An injured animal often loses
its ability to urinate. This is a critical, sometimes fatal problem
unless the caretaker knows how to manually cause the animal to urinate,
'expressing' the animal.
Your vet will show you how to do this and it is important that you
follow your vet's instructions carefully. This page is a discussion of
expressing and not intended to be a substitute for a vet's advice.
Your pet’s bladder needs to be completely emptied 'expressed' at least
three times a day (every 8 hours). When an animal can't walk, urine can
'pool,' sitting in the bladder. Sometimes, when you find your pet’s
it does not mean that it is incontinent or peeing in its sleep but
rather that the bladder has become so full that it is overflowing.
Following injury to the spine, or the rear area of an animal, cystitis
of bladder can become a serious threat to your pet’s health. These
infections can cause death in a few days if not treated. Bladder care
plays a crucial part in the health of your pet, whether is has had
surgery or not and whether it is completely, or partially disabled.
Here are the most common signs of a bladder problem or urinary tract
Dribbling or urine evidence. Look for a wet rear and wet bedding.
Foul odor to urine and increased licking of the genital area as
infection worsens (although licking behaviour is not always present).
Bloody or dark colored urine. Note that severe symptoms require
immediate veterinary care.
Depression, loss of appetite, and a rise in temperature as infection
Treatment of Urinary Tract Infection
Prophylactic medical treatment before signs of infection occur offers
the best route of treatment. Work with your veterinarian in prescribing
the best medication, monitoring PH, culturing the urine, and and
you how to express your pet. Urine left in the bladder can become a
where bacteria breeds.
This describes how to express a bladder... but you MUST check with
your veterinarian first.
How To Express your Pet’s Bladder
Smaller pets are easily managed by one person. Larger pets may require
two people. Extremely obese pets may require a veterinarian. All of the
photos below may be clicked on for larger views
|Support the animal in an upright
Locate the bladder. Gently do 'test squeezes' on different spots until
you identify it.
|With your right hand, feel where
the ribs end on the abdomen. Your thumb should be on one side of the
abdomen and your fingers on the other side.
GENTLY SQUEEZE your thumb and fingers together and while holding that
position, move hand towards rear of abdomen. A full bladder should feel
an inflated balloon.
The animal should lift her tail when the right spot is squeezed. This
is not painful for the dog. It is often a great relief.
|Q: Does this happen with a male
A: Yes, Waffles' tail does go up while I am expressing him. Maybe not
everytime but definitely when I get a good flow of urine going. Waffles
this thing sometimes. Both his legs start to do this crazy dance
(sometimes while I am expressing but more times when he is just sitting
around). His legs start to kick (almost seems like spasms) and he will
start to urinate in forceful squirts. Sometimes it will happen a few
times a day and sometimes it will happen once in a week. He started to
do it about 4 months from
This is the right spot (you can enlarge this picture by clicking on
Urine should be released in a fairly steady stream. When urine
decreases to a dribble, the bladder has been sufficiently expressed.
|If urine squirts out or you feel
some resistance and the urine does not stream out, then your pet may be
starting to have bladder control. Check with your veterinarian.
Expressing may not be necessary.
Here is a photo of a method that can be used outdoors.
On small pets, place one hand on either side of the pet’s side behind
the rib cage and gently squeeze your hands together.
NOTE: The bladder must be manually expressed until your pet is
able to fully urinate on its own. Having the bladder expressed at least
three times daily, every 8 hours, is a permanent nursing care necessity
permanently impaired pets
Bladder Care is often a long-term nursing care need for months or
years. The success of your nursing care program will hinge on how
effective you become in this care.
"Dont Worry!" say hundreds of messages on our message board. This
becomes so easy for you and your pet after a very short time.
Message Board Comments
Many of these comments have been posted on the discussion board at www.HandicappedPets.Net
a good place to post your questions and concerns.
Urinary: UTI's, meds, ph, etc Posted By: Anita
Date: Thursday, 7 July 2005, at 5:59 p.m.
