What is fecal incontinence?
Fecal incontinence occurs when a loss of control of the lower bowel and rectum allows feces to be passed at inappropriate times or places. Fecal incontinence may be neurogenic in origin and associated with the failure of nervous sensation. In these cases, the animal does not realize that it is defecating and does not assume a normal posture for defecation. By contrast, some animals have urge incontinence. That occurs with uncontrolled and strong urges to defecate. In these cases, the animal acutely needs to defecate and is aware of that need.
Diseases of the nerves in the lower spine, of the rectum and anus, and of the large intestine can all result in fecal incontinence. Diseases of the nerves in the lower spine include intervertebral disc disease and chronic arthritic changes to the lower spine. Urge incontinence can result from inflammation of the colon or rectum. Some older animals develop incontinence from a decline in their mental status, which leads them to become less attentive to many aspects of daily life.
The major sign is passing the feces at inappropriate times or places. Passing feces while walking, leaving bowel movements on the floor after rising and continued dribbling of feces while being unaware of the defecation are typical of neurogenic fecal incontinence. With aged animals, loss of awareness of whether they are inside or outside with indiscriminate defecation and a variety of locations is often indicative of senile cognitive dysfunction.
Examination of the rectum and anus with a gloved finger is usually done to check the strength of the rectal sphincter and the presence of masses or other diseases. Routine laboratory tests and X-rays of the spine are performed to rule out underlying causes.
If a primary cause of the incontinence can be identified, your veterinarian may recommend surgery. Animals with fecal incontinence from colitis generally respond well to changes in diet and/or anti-inflammatory drugs. Animals with fecal incontinence from cognitive dysfunction may be treated with drugs that stimulate mental activity, though those treatments do not produce a reliable positive response. No effective treatment is available for some forms of neurogenic incontinence.
Prognosis varies widely, depending on the cause. Animals with urge incontinence from lower bowel disease have a good prognosis once their condition is controlled. Prognosis for incontinence resulting from cognitive decline or neurological disease is more variable and generally poor.
Dr. Karsten Fostvedt is a veterinarian at St. Francis Pet Clinic in Ketchum.