Q. Our old sheltie, Rona, doesn’t get up every time she needs to pee, so she ends up getting lots of bladder infections. She’s on a drug that helps keep her from leaking urine and she gets antibiotics every time she gets an infection, but I’m worried that we’re not doing enough.

It’s common for older pets to suffer incontinence issues. It’s also common for them to get urinary tract infections when they become incontinent. However, if Rona’s getting these infections often, there’s probably more you can be doing.

Pets can get urinary tract infections for lots of reasons, including bladder stones, tumors, skin infections, spinal diseases and hormone-related incontinence. Old-age issues like arthritis and dementia can also be a factor when dogs lose their ability to eliminate as they once did. It’s important to rule out as many causes as possible before embarking on a course of treatment, especially antibiotics.

An analysis of the urine’s bacterial composition is essential to determine which antibiotics will work best. As far as other drugs go, it sounds as if you’re already using Proin, a commonly prescribed drug for hormone-related incontinence to help tighten the bladder sphincter. Increasing the dose is sometimes helpful, but only in otherwise healthy pets.

It’s become popular to use cranberry juice in cases of chronic urinary tract infections. Cranberries contain compounds that are thought to help keep certain bacteria from attaching to the wall of the bladder. Studies are ongoing, but the effectiveness of this supplement is questionable. Meanwhile, vitamin C can actually make things worse by accelerating the formation of calcium oxalate stones.

Given the limitations of drugs and supplements, it’s always best to concentrate your efforts on making sure you’re treating the underlying cause of these infections.

Dr. Patty Khuly has a veterinary practice in South Miami and blogs at www.dolittler.com. Send questions to khulyp@bellsouth.net, or Dr. Dolittler, Tropical Life, The Miami Herald, 1 Herald Plaza, Miami, FL 33132.