Urine scald is a painful condition that occurs when urine contacts the skin for long periods of time, causing red, irritated skin and secondary infection. It is most often seen in dogs who are paralyzed or dealing with urinary incontinence for another reason. However, it can also be seen in dogs with birth defects, or who are suffering from other debilitating systemic diseases affecting their mobility and causing them to lay in puddles of urine. Urine scald requires veterinary attention to treat, as well as diagnose and resolve the underlying condition to prevent recurrence. Let’s explore some of the most common causes, how your vet may manage the condition, and what you can do at home to help.
What are the Symptoms Seen with Dog Urine Scald?
Urine scald appears as:
- irritated skin
- in areas where urine frequently contacts the body. This often includes the skin around the genitals, inner thighs or hind limbs, and lower abdomen.
Urine scalds can lead to secondary infection causing:
- open sores
- The area will be painful and will generally exude a strong odor of urine.
Urine scald is a complication that is the result of other diseases, ranging from paralysis to urinary tract infection to incontinence. Depending on the underlying cause, other symptoms may be present, such as
- frequently licking the genitals,
- small frequent urinations,
- urinary accidents in the house,
- inability to empty the bladder,
- blood in the urine,
- loss of proprioception (awareness of the body)
- pain in the hind limbs, ataxia (abnormal/wobbly gait)
- dribbling urine while awake or asleep.
What Can Cause Your Dog’s Urine Scald?
Urine scald occurs when urine contacts the skin for extended periods of time. The caustic nature of urine is irritating to the skin, and bacteria thrive in the moist environment leading to inflamed and infected skin.
Urinary incontinence is the involuntary passing of urine, and is a major cause of urine scald. If your dog is suffering from incontinence they will not be aware that they are urinating, and urine will get on their skin and fur. This condition is most commonly seen in middle-age to older dogs, and in female dogs. There are numerous possible causes of urinary incontinence:
- Urethral sphincter incontinence – The urethra is the tube through which urine leaves the body. Decreasing estrogen levels lead to weakening of the closure of the urethra. This is most frequently seen in large-breed spayed female dogs. These dogs can still urinate normally but also leak urine. This condition generally responds well to medications such as phenylpropanolamine (Proin), estriol (Incurin), and others.
- Bladder storage dysfunction – such as increased contractility of the bladder
- Neurological causes – Brain or spinal cord injury can disrupt the nerves controlling urination.
- Anatomic abnormalities – A birth defect such as ectopic ureters (abnormal location of the tubes that carry urine from the kidneys to the bladder) can cause urine leaking or dribbling.
- Urine retention – If an animal is not urinating for some reason due to stress, behavioral issues, or a partial urinary obstruction (eg from bladder stones), the bladder can become overly full and begin to leak urine.
- Cognitive dysfunction and aging – Older dogs may develop dementia and be unaware that they are urinating. The muscles of the bladder and urethra may also weaken with age. If a dog is painful due to arthritis or other conditions it may also affect their ability to urinate normally.
Other conditions causing changes in urination:
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- Urinary tract infection, cystitis (inflammation of the bladder), or bladder stones – These conditions can cause a strong urge to urinate, frequent urination, blood in the urine, and urinary accidents in the house. A urinary tract infection can also exacerbate incontinence.
- Polyuria/polydipsia – This is a term for increased thirst and urination. It is a symptom of several disease processes such as diabetes, kidney disease, and Cushing’s Disease. While this does not technically cause incontinence, it can present with similar symptoms such as urinating more frequently, urinating large amounts, and having urinary accidents in the house.
Other possible causes of urine scald include debilitating systemic disease causing a dog to lie in a puddle of urine for long periods of time, obesity causing urine to pool in the skin folds, or even abnormal posture when urinating in an otherwise normal dog.
Do You Need to Worry about Dog Urine Scald?
Yes, while urine scald alone is unlikely to be fatal, it is a significant source of pain and discomfort for your dog, and something that requires veterinary treatment. Not only will your vet need to prescribe topical or oral medications to treat this condition, they will also address the underlying issue that has led to urine scald in the first place. This is critical to help keep your dog comfortable and prevent a recurrence. If left untreated, the infection does have the potential to spread and affect your dog’s overall health.
How Can the Vet Help with Dog Urine Scald? How Much Will It Cost?
What you Should Know Before the Vet Visit
Before your veterinary visit, be prepared to answer questions about your pet’s history. Your vet will want to know what diet your dog is eating and if they are taking any medications or supplements. They will likely ask detailed questions about your dog’s urinary habits to help determine if your dog is leaking urine unintentionally or urinating inappropriately for another reason. Ask your vet if they would like you to bring a urine sample or if they would prefer to collect one in the clinic.
Urine scald itself can be diagnosed by your vet based on a physical exam and history. However, as urine scald is always due to an underlying issue, your vet will want to get to the bottom of why it is occurring. This process will likely include additional testing such as:
- Bloodwork ($80-$200) – to help evaluate your dog’s overall systemic health. If long-term medications will be needed it is also important to have baseline bloodwork prior to starting them, and to recheck as recommended by your vet.