Urinary Tract Infections
These subjects seem to always be coming up and there really isn't one
answer for everybody.
I have been this route and have learned quite a bit through my
experience. Here are some pointers and things to conside when dealing
Remember that I am not a doctor but a mom of a wonderful critter that
has been through it all.
1. Not all UTI's are the same. Each time that one is suspected a
culture should be done to see what medicine will work. They all don't
work for all infections. Sometimes you have to FORCE your vet to do a
culture but it has to be done. Ask for a copy to keep in your files at
home so that you can
look at it later if need be.
2. Make sure that you understand how to express correctly and
completely. Pooling urine is what causes some UTI's. If you are not
sure, make an appointment with the vet, express them while you are
there, then have the vet see if you got it all. It takes me less than 1
minute to express Sydney. Sometimes I can't get it all the first time
but I let her rest for awhile, them try it again. I don't give up until
I get what I beleive is all of it.
3. Keep the bottom areas as clean as possible. Roll them on their backs
daily and clean it with a baby wipe, females especially. You will be
amazed at all the yucky stuff that can build up. Just think of the
bottom of your shoes!! Get into all the folds and crevices.
4. After you express them, especially females, make sure that you wipe
them to dry them off. A wet bottom loves bacteria.
5. Try not to let them lick themselves down there (yeah right). That
brings in bacteria too.
6. Cranberry tablets are good at preventing UTI's. You need a good one,
like from a health food store or on line. Cranactin is a very good one.
Use one capsule per 20 pounds of the regular Cranactin per day, not the
super one. The ones you buy at Walmart or places like that aren't
strong enough. Solid Golds Berry Balance is good to, but it is in
form and I found it hard to give. Remember too much cranberry can cause
stones so you have to be careful.
7. You can check their ph balance and that will give you an idea what
is going on in there. A good ph balance is 6.5-7.0. Bacteria will grow
the higher numbers. You can purchase strips on line. Check the ph early
in the morning before breakfast. Certain types of foods cause higher ph
balances. You can call the dog food company and ask them what ph their
causes. They know.
8. Remember that water is very important to flush out the urinary tract
and the bladder. One good way to give water is to boil a whole chicken
in plain water (no salt). Eat the chicken yourself but save the water.
Freeze them in ice cube trays and when you feel that your baby needs
or just isn't drinking enough, put one in a bowl and add some more
put it in the micro for a few second and they will think that they are
getting a wonderful treat. If they like ice cubes, just give them the
sure that you express them about 3-4 hours aferwards. When I have been
a little to long and I know that Sydney has had a lot of urine in her
bladder I give her chicken water to flush out her bladder.
9. Anti-biotics remove the bad bacteria and the good bacteria in the
urinary tract so a good thing to give is a pro-biotic, like acidophilis
(sp). Ask at your local health food store. Yogurt is good but sometimes
not concentrated enough. Some believe that dogs should be on it all the
10. Remember that UTI's are just part of not having bladder control.
They just happen sometimes no matter how hard we try to prevent them.
If chronic UTI's are your problem ask your vet about "pulse therapy"
which is giving the meds full strength for a certain amount of days
during the week, then a few days off. I think it is 4 days on and 3
days off. Another thing that works is a daily dose of the meds for a
long period of time. I know that sounds harsh but if it keeps the
infections away it is worth it. Some people say that they will build up
a resistant to the medicine. Sometimes yes, sometimes no. If they do,
then there are a lot of different medicines out there that will work.
That is why a culture is very important.
11. Once you have the infections under control, do a culture
occasionally to make sure that it is working and to give you peace of
WHEW!! That was a lot on info. I hope you all don't mind.
Let me tell you what happened to Sydney and her UTI's. She has been
paralyzed since Sept of 2003. She went into surgery with a UTI and had
one constantly for the next year and a half. I had did it all,
Cranactin, Berry Balance,ph, cleaning, smelling, praying, etc to no
Then one day I thought that maybe it was ME that was causing the
infections because I wasn't expressing her the right way. I was here on
this board and others, telling people how to express their babies and I
wasn't even doing it the right way with Sydney myself. I wasn't
practicing what I was preaching!! I was telling the correct way but
wasn't doing it.
