Two dogs on a bed.

Why Is Your Dog Peeing on the Bed? Taking a Look at Hormone-Responsive Urinary Incontinence

A syndrome called hormone-responsive urinary incontinence is a common cause of a dog peeing on the bed — at least in middle-aged, spayed female dogs. Let's find out more about it here.
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I recently received this question by way of Facebook about a dog peeing on the bed: My dog is potty trained and very good about going outside or tapping me to let me know she needs to go out. However, there’s been a recent bout of her wetting our bed. She often sleeps in bed with us and wets it when we aren’t in the bedroom. — Jennifer. 

Two key words — “she” and “bed” make me very suspicious that Jennifer’s dog is experiencing a syndrome called hormone-responsive urinary incontinence. The syndrome is common in middle-aged, spayed female dogs, but it also can develop in younger or older female dogs; it rarely has been reported in males.

What Is Hormone-Responsive Urinary Incontinence and Why Does It Result In a Dog Peeing on the Bed?

A dog looking up surprised from a red bed.
Is your dog peeing on the bed — whether it’s her bed or your own? Photography ©ZoonarRF | Thinkstock.

Hormone-responsive urinary incontinence typically manifests as urine dribbling, which can mean a dog peeing on the bed. The dog usually is not aware that she is soiling the house, and the issue is not a behavioral problem. Dogs with the syndrome do not purposefully urinate in the house, and dogs with the syndrome have not lost or forgotten their house training.

Rather, they are not able to hold their urine, and it leaks out involuntarily. Urinary leakage is most likely to occur when the dog is resting or sleeping and not actively thinking about trying to hold urine in. Therefore, bedding is the most commonly soiled household material.

Dogs who are mildly affected with the syndrome typically wet only bedding, and they don’t suffer from incontinence every day. More severely affected dogs may dribble urine continuously wherever they go.

How Common Is Hormone-Responsive Urinary Incontinence?

I mentioned above that one of the main reasons for a dog peeing on the bed, hormone-responsive urinary incontinence, is common. In fact, extremely common might be a better way to put it. Some resources indicate that up to 20 percent of spayed female dogs experience (“suffer” is not an appropriate term, because most dogs with the condition aren’t aware that they have it) the syndrome.

The mechanism of the syndrome is not completely understood, but it appears to be related to the urethral sphincter, a circular muscle that, when contracted, prevents flow of urine out of the bladder. It appears that estrogen helps to potentiate the activity of the sphincter in females. Spay surgery involves removal of the ovaries, which are the body’s main source of estrogen. The decreased estrogen levels then predispose the urethral sphincter to be more relaxed, which allows urine to dribble out of the bladder. This will be especially common when the dog is relaxed and not thinking about her sphincter. Older individuals tend to have weaker sphincters (which is something we all can look forward to in the future), so the syndrome becomes more common with increasing age.

How Is Hormone-Responsive Urinary Incontinence Treated?

A senior dog sleeping on a dog bed.
Hormone-responsive urinary incontinence is common in middle-aged to older female dogs, and can cause issues like a dog peeing on the bed.  Photography by Marilyn D. Lambertz/Shutterstock.

Since the condition is linked to low estrogen levels, one might think that the treatment would involve estrogen supplementation. In fact, synthetic estrogen (in particular, a compound called diethylstilbestrol, or DES) historically has been used to treat the condition.

However, you may recall that there was quite a fad for prescribing estrogen in humans. Estrogen pills routinely were prescribed for women going through menopause, until a large study found that they did more harm than good.

It turns out that hormone replacement is a very tricky undertaking. Natural hormone levels fluctuate throughout the day, and they are balanced by a number of feedback mechanisms. Simply pumping estrogen into a person’s body is not without risk.

Therefore, although DES can be used (and, in certain circumstances — especially refractory cases — still is used) to treat hormone-responsive urinary incontinence, it generally is not a first-choice treatment. In particular, DES has been linked to blood cell problems that, if not detected, can be life-threatening.

Hormone-Responsive Urinary Incontinence and PPA

The first-choice medication for treatment of hormone-responsive urinary incontinence is a medication called phenylpropanolamine, or PPA (I have seen many clients snicker when they learn that the treatment for the condition sounds like the word “pee pee”).

PPA is not a synthetic estrogen. It is more closely related to adrenaline, which is in a category of substances called catecholamines. PPA once was widely used in humans as a weight loss medication — it was the active ingredient in Dextrim. In humans, the product has been linked to a possibly increased risk of stroke. No such link has been found in dogs.

PPA is still available for dogs, although the US Drug Enforcement Agency, in its rabid (and utterly ineffective) attempts to eliminate methamphetamine from the world, sometimes threatens to reduce its availability (PPA can be used in the making of methamphetamine). For now, however, the product remains available for veterinary use.

Although the above paragraphs may make PPA sound scary and dangerous, most dogs do not experience any side effects from the medication, and there are no common long-term health risks associated with PPA use in dogs. Most dogs who take it simply stop dribbling urine or wetting the bed and otherwise go on with their lives.

