diagnostic workup used for urolithiasis, which is covered in Canine Urolithiasis: Diagnosis and Medical Management.

Limitations and When to Contact a Veterinarian

No article can tell you what is happening inside your dog's bladder. Individual cases need a veterinarian who can examine your dog, run tests, and adjust treatment.

Call your surgeon the same day if:

Your dog cannot pass urine at all
Your dog strains and produces only drops or nothing
The abdomen looks swollen or feels hard
Leaking gets worse instead of better
You see bright red blood or clots
Your dog vomits, stops eating, or seems painful

Go to an emergency clinic now if your dog is crying out, collapsing, breathing hard, or has a distended belly with no urine output. A blocked urethra is a life-threatening emergency, especially in male dogs.

Schedule a routine recheck if leaking is mild, steady, and your dog is otherwise bright and eating. Bring a fresh urine sample if you can collect one.

Frequently Asked Questions

How long does leaking last after bladder stone surgery?

Mild leaking often settles within a few days to a couple of weeks as swelling goes down. If it continues past your recheck or gets worse, your veterinarian will look for infection, retained stones, or sphincter weakness. There is no fixed timeline that fits every dog.

Is it normal for a dog to leak urine after surgery?

Some leaking in the first days is common and usually temporary. Anesthesia, catheter irritation, and bladder inflammation all relax or irritate the muscles that hold urine. Leaking that starts later or never improves is not expected and should be investigated.

Can I stop the leaking by limiting water?

No. Restricting water makes urine more concentrated, which raises the risk of new stones and irritates the bladder lining. Your dog needs free access to water during recovery. Ask your veterinarian about other ways to manage the mess, such as diapers or waterproof pads.

Will my dog need medication forever?

It depends on the cause. Dogs with a weak urethral sphincter often need long-term medication, sometimes for life. Dogs whose leaking came from infection or post-surgical swelling usually stop medication once the underlying problem resolves. Your veterinarian will set the plan based on your dog's response.

Should I wait until the recheck to mention the leaking?

No. Call your surgeon as soon as you notice it. Early reporting lets your veterinarian decide whether to test for infection, adjust pain medication, or move the recheck sooner. Waiting can delay treatment for a problem that is easier to fix early.

References

An international survey on canine urinary incontinence: case frequency, diagnosis, treatment and follow-up. Frontiers in veterinary science, 2024.
Comprehensive diagnostic evaluation of urolithiasis and cystitis in K9 dogs in Iraq: Clinical, laboratory, and imaging correlates. Open veterinary journal, 2025.
Overview of Urolithiasis in Small Animals - Urinary System. Merck Veterinary Manual.
Intraoperative needlescopy facilitates complete urolith removal during open cystotomy in dogs and cats: 19 cases. The Journal of small animal practice, 2026.
Minimally Invasive Surgical Techniques for the Treatment of Dogs with Urinary Incontinence Due to Ureteral Ectopia. Life (Basel, Switzerland), 2025.
Urolithiasis in Dogs - Urinary System. Merck Veterinary Manual.
Assessment of predictive value of pre- and postoperative urethral pressure profiles for long-term continence in female dogs with ectopic ureters: a preliminary study. Acta veterinaria Scandinavica, 2026.