Well, once I realized that I wasn't doing it right I really
concentrated on doing it the right way. Boy was I surpised at how much
more urine was in there. To make a long story short, Sydney is no
longer on ANY medication and doing just fine. She is due for another
culture soon to make sure that nothing is growing. I have learned alot
through all of this and hopefully what I have learned will help you
out. Email me privately of you have any questions.
Anita and one UTI free Sydney
Expressing an animal is tricky the first few times, but gets much
easier with patience and practice. Mom expresses mimosa twice a day
even though she is not incontinent. She has trouble getting in and out
of a litter box, so at about the same time each day, mom picks her up
& expresses her over
Put your hand just below the ribcage and squeeze, moving down towards
the hips. You can usually feel the bladder as a hard roundish lump. The
bladder is slippery and can get out of your grasp easily. For months
knew just when to wiggle to make us lose her bladder.
When the bladder is against the hips - and so doesn't have anywhere to
escape to - you can squeeze the urine out.
My dog can't really feel a UTI so she does not lick. I'm sure it is a
sign of cystitis (my non-disabled cat has done that when he had
but I don't know if paralyzed pets who can't feel their urogenital area
will do that.
Here are a few tips on expressing:
1) it is easier to express a pet that is not constipated.
2) it is easier to express on the bathroom counter in front of the
mirror--it saves bending and you can see what you're doing.
3) you can express straight into the sink if you pour bleach down it
once in a while.
4) be careful with a small bladder to avoid injury
The easiest way I found to do it was to hold him by his armpits so that
his bottom and legs hang free over the toilet or outside and then with
your finger trace his ribcage to the bottom of the ribcage, you should
little squishy bulb sometimes firmer depending how full his bladder is.
If you gently squeeze this between two fingers and move your fingers
down while gently squeezing them together to his bottom he should pee
freely as they say. Or her whichever the case may be... She may feel
more comfortable with her feet on the ground in this position
"standing" if she does have use of her back legs, or she might not mind
the dangling, really is experimentation on that part. If you still have
trouble don't be afraid to ask your vet to show you again, and again.
Heavy Dog: I created an "expressing station". My back porch has exposed
rafters, so we put a small metal hook in the rafter, and used clothes
line and small pulleys to hook up the line. We put a clip on one end of
the line so that we could clip it to Porkchop's walking harness and
step on the line to hold it steady.
Before expressing, check the size and location of the bladder. If it is
not too full you can feel its firm roundess and dimensions. Sometimes
is round and sometimes it is elongated. If it is quite full, all you
is what seems
like an abdomen that is big and tight as a drum.
The bladder is not in the same place every time. It depends on how full
it is and what is in the GI tract. Therefore, you are not squeezing in
exactly the same place every time.
Position your hand on the bladder and try a few gentle test squeezes,
moving your fingers a quarter-inch this way and that way patiently
you hit the spot. If you are having trouble getting started or are
only a small
dribble, try working your fingers farther up into the abdominal cavity
toward the spine so you're squeezing higher on the bladder.
Often my dog tenses and straightens her back legs just as we are ready
to begin. We wait a few seconds until she relaxes and try again.
Sometimes she tries to pull away and I allow her to do so because I
don't want to make
ordeal. Then I reposition her and try again. My vet suggested using
treats if needed.
Taking care of the bowel helps with expressing the bladder.
Jennifer uses this "ragdoll" method to express a cat.
The easiest way I found to do it was to hold him by his armpits so that
his bottom and legs hang free over the toilet. Then, with your finger,
trace his ribcage to the bottom of the ribcage, you should feel a
little squishy bulb sometimes firmer depending how full his bladder is.
Gently squeeze this between two fingers and move your fingers down
while gently squeezing them together to his bottom he should pee
freely. The animal may feel more comfortable with her feet on the
ground in this position "standing." If she does have use of her back
legs, or she might not mind the dangling. It takes some
patience and experimentation to find a way tat suits both of you.
