Q: My two-year-old Maltese recently wet her bed in her sleep. She’s completely housetrained and even did her potty before bedtime. There was no blood in her urine, but she’s never lost control of her bladder like this before—especially not in her bed and not in such huge amounts. Could this be a urinary tract infection and if so, what other signs should I look out for?

A: Typically, the signs of a urinary tract infection include frequent urination but in small amounts; sometimes straining to urinate; and/or urinating with blood. As there was no blood in her urine and this is the first time she’s wet her bed to this extent, there might be other reasons behind her incontinence. These include a weak urethral sphincter (for spayed or desexed female pooches), congenital causes like ectopic ureters in younger dogs, weak bladders and short urethras that might occur in some female dogs.

It would be helpful to get more information on the dog, such as whether she’s lost control of her bladder previously—no matter how small the amount—and whether she was awake or asleep when it happened. For example, if she was sound asleep, it might be due to a condition called urethral sphincter mechanism incompetence (USMI). I would normally recommend an examination of the dog and at least a urinary analysis as part of the process for investigation of urinary incontinence.

There are several treatments for this condition. Firstly, you can give your dog medical support by hormonal supplementation if the cause of the urinary incontinence is muscle weakness. Depending on the type of ectopic ureters (whether it’s within or beyond the bladder wall), you can consider sending your dog for surgery or minimally invasive endoscopic laser ablation. For furkids that have weak bladders or short urethras, it might be more challenging due to conformation problems. As for USMI, there are surgical options, such as operating on the urethra or urethral collagen bulking, which is a minimally invasive endoscopic procedure.