Updated September 25, 2026. Fact-checked against veterinary sources; review by a licensed veterinarian is in progress. See our editorial policy.
Quick answer: When a house-trained dog starts having accidents, a vet visit comes first, since urinary infections, incontinence, diabetes, Cushing’s disease, kidney disease, digestive problems, and cognitive decline are common causes. If medical causes are ruled out, behavioral causes like incomplete training, anxiety, marking, or changes at home are addressed with retraining, not punishment.
Medical causes
- Urinary tract infections or bladder stones
- Urinary incontinence, especially in spayed females while sleeping
- Diabetes, Cushing’s disease, or kidney disease (increased urination)
- Diarrhea or other digestive problems
- Arthritis making it hard to get outside
- Cognitive decline in senior dogs
Behavioral causes
- Incomplete house training
- Marking, often on vertical surfaces
- Separation anxiety or fear
- Changes in routine or a new pet
- Submissive or excitement urination
Retraining tips
- Frequent trips outside, especially after meals, naps, and play
- Reward immediately for going outside
- Supervise indoors or use a crate for short periods
- Clean accidents with an enzymatic cleaner
- Neutering may reduce marking
What to avoid
- Punishment, which increases anxiety and hiding
- Restricting water
- Ammonia cleaners, which smell like urine
More: UTI symptoms in dogs.
Sources
- AAHA Canine and Feline Behavior Management Guidelines. 2015
- Merck Veterinary Manual: Behavioral problems of dogs
- Merck Veterinary Manual: Urinary incontinence in small animals
This article is for general education and is not a substitute for care from your own veterinarian. Learn about The Pet Vet and our editorial policy.