When a dog on prednisone starts having accidents in the house, it can be both confusing and concerning.
Prednisone is a powerful steroid medication used to manage inflammation, allergies, and autoimmune diseases—but one of its less pleasant side effects can be urinary incontinence.
We outline the common causes of incontinence in dogs on prednisone, what you can do at home, and when to seek veterinary help.
Dog Prednisone Incontinence — Why It Happens
Incontinence in dogs taking prednisone usually occurs because the medication affects hormone balance, muscle control, and the body’s ability to retain water.
Prednisone acts as a corticosteroid that suppresses inflammation, but it also increases thirst and urine production. As a result, your dog may struggle to hold their bladder or may urinate more frequently.
In some cases, underlying conditions—such as urinary tract infections or Cushing’s disease—can worsen the problem. Age, dosage, and duration of prednisone therapy also play a role in how severe the incontinence becomes.
Dog Prednisone Incontinence: Common Causes
Increased Thirst and Urine Production
Prednisone increases a dog’s thirst (polydipsia) and urine output (polyuria) as part of its systemic effects on metabolism. This means your dog drinks more water than usual and, naturally, has to urinate more often.
Even well-trained dogs can have accidents indoors because their bladder fills faster than usual. This isn’t true incontinence in the neurological sense—it’s more of an overflow issue.
However, if your dog can’t make it outside in time or begins to urinate in their sleep, it can feel like genuine bladder control loss.
This effect is dose-dependent—higher doses or long-term use increase the likelihood of accidents.
Read more: Dog Losing Weight on Prednisone (Here’s why)
Weakening of Bladder or Sphincter Muscles
Over time, prednisone can cause mild muscle wasting due to its catabolic effects. When the pelvic and bladder sphincter muscles weaken, a dog’s ability to “hold it” decreases.
Older dogs are particularly vulnerable because age-related muscle loss compounds the problem. Female spayed dogs may also be more prone to sphincter mechanism incontinence, which can be worsened by steroids.
This can manifest as small leaks while resting, sleeping, or even after standing up suddenly.
Urinary Tract Infection (UTI)
Prednisone suppresses the immune system, which can make dogs more susceptible to infections—especially UTIs. When bacteria colonize the urinary tract, it causes inflammation, urgency, and leakage.
If your dog is straining, licking their genitals more than usual, or passing cloudy or bloody urine, a UTI could be the underlying issue. In these cases, prednisone’s side effects can disguise early symptoms, allowing the infection to worsen unnoticed.
Cushing’s Disease
Prednisone mimics cortisol in the body, and long-term use can trigger symptoms similar to Cushing’s disease (hyperadrenocorticism). Dogs with Cushing’s often show signs like increased urination, thirst, panting, and muscle weakness.
When this steroid overload occurs—either from medication or from the body itself—it can disrupt normal hormone regulation, leading to frequent urination and accidents.
Dogs on prolonged prednisone treatment should be periodically monitored for these signs, as steroid-induced Cushing’s can become a chronic issue requiring medication adjustment.
Diabetes Mellitus
In some dogs, prednisone can raise blood sugar levels by promoting insulin resistance. Over time, this may trigger diabetes, especially in older or predisposed dogs.
Excess glucose in the blood spills into the urine, pulling water along with it—causing the dog to urinate excessively and become dehydrated. You might also notice weight loss despite increased appetite.
If your dog’s urine smells sweet, or they’re losing weight while on prednisone, diabetes should be ruled out with a blood test.
Age-Related Hormonal and Muscle Changes
Senior dogs often experience incontinence simply due to aging. When combined with prednisone’s side effects, the issue becomes more pronounced.
Loss of muscle tone in the urinary tract, reduced hormone levels (especially estrogen in females), and slower kidney function all contribute. Even a mild steroid dose can tip the balance, causing previously minor leakage to become a frequent issue.
Read more: Dog Weak Hind Legs Prednisone (Here’s why)
What to Do If Your Dog Is Experiencing Prednisone Incontinence
If your dog has started having accidents while on prednisone, the first step is to speak with your veterinarian before making any changes to medication. Prednisone should never be stopped abruptly, as it can cause adrenal crisis—a potentially life-threatening condition.
At home, increase your dog’s opportunities to go outside. Offer bathroom breaks every 2–3 hours, especially after drinking, eating, or waking up. Some owners find success using washable dog diapers or waterproof bedding until the dosage is adjusted.
Encourage hydration, even if accidents are frequent. It may seem counterintuitive, but restricting water can lead to dehydration and urinary tract infections.
Instead, talk to your vet about adjusting prednisone dosage or transitioning to a lower-impact steroid like budesonide.
If a urinary infection is suspected, your vet may recommend a urinalysis and prescribe antibiotics. Incontinence caused by sphincter weakness may respond to medications such as phenylpropanolamine (Proin) or hormone replacement therapy in spayed females.
Also consider lifestyle support: maintain a stable routine, keep your dog’s sleeping area clean and dry, and avoid scolding them for accidents—they can’t control it.
When to Call or Visit Your Vet
Contact your vet if your dog’s incontinence is sudden, severe, or accompanied by other symptoms such as lethargy, vomiting, or excessive panting.
If you notice blood in the urine, pain while urinating, or signs of discomfort, these may indicate a urinary tract infection or bladder stones. Immediate testing is warranted.
You should also call your vet if your dog’s accidents persist even after lowering the prednisone dosage, or if they’re losing weight, drinking excessively, or seem weak. These may point to more serious metabolic effects like diabetes or Cushing’s disease.
Lastly, if your dog’s prednisone was recently discontinued and they’re now weak, vomiting, or lethargic, contact your vet right away. This could signal adrenal insufficiency, which is a medical emergency.
Read more: Dog Acting Weird on Prednisone (Behavioral side effects explained)
Key Takeaway
Prednisone incontinence in dogs is often temporary, but it can be distressing for both the pet and owner. The medication alters thirst, urine production, and muscle control, making bladder management harder—especially in older dogs.
Never adjust or stop prednisone without veterinary guidance. With your vet’s help, you can manage dosage, rule out infections, and provide comfort until your dog’s system stabilizes.
With patience, regular outdoor breaks, and the right medical adjustments, most dogs regain control and continue their treatment safely.