Caution

Have your vet give you a demo first to show you the required hand pressure. 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 and ensure that you were able to get all 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!

Other positions:

1. Sit on a stool with dog seated in front of you (male faces away, female is seated with head facing you).
2. Kneel in the grass with male dog's rear leaning against your thigh, female would have head near your thigh.
3. Dog is in a wheelchair.
4. On the toilet (not recomended until after a conservatively treated dog has finished crate rest. A dog needs to learn his balance and to feel safe and comfortable. While healing is not the time to train for this).
5. Dog is prone on the floor or a counter.

Where? in the tub, shower stall, outdoors, on a pee pad, on a counter.

Alternate link to Expressing Bladder movie

IIllustrations reprinted with permission by the copyright owner, Hill's Pet Nutrition, from the Atlas of Veterinary Clincal Anatomy.

For larger photo

Expressing while standing or seated
When the bladder is full, you will be pressing the 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 above the dog, place your hand as far back into hip area as possible. Notice how far back the right-hand pinky is into the thigh area in the insert picture on the right.

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 a consistent pressure. As the bladder gets smaller, cup your right-hand fingers to trap the slithery bladder. Use the right-hand pinky to find the bladder hiding back in the hip/thigh area. Slow, gentle, consistent pressing is not painful to the pup.

For larger photo

Expressing in a prone position

Alex, a female, is placed on a pee pad. Her owner's hand is under the stomach approximately at the next-to-last set of nipples. The nipples are a starting point to find the correct area on your dog. The right hand with fingers together and palm down presses with even, steady pressure against the left hand. As the bladder gets smaller, the bottom left hand can be cupped a bit to trap the bladder from moving. As the bladder empties, it may slide back into the leg area -- simply slide your hands toward the hip/thigh area. Pull the bladder with your pinky finger out into the cupped bottom hand. When you press on the "sweet spot " of the bladder, the tail may begin to move and urine will come out.

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Hints

• There may be a delayed reaction until the urine comes out -- hold pressure three to six seconds before repositioning hands.
• You need to express until urine comes out in dribbles rather than a stream, then the bladder is pretty much empty.
• 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."
• Sometimes your dachsie will tense up his stomach muscles, 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 just learning. Tapping gently on the tummy to jiggle the muscles will also help relax a tight tummy.
• When the bladder is really full, you will not discern a shape, just a firm stomach which is the 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.
• If your dachsie wiggles during expressing, it can cause the bladder to slide out from your hands.
  

NOTE: 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. A test to verify 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.

Tips by Amy, Neuro Vet Tech

1. Steady even pressure (not a pulsing type of action) works best. Never a drastic or jarring or even sudden punching type of technique.
2. When dealing with a really tense abdomen best to try bladder expression 20-30 minutes after administering muscle relaxants like Diazepam/Valium or Methacarbomal or after a touching and massage session until routine and new habit is formed
3. Use 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 be 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!

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The first reason to express is to avoid urinary tract infections that can be difficult to clear up and which could ultimately lead to kidney failure.

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.

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.

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.

Note: If a dog is on Prednisone or another steroid, they 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.

If you've been away at work or in the morning upon waking, give extra 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.

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Alternate link to Expressing Bowel movie

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 dachsie's schedule so you can act before surprise poop ends up on the floor.

Feed your dachshund 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 milliliters 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 BM's to deal with when food has less fiber. Feed twice a day, and you'll have two to three poops a day.

Another technique to encourage a bowel movement is to use a Q-tip and KY or other water-soluble gel: Insert just a bit of the tip in the anus and make a circle (don't just twirl the Q-tip but sort of draw a circle with it) until the sphincter opens and the dog pushes it out. This will also stimulate the bowels to push the fecal matter out along with the Q-tip.

When the dog is finished, 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.

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 canned, plain, pureed pumpkin one time per day to equal amounts of kibble and water, plus other liquids during the day).

To know how long it takes for your dachsie 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!!

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