Work with your vet
If your vet has shown you how to express your pet and you are still unable to do it, do not hesitate to ask for another demonstration!
If you do not think you are getting the bladder empty every time, tell your vet. Antibiotics may be prescribed to prevent infection until you are better at expressing.
Find the right method for your pet
There is no single method that is best for every pet. Your pet may be expressed while standing up, lying down, being held in your arms, or sitting in a cart. You may stand in front of your pet, behind your pet, beside your pet, or sit with your pet across your lap. You may use one hand, two hands, or only a sling. Try to find the most effective method for your individual pet.
Bowel care makes expressing easier
It is easier to express a pet who is not constipated. When there is stool in the colon or gas in the abdomen, it is harder to express the bladder. You may find the pet begins to eliminate stool when you squeeze the abdomen to express the bladder. Many people find it best to stimulate the pet to empty the bowel before expressing.
Locating the bladder
Before expressing, check the size and location of the bladder. If it is not too full you can feel its firm roundness 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. Here is a website that shows x-rays of a normal sized bladder and one that is too full. http://www.lbah.com/feline/flutd.htm
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.
Express, rest, express
You may get the bladder emptier if you express more than once during a session with rest breaks in between. This allows the bladder to shrink to a smaller size each time and regain tone. Rest breaks may be a few seconds or several minutes, however long it takes for the bladder to become round and firm again.
Pets with partial control
Some pets have partial bladder control. In some pets the spinal injury did not cause complete paralysis. In other pets, control begins to return during recovery but may not be perfect yet. With these pets it is important to continue to express or check the bladder to be sure they are emptying completely. Do this until bladder control is dependable.
There are medications that can aid in expressing the bladder by relaxing the urinary sphincter and increasing bladder tone. Experience here shows they are usually not needed, however some pets are more technically difficult to express than others. Your vet will determine if medication is right for your pet’s case.
Let the vet check your work
If you are not sure you are getting your pet empty, a good way to check is to express your pet and then let your vet express the pet right after you to see if any urine is left.
Feeling the bladder
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. I feel that most of the time we get her as empty as if she was not paralyzed.
The last hour or so of the night I express him repeatedly. First I take him outside for a walk and I express out the majority of his urine. When I come inside I leave Waffles in his cart and then while watching TV I continue to express him into a bucket. I’ve said this before but I know from when I used to catheter him after expressing that there is always more urine left then you think. Giving him a 15 minute break inbetween expressions seems to give the urine a chance to collect again in the bladder. Then I take him out of his cart for about a half an hour put him back in and express again and sure enough I get a few more ounces out. I give him 15 more minutes in the cart and then express him again. I usually get a couple more ounces out and then nothing. I feel pretty confident at this point that his bladder is pretty empty. But I have to say that if not for the cathetering and knowing that I still had a fair amount of urine left in Waffles after that first expression during the walk, I probably would stop after that. It is a lot of work but I am hoping that this will keep him infection free.
Expressing in the laundry room
My dog is a male like yours and weighs about 25 lbs. Sometimes before expressing I take him to the toilet for “poop on demand”. This makes the urination process easier.
I stand him on the washer with his CLEAN butt (very important) against the front of my body. He is able to lock his legs to stand but if your dog doesn’t lock his legs as yet, (he will with time) you can still hold him upright on all fours with his rear end snug against your body. My two clenched fists are now in position to squeeze his bladder. My elbows are at waist level against my body for leverage. <snip> I apply gentle pressure to the part of the bladder closer to the navel to start, and then as the urine is expelled I reposition my hands further toward the rear of the abdomen toward the rear end. This might take several repositionings of my hands to completely empty the bladder. It will expell as a stream at first and then go to a slow dribble, and then a few squirts. Keep up the gentle pressure and try repositioning your hands until you are SURE there are no more squirts. You soon get a FEEL for full and empty bladders.
It is a game at our house to see who can aim the stream of urine the straightest. Sometimes we miss the target washcloth… Oops!
When you are finished expressing, drop the wet washcloth into the nearby diaper pail, and ALWAYS wipe off the top of the dryer to avoid rust!! I have a handy squirt bottle of WINDEX-type cleaner to spray the top after each use. The stack of old washcloths is always within reach so if I need more than one to complete the job.
Expressing into the toilet
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 3-4 times daily the leaking will be a minimum. i sometimes get 3-4 uses out of 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 2-3 inches above her tail to kinda push her down on my arm and voila, she pees a good stream. I keep baby wipes on the tub to wipe. (See External Links below for a video of this technique.)
Expressing into the sink
I set my female dog on the bathroom counter with her rear toward the sink and express her, aiming the urine into the sink. I dry her with kleenex and wipe the counter and rinse the sink. From time to time I pour bleach down the sink and leave it for 10 minutes. I keep paper lunch bags in the drawer under the vanity and put the tissues into one and carry it out to the trash. Expressing on the counter lets me see what I’m doing in the bathroom mirror better than trying to bend my head down to watch directly.
Expressing in the bathtub
Expressing is not as difficult as you think. Once you find “the magic spot”, the urine comes out easily. We have a dachshund that we express every day, and we do it in the bathtub. The urine comes out, then cleaning up is easy. It quickly becomes routine.
Expressing on a puppytraining pad
Puppytraining pads let you express anywhere. They also let you check the color and odor of the urine when you are done.
Spasms While Expressing
Waffles does 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 his surgery.
My dog always does something like a mule kick at the beginning of every express, stretching her two hind legs out all the way for a second, in response to my first test-squeezing the bladder. I wait until after the kick and reposition my hand and express.
After Abdominal Surgery
Ruptured intestines and swelling
What a wonderful day today!!! I called up to Medvet and told them about the problem we were having expressing her. The nurse told me to try taking her out in the yard and placing her sling under her and lifting her slightly off the ground with it, this way the pressure would be across her whole abdomen without too much direct stress on her wounds.
IT WORKED!!! She urinated seven times throughout her walk. We were so happy we were crying! LOL The small joys in life, right?
(Note: This dog was hit by a truck, broken leg and broken pelvis, intestines ruptured through her abdomen, emergency surgery to repair and replace intestines stitched part of the bladder, second surgery needed to repair mistake, then she had to be expressed.)
Kat got a uterine infection last year and she had a full ovario-hysterectomy. I was in a major state of panic about expressing her and doing her harm or bursting her stitches. In the event it wasn’t as bad as I thought. Firstly, I was able to “change my approach” and sometimes I was able to express her from above, but I’m not sure if that would be possible with a dog. I would put the base of both palms of my hand over her spine and apply pressure to the bladder from the sides instead of from underneath as I normally do. I would do most from there and then finish off from underneath, as at a certain point I couldn’t feel the bladder anymore. Kat didn’t complain any more than she normally does, but maybe she doesn’t have much sensitivity where the scar was. The vets said that it was difficult for me to do any real damage, they had put in I don’t know how many rows of stitches… I think as long as the vet who operates on her knows that you have to express her, it should be ok.