I have not cathaterized a female dog. I was attempting to express and
cathaterize a male dog at home and all the people who where trying to
me via e-mail and phone all had female dogs, so... MAYBE I just ASSUMED
the females were easier!!( But I could have swore the vet told me they
I know that cathaterizing the male dog is tricky when you get to that
turn, as I had difficulty with it. It seemed part of my difficulties
expressing porkchop was due to the fact that he actually had muscle
and was resisiting....However, he was cathaterized at one vet and he
and it took four people to hold him down and the vet informed me of the
need to sedate, euthanize, etc... at another vet, noone had to hold him
down and he was perfectly well behaved while being cath'ed. He was even
trying to give
kisses to the vet doing the proceedure.
(In response to Beth's answer to "Does a Male dog raise his tail...)
Beth, that is so cool, because my dog does it too, but not as much. For
example, she will be sitting on her bottom like a doll with her back
legs pointing forward, and she will begin to bend one knee, then the
other, bend, straighten, bend, straighten, and a few times (like maybe
5 times total?) she has actually expressed herself a little bit. I
think it means she knows she needs to go, and if she really really
tries, she can go a little bit. The problem is, since she is sitting
most of the time, she is going to be urinating right where she is
sitting, which spoils it because she feels
like she has to scoot away from the forming puddle, so the panic
interferes with her expressing herself. I wonder if down dogs would be
to get their bladder control back better if there was just some way
could urinate *when they want to* without risk of having to sit in it.
not going to be encouraged to relearn to urinate if you're just going
wet yourself. The other thing she does routinely is when I express her,
she raises her hind feet into a dainty mid-air squat. Tail up in a
feet up in a squatting position. It's very neat. I was disappointed she
do it for our photo shoot of expressing at the vet. She was too nervous
Anway, it sounds like Waffles has some bladder control and he is
exercising it. :) It is delightful for me to read someone else
describing this. Thank you.
Re: Urinary: Does anyone here express in a cart?
I express Waffles in his cart. I stand behind him with my legs on each
side of his wheels (he uses Fixed Saddle. I put my hands inside of the
bars of the cart (from the top) and with both hands open I press both
sides of his bladder at the same time.
Question: It took me so long to figure out how to express him. It is
easy now but I still catheter him before I go to bed (I express first
then immediately catheter to see how much urine is still in him). There
is always about 6 or 7oz left. Do you ever total empty a dogs bladder?
Do you have any suggestions on how to get those last few ounces out?
Answer: I think maybe it's one of those situations where you have
limitations that I don't. My dog is female. I understand expressing
males is more technically challenging because of the curves in the
urethra. If I had your dog, I'd probably be catheterizing him too. I
wish I had a better answer. I've never tried to express a male dog.
In our case, yes I do get all of the urine out. She is small, she is
thin, I have long fingers, and I can tell by feeling if we didn't get
it all. Then we do it again to finish the job. I am keeping her skinny,
and I give her lactulose so she doesn't get constipated, which allows
me to be able to
feel what's going on in there as well as possible.
The first half a year, she was *hard* to express, but a month or two
after she started physical therapy that got better. I will never forget
the Sunday morning I was very tired and wanted to sleep in, but I set
the clock and got up to express her to keep her on schedule, intending
to go back to bed afterward. We had such a hard time, it took 23
minutes, and I was pretty wide
awake by then. Fortunately, after PT, or perhaps simply after she had
time to heal (don't know which) she became able to assist (I think?).
I could overcome the sphincter, she could help push the urine out.
I feel that most of the time we get her as empty as if she was not
paralyzed. The only thing I can think on your dog is, can you dig into
his sides and get your fingers any higher up toward the ceiling of the
bladder? If he's like my dog, he will not feel you digging.
If I describe this, it wouldn't make sense to most people, but maybe it
will to you. By pressing on her sides I can tell where her bladder is.
