How to Express Your Pet's Bladder

For those seeking advice on caring for incontinent pets and animals with kidney-related problems.
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How to Express Your Pet's Bladder

Post by HandicappedPets.net » Tue Oct 11, 2011 1:37 pm

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Some injuries cause animals to lose the ability to urinate. This is a critical, sometimes fatal problem unless the caretaker knows how to manually cause the animal to urinate. This is called 'expressing' the bladder.

Your vet will show you how to do this and it is important that you follow your vet's instructions carefully. If your vet will not show you, find another vet who will. This page is a discussion of how to express a dog or cat and is not intended to be a substitute for a veterinarian's advice.

Your pet’s bladder needs to be completely emptied at least three times a day (every 8 hours). Some injured animals dribble or leak urine during the day. Expressing will ensure the bladder is completely empty to prevent infection. It will also reduce the amount of urine soaking the skin, which can cause sores.

Some injured animals are unable to release urine even if they want to. They do not urinate unless the bladder gets so full it overflows. Expressing will ensure urine does not stay in the bladder too long and create an environment where germs can grow. Expressing also keeps the bladder from stretching out. If the bladder becomes stretched, the pet may be unable to urinate normally even after the ability to control the bladder returns.

Following injury to the spine or rear area of an animal, cystitis (infection) of the bladder can become a serious health problem. A bladder infection can cause death in a few days if not treated. Bladder care is essential for the health of your pet, whether it has had surgery or not and whether it is completely or partially disabled.

Here are the most common signs of urinary tract infection:
  • Dribbling or a wet rear and wet bed
  • Foul odor to the urine and possibly increased licking of the genital area
  • Bloody or dark colored urine
  • Depression, loss of appetite, and a rise in temperature as infection progresses
Note that severe symptoms require immediate veterinary care.

Preventive medical treatment will help you avoid infections. Work with your veterinarian in prescribing the best medication, checking pH, culturing the urine, and teaching you how to express your pet. Urine left in the bladder can become a place where bacteria breeds.

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 a day is a permanent nursing care need for permanently impaired pets. The success of your nursing care program will depend on how effective you become in this care.

This page describes how to express a bladder... but you ''must'' check with your veterinarian first.

"Don't Worry!" say hundreds of messages on our message board. This becomes so easy for you and your pet after a very short time.

Small Dog

Support the animal in an upright position.

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Locate the bladder. Gently do 'test squeezes' on different spots until you identify it, starting where the ribs end and moving back. Your thumb should be on one side of the abdomen and your fingers on the other side.

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Gently squeeze your thumb and fingers together and see if urine is released. If not, move to a slightly different area on the bladder and try again.

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This is the right spot.

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The animal may lift its tail when the right spot is squeezed.

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Urine should be released in a fairly steady stream. When urine decreases to a dribble, the bladder has been sufficiently expressed. This is not painful for the pet. It is often a great relief.

Medium or Large Dog

Place your hands on the pet’s sides behind the rib cage. Here the thumbs are resting lightly on the back.

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Apply pressure squeezing inward and upward. Do ''not'' put pressure directly on an injured spine, especially if the dog has disk disease.

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If your hands become tired, pause to rest, then begin again. As the bladder shrinks you may need to stop and move your hands to a better position. Continue expressing until the bladder is empty.

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Cupping one hand

This is how I would (do) it. Stand or kneel behind Riley and gently feel for his bladder. I(t) should be about the size of an orange or small grapefruit. You want to cup it in one hand while gently pressing in and down on the opposite side. You need to control the location of the bladder with your cupping hand, trying to keep the pressure centered. Keep the pressure enough so the urine comes in a good flow. As the bladder gets smaller you will need to flatten out your cupping hand and press with it to get the rest out. I found that closing my eyes, helped because I could imagine what I was doing, since I couldn't actually see it. If you lose it, don't panic. Try again. if Riley resists, give Riley a few minutes to settle down and his bladder reposition itself. Then start again. We found that 3x-4x a day for a beagle was about right. Setting and keeping a regular schedule helps avoiding accidents.

