HandicappedPets.com For the caretakers of elderly dogs, disabled pets,  and handicapped pets. We help you care for them     How to Express a dog or cat.

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, called '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 bedding wet 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 infection:

• 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 progresses.

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 teaching you how to express your pet. Urine left in the bladder can become a place 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 position.
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 like an inflated balloon.

	The animal should lift her tail when the right spot is squeezed.
This is the right spot (you can enlarge this picture by clicking on it).
	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 is 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.

Alternate Method. 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 for 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.

Your Comments:

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 the box.

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 Mimosa 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.

See also a litterbox for a handicapped pet

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 crystals) 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 feel a 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. IT'S IMPORTANT!

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 it is round and sometimes it is elongated. If it is quite full, all you feel 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 until you hit the spot. If you are having trouble getting started or are getting 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 it an
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.

Expressing Links:

http://www.rushmore.com/~dds/InformationalBladder.htm
(Disabled Dachshund Society)

http://dmroster.tripod.com/bladderbowel.html
(Article on bowel and bladder management)

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