Although PPA usually is safe, as with any chronic medication I recommend using the minimum effective dose. Some dogs with hormone-responsive urinary incontinence do not require PPA every day. Some dogs experience incontinence in an intermittent fashion, and require the medication only a few times per year. Other dogs grow out of (or into) their incontinence. The medication should be used only as needed.

The Bottom Line on How to Help a Dog Peeing on the Bed

Jennifer, a dog peeing on the bed will likely stop if you treat her with PPA. But before you do, I recommend that she undergo blood and urine testing. Sometimes other medical conditions, such as bladder infections, diabetes, kidney disease, and certain glandular disorders, may result in a dog peeing on the bed. If she tests negative for these conditions, then she likely has hormone-responsive urinary incontinence.

Tell us: Is your dog peeing on the bed? What was the issue at hand?

Thumbnail: Photography by manugo/Thinkstock.

Read more on dog health on Dogster.com:

25 thoughts on “Why Is Your Dog Peeing on the Bed? Taking a Look at Hormone-Responsive Urinary Incontinence”

  1. Jeannette Harris

    We have a 15yr old Jack russellX. She has been dianosed with a 5heart murmur and is on medication for that. 2yrs ago she had a type of seizure and wet the bed. 6mths later it happened again. We took her to the vet, she was given an examination and found with no health problems. A few months later she developed a barking seal like cough. This is when we were informed about her heart murmur. Every night we take her out to toilet her before bed,again during the night if she gets restless. Early hours of the morning she is in a deep sleep and soaks the bed in urine. Thank goodness for waterproof mattress protectors. During the day she will happily go into the yard to pee it is only at night she wets the bed or wets on my pillow as she likes to sleep behind my head. She was speyed at 16wks of age. What can we do?

    1. Take your baby out at nite.just as you would potty training a human child.hoofully it will due well.im no professional just another dog owner.god bless

  2. Hi,
    I have a 1 year 3 month old beagle who is neutured.. he dribbles all the time a d wets his bed..tried all kind of medicines and consulted multiple vers but there seems to be bo solution..
    from bladder infection to behavioral issues..nothing seems to stop it..
    please help or suggest if you know what this is..
    we have seen this before and after neutering..

    thanks..

  3. My husband and I recently adopted a 12 week old English Mastiff. From what we were told, she was locked in a barn stall for the last 4 weeks before coming to us. The previous owners became frustrated as they stated she was not potty training successfully.
    After we adopted her we noticed she was having accidents in our house, but only while she was sleeping. When she’s awake, she’s able to let us know she has to go out. We brought her to the vet and she tested positive for a UTI/ bladder infection. She’s been on antibiotics for 6 days now but her bed wetting has worsened.
    Any suggestions on what this could be and what more we can do? She’s wetting all over our carpeting and her bedding daily. The vet thinks it could be an underdeveloped urinary sphincter or urethra. I’m at a loss of what to do. Doggy diapers have not worked, she leaks out of those every time. Any help is appreciated. Thank you

  4. I took my puppy from a dog foster home about a year ago. I love him to bits; he has a great personality, and I feel that he loves our family so much. BUT, whenever I leave him at home he pees in the house: on the carpet, on the bed, on flowers… My husband and I were thinking about taking him to ‘doggy school’, but then again, it’s extremely expensive, and the nearest ‘doggy school’ is far away from us. Maybe you have some advice? THANK YOU!!!!

    1. Hi there,

      Please ask your vet and look into pro trainers in your area. These articles might provide some insight, too:
      https://www.dogster.com/dog-training/how-to-deal-with-your-dog-peeing-in-the-house
      https://www.dogster.com/dog-training/dog-accidents-what-to-do-when-your-pup-forgets-his-potty

  5. My dog will occasionally pee in our bed. I’ve caught her twice and it seems to happen when she is “nesting” I was wondering if the feeling of the brushing between her legs as she moves the covers around could stimulate her to go, similar to when a puppy is stimulated?

  6. I just adopted a 10 month old dog from the shelter. I take him outside every morning, afternoon and night and many times in between. There are times we are outside for 20-40 minutes. As soon as we come inside and he is in his crate or on his bed, he will pee. I am not sure what else to do. It’s driving me nuts and I am washing his sheets or bed everyday. What else can be done? Is this normal?

