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Express bladder and bowels for health

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How to express the bladder for health and the bowels to avoid anxiety

Manually expressing the bladder for a paralyzed dog is vital to warding off additional health issues caused by stale urine sitting in the bladder. Expressing for poop is easy to learn and avoids your dog having anxiety of finding feces where he sleeps.

First, have your vet give you a hands-on demonstration to show you the bladder location and the required hand pressure to place on the bladder. This is something that is hard to describe in writing.

It may be necessary to go back to the clinic the next day to have the vet/vet tech check your technique while you are expressing your dog to ensure that you were able to get all of the urine out of the bladder.

Attaining proficiency in expressing all the urine at a session takes practice – it’s not learned on the first try. It can be mastered with a little bit of practice. You CAN do it!

WHERE to express bladder during conservative treatment and post-op crate rest

  • Sit on a stool with dog seated in front of you (male faces away, female is seated with head facing you).
  • Kneel with male dog’s rear leaning against your thigh, female would have head near your thigh.
  • Dog is prone on the floor with pee pad underneath right outside of the recovery suite.
  • Expressing while dog is standing or seated

Wait til graduation day to express over the toilet. During conservative treatment and during post-op rest is not the time to teach your dog to be comfortable with balancing on a toilet seat.

During vet’s prescribed REST period, safely express your dog on the floor, or on a sturdy table.

How to approach pressing on the bladder (expressing)

Full bladder

When the bladder is full, gently press a flat hand slightly downward on the top of bladder against the flat of your fist with the bladder captured in between. When the bladder is full, a light pressure is all that is required to cause release of urine. Laurie Miller, Registered Veterinary Technician, reminds us to: “be careful not to poke the bladder with your nails or ends of your fingers.
  • Use a flat hand or the flat of your fist.
  • From your body position above your dog, place your hand as far back into hip area as possible to feel and find the bladder.
  • The bladder varies in size, shape, and position depending on how much urine it contains. As the bladder shrinks, your hands move inwards gently, with the consistent pressure. As the bladder gets smaller, cup your right-hand fingers to trap the slithery bladder.
  • Repeat expressing to ensure all urine has been expressed.
  • Slow, gentle, consistent pressing is not painful to the pup.
  • Now that you have a sense of how expressing works, watch the demonstration below:
  1. Steady, even pressure (not a pulsing type of action) works best. Never use a drastic or jarring or even sudden punching type of technique.
  2. When dealing with a really tense abdomen, it is best to try bladder expression 20-30 minutes after administering muscle relaxants like Diazepam/Valium or Methocarbomal, or after a touching and massage session until a routine and a new habit is formed.
  3. Use a command or same wording every time you do it… “Okay, now let’s do PP” will help with cooperation or learned response–just like puppy potty training.
  4. Also keep to the routine! Figure out a place to do it and a pattern. Dogs are creatures of habit. Routines make them happy.
  5. There are so many levels of bladder recovery. My Buc can initiate a stream but still can’t empty his bladder!
  1. There may be a delayed reaction until the urine comes out — hold pressure three to six seconds before repositioning hands.
  2. Express until urine comes out in dribbles rather than a stream, then the bladder is pretty much empty.
  3. Sometimes waiting 10-20 seconds and pressing again gives the bladder time to reform, and you still can get more urine out. Keep trying until you find the “sweet spot.”
  4. Sometimes your dog will tense up his stomach muscles when you try to express. Wait until he relaxes so you can feel for the bladder. A warm towel from the dryer on the stomach can help relax the dog when you are first learning. Tapping gently on the tummy to jiggle the muscles will also help relax a tight tummy.
  5. When the bladder is really full, you will not discern a shape, just a firm stomach which holds the expanded bladder. As the bladder empties, it may feel like a small plum. When empty, it goes flat. As the bladder empties and gets smaller, it will move around, so it will not always be in the same position in the body. You will need to feel for it. You’ll probably find it’s moved farther back into the hip area.
  6. If your dog wiggles during expressing, it can cause the bladder to slide out from your hands.
  7. Some dogs are just harder to express initially. Ask your vet about Phenoxybenzamine, a drug that helps relax the urinary sphincter and makes expressing easier. When bladder function is beginning to return, it can also be more difficult to express.
  8. The “Sniff and Pee” test verifies if bladder function has returned: Let the dog sniff a previous pee spot in the grass. If the dog urinates right after, that shows a message has been able to travel from the brain to the bladder! It will be necessary to manually check after urination until you are satisfied the dog can empty the bladder fully. The first reason to express is to avoid urinary tract infections which can be difficult to clear up and could ultimately lead to kidney failure. Recurrent UTI’s
  9. The second reason is you do not want the bladder to overflow and be stretched out of shape on a prolonged basis. A bladder that has lost muscle tone due to over-stretching may affect the dog’s ability to regain bladder control, or extend the time it takes to regain bladder control.
  10. When first learning to express, try every three to four hours during the day and just before bedtime. As you become proficient in expressing, move to three times a day (every four to six hours). That is typically how often a normal dog would pee. Dogs not allowed to void their bladders at least three times a day could be more prone to UTIs.
  11. While learning to express, it is better to express more often and have the pup drink water (1/8 cup) to keep the bladder flushed. Adjust the expressing schedule according to your dog’s needs as you get more comfortable with expressing.
  12. If a dog is on Prednisone or another steroid, he will likely need to be expressed every two to three hours until off this medication. Steroids create thirst and thus more urine production. Always provide access to water while on steroids.
  13. If you’ve been away at work or in the morning upon waking, give an extra 1/8-1/4 cup of water (flavored with low-sodium broth if necessary) to flush out the stale urine in the bladder. It takes about 1-1/2 hours for liquids to process and reach the bladder. Stop water access three hours before bedtime. Express right before you turn in for the night, and your pup should have a dry night.