- Urinalysis +/- urine culture ($70-$200) – If a dog has a urinary tract infection, bladder stones, or another urinary issue it can exacerbate urine scald, therefore this is an important part of the workup.
- X-rays ($150-$250) – to help look for the presence of bladder stones and orthopedic issues such as arthritis in the hind limbs and vertebrae.
- Ultrasound ($300-$600) – may be indicated for a more in-depth look at internal organs including the bladder for the presence of sludge, bladder wall thickening, or masses
- Neurological exam and testing (pricing varies widely) – may be performed if a neurological disorder is suspected
- Skin cytology +/- culture ($50-$200) – If a deep infection is present secondary to urine scald, looking at a sample under the microscope or submitting a sample for culture to grow any bacteria present can help determine the cause of secondary infection and the best course of treatment.
Depending on the severity of the urine scald, it may be treated with topical ointments, oral antibiotics, pain medications, and at-home nursing care (see below). The average cost may range from $100 to $300 for exams and treatment only. However, if the underlying issue is not addressed urine scald will be difficult to treat and will likely continue to recur.
Treatment for Urinary Incontinence
Urinary incontinence in older dogs is a common reason for veterinary visits. There are many possible causes as discussed above, and treatment will depend on your dog’s specific diagnosis. In clinical practice one of the most common causes of urinary incontinence is urethral sphincter incontinence, often seen in older spayed female dogs. This condition is caused by decreased estrogen levels which result in weakening of the closure of the urethra and urine leakage. This condition often responds well to medications such as phenylpropanolamine (Proin) to increase urethral muscle tone, Diethylstilbestrol (DES) or estriol (Incurin) which are estrogen replacements, and others.
Other treatments depend on the underlying cause. Urinary tract infections are treated with antibiotic therapy. Bladder stones or anatomic abnormalities often require surgery. Nursing care such as frequent bathing, absorbent bedding, and doggy diapers may also be used to help manage the condition.
Treatment for Paralysis/Spinal Injury
Paralysis of the hind end may occur in dogs with intervertebral disc disease, spinal injury, or other neurological disease. If caught early treatment or surgery with a neurologist may be curative for certain conditions, however once loss of deep pain and paralysis has occurred it is likely permanent, and requires extensive management and commitment from the pet parents to help their dogs maintain a good quality of life. Nerves to the bladder exiting the spinal cord may be affected leading to temporary or permanent urinary (and possibly fecal) incontinence in these pets. This can not only result in urine scald, but frequent urinary tract infections. Many of these dogs will need to have their bladder expressed at home. If this is not done frequently enough urine can overflow and leak as well.
Treatment for these pets involves extensive at-home nursing care to avoid urine scald, bed sores from laying in the same position, and skin injuries from dragging their back limbs. Some animals may use a cart or otherwise allow their owners to support their hind end. Referral for physical therapy may also be beneficial to help maintain muscle strength.
How You Can Help Your Dog At Home
While this is a condition that requires veterinary attention, there are many things that can be done at home to help manage and prevent recurrence. Recommendations will likely depend on the underlying cause and should be discussed with your vet. If you are dealing with a dog with urinary incontinence or paralysis the following may be helpful:
- Keeping the area clean and dry is critical.
- If your dog is licking at the area they will need to wear an E-collar.
- Clipping fur in affected areas may help with ease of cleaning and treatment.
- You may need to bathe your dog every few days to help maintain cleanliness, decrease odor, and help prevent urine scald. As frequent bathing can lead to dry skin, be sure to use a gentle or moisturizing canine shampoo. You should also frequently spot clean areas where urine scald tends to occur, including around the genitals, hind limbs, and abdomen, with warm water and doggy shampoo, baby wipes, or Malaseb wipes.
- Consider a doggy diaper to help catch and absorb urine leaks – be sure to change it frequently so that a wet diaper does not sit on your pup’s skin for too long, further exacerbating the problem.
- Place puppy pee pads or other absorbant/moisture-wicking padding in areas where your dog lays or sleeps.
- Apply topical products as recommended by your vet. There are a wide variety of products that may be helpful such as Cavilon barrier spray, malaseb cleaning wipes, silver sulfadiazine, and vaseline:
These products can help treat urine scald as well as provide a protective barrier to prevent urine from directly contacting the skin. Some vets recommend A&D or Desitin cream, however as these products contain zinc which can cause toxicity in dogs, they should only be used under the direct guidance of a vet.
How Long Does it Take for Dog Urine Scald to Heal?
Urine scald may be difficult to treat in some cases, until the underlying issue is resolved. If a dog continues to leak or dribble urine onto their skin, it will be more difficult to keep the area clean and dry, which is necessary for the urine scald to heal. Therefore, at-home nursing care is critical.
It can take several weeks for skin infections to fully heal. Urine scald may be especially difficult to treat because until the underlying issue is addressed, urine will continue to contact the skin in the same area. Keeping the area clean and dry and following your vet’s treatment recommendations is the best way to help your dog recover from this condition.
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