Living with Canine Fecal Incontinence

Practical Tips to Reduce Accidents and Make Life Easier

Fecal incontinence is the involuntary passage of stool. It is not a disease itself, but rather a sign of an underlying problem such as age-related muscle weakness, nerve damage, spinal disease, cognitive dysfunction, chronic diarrhea, anal sphincter injury, or gastrointestinal illness. While complete control is not always possible, many dogs can experience fewer accidents and a much better quality of life with the right combination of medical care and home management.

Improving Stool Control

One of the most effective ways to reduce accidents is to produce firm, well-formed stools that are easier for the anal sphincter to retain.

• Feed a consistent, high-quality diet.
• Ask your veterinarian whether adding soluble or insoluble fiber may help your dog.
• Treat diarrhea promptly—loose stool is much more difficult to hold.
• Keep your dog well hydrated.
• Never stop prescribed medications without veterinary guidance.

If your dog strains, has blood in the stool, loses weight, or develops a sudden change in bowel habits, schedule a veterinary examination promptly.

Helping Your Dog Hold It Longer

Although many dogs cannot regain perfect continence, you can often reduce accidents by establishing a predictable routine.

• Take your dog outside first thing in the morning, after every meal, after naps, and before bedtime.
• Increase the frequency of potty breaks if accidents tend to occur between outings.
• Gentle daily exercise often stimulates bowel movements outdoors rather than indoors.
• Learn your dog’s “schedule.” Many dogs defecate within 15–45 minutes after eating.

If accidents occur mostly overnight, a late-evening walk can make a significant difference.

Making Your Home Easier to Manage

Even with excellent medical care, occasional accidents are common.

Helpful strategies include:

• Restrict access to carpeted areas when unsupervised.
• Use washable runners or waterproof floor coverings.
• Place easily cleaned bedding in your dog’s favorite resting areas.
• Consider washable dog diapers or protective garments if recommended by your veterinarian.
• Keep enzymatic cleaners available to completely remove odor and discourage repeat soiling.
• Keep disposable gloves, paper towels, and cleaning supplies together in a convenient “accident kit.”

Many owners also find that keeping the dog in rooms with tile, vinyl, or sealed flooring dramatically reduces stress.

Work With Your Veterinarian

Successful management begins with identifying the underlying cause. Depending on your dog’s condition, treatment may include medications to improve stool consistency, therapy for gastrointestinal disease, treatment of neurologic disorders, management of arthritis that limits mobility, or surgery in select cases.

Remember that dogs with fecal incontinence are not being stubborn or spiteful. They often have little or no awareness that stool has passed. Patience, routine, and thoughtful environmental management can greatly improve both your dog’s comfort and your family’s daily life.

With a customized treatment plan and realistic expectations, many dogs with fecal incontinence continue to enjoy happy, active lives while their owners successfully minimize accidents.

Anal sphincter atony is one of the more frustrating causes of fecal incontinence because the problem isn’t that the dog can’t make stool—it’s that the sphincter can’t maintain enough resting tone to keep it in. The goal becomes either improving sphincter function (if possible) or making the stool easier to retain.

1. Confirm the diagnosis

Before assuming sphincter atony, I would rule out:

• Sacral spinal cord disease or cauda equina syndrome
• Pudendal nerve injury
• Previous anal surgery (especially bilateral anal sacculectomy)
• Trauma
• Perineal hernia
• Rectal masses
• Severe cognitive dysfunction in geriatric dogs

A digital rectal exam is usually very revealing—the resting sphincter tone is simply absent or markedly diminished.

2. Optimize stool consistency (probably the single most important step)

A firm, formed stool is much easier for a weak sphincter to retain.

• Highly digestible diet
• Moderate fiber (tailored to the patient)
• Psyllium or canned pumpkin in some dogs
• Probiotics if indicated
• Prompt treatment of any diarrhea

Loose stool will leak through even a moderately functional sphincter.

3. Empty the rectum on a schedule

This is one of the most effective management techniques.

Some owners learn to:

• Walk the dog after meals
• Use gentle rectal stimulation with a lubricated thermometer or cotton swab
• Perform manual evacuation in dogs with severe disease

If the rectum is empty, there is nothing to leak for several hours.

4. Increase bathroom opportunities

Instead of three trips daily:

• Every 4–6 hours
• Immediately after meals
• Before bedtime
• Immediately upon waking

This often decreases indoor accidents dramatically.

5. Environmental management

These dogs often do very well with:

• Washable bedding
• Waterproof mattress covers
• Easy-clean flooring
• Dog diapers (changed frequently)
• Baby wipes for hygiene
• Barrier creams around the perineum (zinc oxide should be avoided if the dog may lick it)

6. Treat any underlying neurologic disease

If there is:

• Degenerative lumbosacral stenosis
• Cauda equina syndrome
• Sacral nerve compression
• Trauma

Treating the primary problem sometimes improves continence.

Are there medications that tighten the anal sphincter?

Unfortunately, unlike urinary incontinence, there isn’t a consistently effective drug that reliably increases anal sphincter resting tone in dogs.

Various medications have been tried, including:

• Phenylpropanolamine
• Ephedrine
• Imipramine
• Bethanechol

Results have generally been inconsistent, and none has become standard therapy specifically for anal sphincter atony.

Surgical options

For severe, refractory cases, referral to a surgeon may be worthwhile.

Reported procedures include:

• Anal sphincteroplasty
• Muscle transposition procedures (using nearby skeletal muscle)
• Artificial anal sphincters (rare, experimental in veterinary medicine)

Success rates vary, and these surgeries are uncommon.

Emerging therapies

Small studies and case reports have explored:

• Electrical stimulation
• Pelvic floor rehabilitation
• Stem-cell therapy
• Regenerative medicine approaches

These remain investigational but may become more important over time.

Prognosis

If the anal sphincter has been permanently denervated or severely damaged, complete recovery is uncommon. However, many dogs can achieve good functional control through a combination of:

• Firm stool production
• Scheduled rectal emptying
• Frequent opportunities to defecate
• Careful environmental management

In my experience, dogs with true anal sphincter atony often improve more from managing the stool and the schedule than from medications. A dog that leaks several small stools a day may become nearly accident-free if the rectum is emptied consistently and the stool remains firm.