females: 2 Extra tips videos

Express bowels to avoid anxieties

What about poop?

The good news is auto reflex causes all the poop to come out on its own. All you need to do is figure out your dog’s schedule so you can act before surprise poop ends up on the floor or in bed.

  • Feed your dog a good diet of quality protein and low or no corn (corn has a higher fiber content than other grains).
  • If you feed a dry food, soak the kibble with an equal amount of water.
  • Provide access to water during the day. Dogs normally take in about 20 to 40 mL per pound of body weight per day or about 3 to 4 cups of water per day for a 20-pound dog.
  • The water is a combined total of both moisture contained in the food and liquid intake.
  • You’ll find smaller and nicely formed bowel movements to deal with when food has less fiber.
  • Feed twice a day, and you’ll have two to three poops a day.

Anal Glands

Squeeze the sides of the anus to stimulate the emptying of the anal glands. A healthy dog, squatting, would empty the glands normally when going on its own. But we must do this for a paralyzed dog to prevent anal glands from getting too full. 

Frequency of bowel movement

Plan on expressing for poop once a day. Some paralyzed dogs may not have regular, daily, bowel movements. They must go a minimum of every other day to avoid developing painful, hardened (or hard) stools. The fiber in pumpkin, along with water, will soften stools. Add one teaspoon of canned, plain, pureed pumpkin one time per day to kibble with an equal amount of water as kibble, and provide water access during the day.

Time to process food

To know how long it takes for your dog to process food, put a few small pieces of raw carrot or kernels of frozen corn in with dinner. The veggie pieces don’t digest — watch for the stool with veggies and you’ll know your pup’s digesting time. Often you will be able to park your pup’s butt over the toilet and then flush away…. How easy is that!!

Video below demonstrates the non-invasive way to express for poop. 

30 to 60 minutes prior to ‘”the time,” you can encourage muscles to expel feces. Stroke the area on both sides of the rectum with thumb and forefinger. You will feel that there is poop in the rectum. Muscles will now start to push out the content of the colon.

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