I was treating a young patient with MS, who I noticed was incontinent while I was treating them. They seemed unaware of this and I approached my supervisor about this, to ensure I handled this the most discreet and appropriate way. I was told that I should try to hint towards it by offering to take the patient to the toilet, and did so, but she did not catch on. The supervisor then advised me to ignore it (as it was not that obvious, if you get my drift), and hope it was a one off.
At the next treatment the same thing happened. I had to talk to her about it, and I absolutely dreaded it! I started by telling the patient that I did not want her to feel embarrasses or offended by what I was going to say, and then I told her (at the end of or treatment session), as delicately as I could, and asked her if she could look into preventing this, and that I was more then happy to offer a referral or some advice if she would like. No matter how I said it, it was extremely awkward, and I could tell that the patient was very flustered and embarrassed, muttering that they don't normally suffer from incontinence and that it wouldn't happen again.
The patient cancelled their next appointment, and has not re booked as yet. Initially I felt that I should have just ignored it, perhaps wrote a letter to their GP, as they were doing so well with their physio, and I'd hate to think that this incident would prevent them from getting much needed physio treatment. However, I came to the conclusion that I did the right thing (plus my supervisor had asked me to). It would have been unhygienic for me and the patient, and as embarrassing and upsetting as it is, the patient must take responsibility for their disability/health and be respectfull of others that could be affected by them.
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I had a similar experience when treating an unhygienic patient, however the approach was different. My supervisor and I decided not to raise the issue with the patient, considering that he lives alone at home, and it is an issue that the patient would not be able to avoid/improve, and no other places we could really refer him to. So I had to put up with it everytime I saw him, even though he really smells (8/10 scale). In your situation, I think it is very brave of you to discuss this sort of sensitive issue with your patient, even though she canceled her appointment, I think you've definitely done the right thing!
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