There is a trigger point, and when I hit it I can tell because she
tail. If I squeeze there, she will empty if I don't lose it. Also, I
to fish her bladder down into position. Sometimes it is in an
spot for squeezing. Other times is it nestled so high up near her spine
and back by her tail that I have to really dig my fingers into both
of her abdomen and fish it down into position. It sounds awful, but I'm
careful when I maneuver the bladder down, and it makes it possible to
a proper grip and do a complete express. I fish her bladder down so the
of the bladder is in my palm and my thumb and forefingers are actually
the exit end of the bladder, not the ribs end (which seems
counter-intuitive). However, it seems that her need is not for someone
to squeeze on the big full
end of the bladder near the ribs, but rather to squeeze closer to the
so it will release.
Note: The link below will take you to a
veterinary school website with a detailed and graphic tutorial on the
use of a catheter. DO NOT PERFORM THIS PROCEDURE WITHOUT THE SUPPORT OF
A VET. Improperly done, this can seriously, perhaps fatally injure your
I checked out the catheter page. I think that it was good but maybe
makes the procedure look a little more scary then it actually is. The
catheters that I use are all kept in a tube with a solution called cold
sterile. I re-use them and do not have that little finger grip thing as
shown in the photo. I also do not use a sterilized hemostat to feed the
catheter through. I just wash my hands well and then rub that
antibacterial liquid on my hands right before I grab the catheter (that
is the way I was taught by my vet). I just try to hold the catheter
back as far as I can. Anyway, so I am not as sterile as those photos.
Waffles has been on a preventative antibiotic for the whole time and,
knock wood, has not had an infection yet. It would probably be good to
how far the catheter goes in and how the syringe is connected and when
stop suctioning out urine. Just little things like that for the
beginner. Because really, it is the beginner that really needs to see
by step photos. I am so glad that my vet started me out with
Waffles. It was so much less stress (once I got over my fear of hurting
in the beginning of his recovery. I think anyone who has a male dog
be shown how to do it by their vet.
My cocker spaniel is 3 years old and had the surgery on 1/13. she is
paralyzed in the back and does not have function of her pee and poop.
She is 33 lbs. I'm sure others have a little easier time with the
smaller dogs, but you will be able to do it with yours. I'm 115 lbs and
I carry molly up to the bathroom and express her bladder in the toilet.
She pretty much poops on demand
too. She always has diapers on in case she does leak but if you express
times daily the leaking will be a minimum. i sometimes get 3-4 uses out
1 diaper because it's totally dry. Our bathtub is right next to the
toilet so I bought a handicapped chair for the tub and put it half in
the tub and half on the floor outside the tub, then I put molly over my
lap so her butt is over the toilet. I put my arm under her stomach
close to her backlegs and
lift up, while I lift up I also take my other hand and push down about
inches above her tail to kinda push her down on my arm and voila, she
a good stream. I keep baby wipes on the tub to wipe. Generally she
doesn't poop in her diaper (maybe 3 times a week) and will go over the
toilet too. I help her there by lifting her tail straight up. You will
learn when you think something may come out. During the day and night
she is in the laundry room in a small area that we have cardened off.
In the morning and when we get home from work, we express her by
putting her on the washing machine with
her butt over the laundry tub, she pees in there and down the drain it
Barely any clean up. When she poops, I catch it with toilet paper and
it in the toilet. You will find what's best for you and your family.
I use the biggest diapers I can find from Pampers, 22-37 lbs. Since my
cocker has a little tail, I just tuck it in. You can also take scissors
cut a little hole in them for the tail. Trust me this is way cheaper
buying doggie diapers and works really well. I too didn't know what to
but Molly is such a loving dog who has adapted so well. She has handled
way better than my husband and I. But we are getting adjusted. She
drinks, and loves just like before. She wants to play and have fun and
adapted. She doesn't even know she's handicapped. We have ordered her a
cart from ebay and hopefully will get it next week.
Don't give up, it gets easier. And do go out and get the pampers, it
make life easier on all of us and it's so surprising when she does pee
in them that they keep her fur and skin sooo dry.
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