Heavy Dog

Expressing with fists for firmer pressure

I am also trying to learn this skill of expression and what has helped me as a woman is actually making a fist with each of my hands and either using the open face of my fist(thumbs pointing forward) or knuckle to knuckle (thumbs pointing toward me when expressing. Perhaps I didn't have the strength in my palm and fingers or I was putting too much pressure on the finger tips, but I had no luck expressing until I used my whole fist which allowed me to use more pressure spread over a larger area than just my fingertips. All the advice written here about positioning with a very full bladder seems accurate. Overcoming the spincter is the hardest part so firm pressure is necessary in the beginning and once you get your dog going you'll have no more trouble. I express all I can, wait a moment and then do it again with duplicate results say 10 or 12 times each session. You can only feel the bladder when it is not abnormally distended. Just find the spot that works for your dog and repeat the actions numerous times each session. I asked a vet at our local veterinary teaching university hospital if this method was OK and he said many of the women students use this method. Hope this helps. Best of luck, don't be discouraged.
Martha

Supporting a 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.

Station for expressing a large paralyzed dog's bladder

To help express our 70 pound female lab's bladder to go potty, my wife and I design a simple but very effective expressing station. It just requires (1) a two-leg ^ ladder, (2) a bar, and (3) a sling. On the bar, we put some nails at several locations (to later fix the sling handles and adjust the height of the sling that holds the abdomen of our dog). First, we use the sling to help our dog stand up and walk to under the ladder. Once there, extend the bar through the two handles of the sling. Then rest the bar on one step of the ladder at one side and the horizontal fix at the other side of the ladder. Adjust the sling height using the nails put at different positions on the bar. Then I can just let the sling go and let it hold her. I then use both my hands to express her bladder. What's amazing here is our dog tends to fall back and the sling will hold her at a position where the bladder would be positioned right behind the sling area and hence easy to locate and express. The whole process takes only 5 minutes to accomplish, and if necessary, one person can do it by himself (for a 70 pound dog!).

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Expressing a female dog who is lying down

Anyway, she weighs 46 lbs, so expressing her with her in standing position is extremely difficult, if not impossible. At wee hours this morning, I placed her on bed on her side and started massaging/pressing firmly but gently the entire abdomen, as you guys taught, from where the rib cage ends, using my right thumb on one side and the other four fingers on the other and w/ my left hand placing on her back to help pushing.

Actually I couldn't feel "the" balloon but urine did came out! Tried that again at 10 am this morning and it worked

Expressing a large male dog who is lying down

Carl is 60+lbs and I cant express him when he is in his cart (he is way too active), can't lift and express at the same time (you need to take care of your back - I learned that the hard way), so I express him lying on one side. I put a pee pad (it actually takes 3 to collect all his urine) underneath him, folding the edges round his penis a bit so the urine doesn't hit his fur. I put one hand underneath him and use the [one] on top to feel his bladder, which feels like a balloon. I apply gentle pressure, gradually increasing it as his bladder empties. When the urine stops I wait a few seconds then repeat the process until I can't feel his bladder anymore. I express Carl three - four times a day and get 2-3 pee pads full each time.

Expressing an 85 lb. dog with a sling

I have a lab 85# and for the week she needed to be expressed here is what I did. Every six hours I would put a sling (a towel rolled worked) under her upper belly and take her to the area to relieve herself. Then I would position it just in front of her hind legs and lift with a slight jerk. Sometimes it would take 3 or 4 lifts. If your dog is smaller you might need to use a thinner sling. In any case I would run this by the vet or vet tech. I can only say what worked for me. One time I couldn't get her to pee so I gave her some water and in twenty minutes - no problem.

Large German Shepherd

I have a large GSD and when I had to express him he required steady pressure to empty his bladder and could not stand on his own. How I did this was to use a harness in the front (I just used a regular back clipping harness but they sell a special front end lifting harness) and a sheet in the back (a crib sheet works well if you have one). I would carry him while trying to place his feet to the potty spot, then I would place his front feet where he could stand on them and I would stand over his back end and pull his hips up and hold them up in between my legs then use my flat hand, fingers together, to express his bladder till empty. It took me over a week of doing this before I could do it and not get pee all over myself and him. It takes some dedication and physical strength but, like everything else, practice makes perfect.

Expressing a large dog 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.

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This large dog is supported in a standing position by a wheelchair. Reach down through the bars to place your hands on the waist in front of the thighs.