    1. I’m just an average person here .I’m no Doctor or professional of any sort except a professional house painter.i just happened to be in this area due to my senior female dog peeing in her bed.soim wondering sense you rescued your pet from a pound,and I think it takes pets a while to get over trama.alsonot knowing the back ground of your pet not everything I’m sure, only what they knew at the place you gotten her or him from.
      Anyway..some times you must stand back from the stressor your issue or issues to try and see a bigger picture.
      1.) A pound is full,loud and smells of other dogs and different dents of urine of all those dogs as well. Not telling how often they where let out of the kennel either .which may not have happened at all.the ppl that work there have there hands so full already.and they do have drains in those kennels for a purpose and reason to pee n poop.when the dogs go out it’s to have there kennel cleaned from the waste. So it maybe that and I’m not sure how long your pup was there so at 10 months this is how it was potty trained.it may take a good min .to brk it from this cycle. So what I WOULD do which area few options so are with me plz.
      I would feed my pet , making sure it has all it can eat this is your helper the full belly of food n when done eating I will wait 10 to 15 min.and let them out to go and release their self.but try and wait it out let them walk how ever long to get the bowls to move.but that pet will have to go poop either way because that food is pushing its way out regardless right just as us humans.when it finally does what it needs to your half way home.just repeat everyday.your showing your pet it’s not the kennel anymore it new rules new home n praise your pet for it.try not to stress or show anxiety they read it n mirror your feelings.which can cause them to hold it all in due to nerves.
      2.) Take them out every 1/12 hrs . trying to give you peace of mind on having to always clean soild bed clothes.its extra work but it will help.when you go to work and if you have no one home give them enough water until your arrival back home.that way it’s less likely to need to urine so much in the kennel til you get home. But take them out when I get home.dogs are feed once a day .if you work in the day feed it at nite.that way it’s not pooping in the kennel.or you can but a large out side kennel that allows some yrd.in it fenced.for it to stay out side while your gone at anytime and it can learn to poop out side in that manner.
      3.) Do you let it play out side?do you play with your pet? Could simply be their nerves at new place.if so play with it to relax them and then she should relax enough to stop and go while you play.if your pet doesn’t get out enough to just relax you may want to change that.which could be very healthy for the both of you.and not knowing what their life or environment was bfor the kennel maybe at hand but try to connect n not show frustrated action or any type of disappointed ways toward them.praise it when you see the smallest try. So they know that’s the path to make you happy.and just that alone you should see a difference.as i mentioned I’m no professional but I have 2pets both were found starving.so me and my husband took them in.and it all trial and error as you both get know each other.but try and always put your self in your dogs eye and what it ma be like to be them at that very moment and what you would need to help you sense your pet can’t speak but only through eye gesture and actions.just try getting to know each other is slot of stress for both of you.and work your life to theirs n theirs to yours.its a relationship of trust and security is what your goal is at the moment n the rest falls into place.
      God bless I hope I’ve helped even just a small portion.

  7. My dog is a male, about 16 weeks. He is learning to go outside but he knows not to pee in the bed. He drinks a lot but he’s older brother did to, until he was older. Trouble has just started peeing the bed, if I get up & put him out early, he want do it. Last night it turned cold & he didn’t stay out long enough to do his business.

  8. My Cow dog came as a stray and is very afraid of everything and will not ride in the car. She has started about a year ago wetting on all rugs and her bedding. She has been sprayed, we are desperate to find out what is wrong with her, she’s ruining everything.

  9. I have a male pit bull 11.5 years old and about 2 months ago he started kind of dribbling sometimes when he went out to pee. Now he has peed his bed the last 2 nights. Is a male dog susceptible to this as females are?

    1. Hi there Dave,

      Thanks for reaching out! This article will provide you with more information to answer your question: https://www.dogster.com/lifestyle/how-do-i-prevent-my-dog-from-leaking-urine

  10. Pingback: Here’s Why Your Dog Pees The Bed…It’s Not What You Think

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  12. I have a 9 month old mini aussie and he is potty trained but will pee on my bed at times. He did it a couple of times before being fully trained but has been fully trained for a couple of months now. I have never had a dog do this so I am not sure how to stop it.

  13. I have a 5 1/2 year old spayed girl. She currently has a UTI and has been on antibiotics for the past 5 days. She just peed in bed for the first time ever. I’m hoping it’s because of the UTI and med combo and clearing itself out. My other male dog had the same issue out of the blue at 10 years old and found out he had diabetes. I don’t want the same for her. Calling vet in the morning for their opinion.

  14. After a visit to the dog hospital turns out my dog had a low red blood count and once that was sorted she has not wet the bed since and the nappies are gone too.I suggest taking your dog to see the vet.

  15. Chris have you had her checked for diabetes – since you mention she drinks more than you expect? Another reason they will pee the bed is seizure.

  16. Pingback: Why Is Your Dog Peeing on the Bed? Taking a Look at Hormone-Responsive Urinary Incontinence –

  17. I have a 3 year old rescue girl who was spayed very young.
    She urinates in her bed when she is in a deep sleep. I have also noticed drips of urine at other times.
    She is housetrained and asks to go out so this is accidental.
    She has been tested for everything under the sun and has had an ultrasound to check her kidneys. All is fine.
    The only problem is that she also drinks more than I would expect and her urine is quite dilute.
    She is gets a lot of exercise and is very well otherwise.

  18. Our dog was a 4 yr old spayed pit bull lab mix. She had anxiety issues. She never peed on the beds till she turned 3. Peeing large amounts on any bed thar was available. We had to keep all the doors shut. This occurred once a week to once a month. No pattern. I wonder if female dogs maybe should not be spayed till they go through a heat cycle. By postponing the surgery it allows their body to mature more.

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