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Try to feel the bladder by pressing into the sides with your fingertips. When you locate it, squeeze your hands together to begin expressing.

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Notice how far the waist is being pushed in as the dog is expressed. Express, rest and repeat until no more urine is produced.

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Cats

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Expressing a cat who is lying down

I probably express (potty) Jaime differently due to the fact that she has posterior paresis (weakness) rather than paralysis. Thus, she has some feeling and control over the spincter of her bladder. She never leaks urine except when she has an infection and she cannot urinate by her self at all. However, she drags herself around like a typical paralyzed pet. Thus, she has a very tight spincter which she has some control over and her excessive tone (tightness) in that spincter is what makes her difficult to express. I never could learn to express her in an upright position even though I had numerous week long sessions with the vet and techs.

I put Jaime on a small table and sit on a footstool. I am slightly above her. I lay her on her right side on a soft towel and rub her back and talk to her to relax her. Then, when I feel her relax I place my right hand on her back and then, use my left hand and physically find her bladder and cup my hand around it. Then, I use that hand and both of my thumbs to trap the bladder and push towards her tail. The bladder will "roll" and you may need to reposition your hand and fingers in order to find the bladder again.

Using a "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. (Note: Not recommended for a recently injured cat.)

Scruffing a cat that twists

Cricket used to twist and scratch when I would go to express. I found that holding her by the scruff when I express works best for her. I hold her facing me with my left hand and hold her up so her front feet don't touch and just her back feet are on the pad. For some reason, if all four paws are on the ground, she thinks she's supposed to push off with them and run. Then I palpate her belly and express with my right hand. She gets fed breakfast/dinner right after she's done. I don't know if that helps at all, but that's our routine.

Two ways to express

Kat's bladder is sometimes near her ribcage and sometimes near her tail, sometimes in
the middle of her body and sometimes over to one side (depending on how full her colon is...) I express (Kat) in two ways, I either go in from underneath, using my thumb on one side and first two fingers on the other, with the last two fingers curled up as a kind of "stop" to try and stop the bladder moving around, or sometimes I go in from above the spine, with the bases of the palms of my hands almost touching and 3 or 4 fingers on each side exploring to find the bladder. When you feel something kind of "rubbery bally" in between them, that's it! It's the only thing in there that feels like that. You can then press from above or keep it located with one hand while you go in from underneath with the other.

Expressing a cat over the litter box

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.

Expressing a cat who won't hold still

I scruff him with my R hand, then I use the L one to find his bladder. I start at his ribs, just in case, but I always find it right between his hips. I then squeeze, readjusting my hand as necessary. I know I'm in the right spot because, frankly, his penis/scrotum start to twitch (sometimes a tiny drop of pee will appear, as well). I've never heard of that sign before, but it may be because he is, at this point, unneutered. Then pee usually rolls out with a lot of force, enough to even reach across the room. To say he squirts like a firehose is NO exaggeration!!

Expressing while feeding

I recently pulled a cat off of Craig's list with nerve damage to her tail area. She had never been expressed before and it took the vet and I holding her to get her expressed. I decided we had to make this more tolerable and pleasurable for us both so I started feeding her only when she was expressed. So, I express her 3 times a day and that is when she is fed. I didn't let her over eat at each meal but kept her hungry. Wow, what a difference this made in her attitude.
While eating it will give you time to feel around and find his bladder. Plus, it will be a pleasurable experience for your kitty.

Another procedure for expressing a cat

Of course, this will not work for a large dog, but for a cat, it retains him in a small area, keeps him in a normal elimination position and easy on the care-giver's back. Also, as most of you know who do this several times a day, you have to take breaks to do full elimination and Sasha rests in the box during the 5 to 10 minute breaks. I have a waterproof baby crib pad on the bottom and a sponge in the right hand corner to absorb any drips during break time.

I think the photos are pretty self-explanatory. I use World's Best cat litter (have to import it from the UK) as it is all natural (made from corn), safer than clay based litters and flushes without clumping and clogging the toilet.

I use little Styrofoam trays from the supermarket as the "litter box" with a napkin in the bottom to prevent the litter from sticking and easier to come clean for disposal.

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Pic 8 is "assuming the position" and how I hold him, while 9 is how I express him.

I do 8 & 9 at the same time. Had to hold the camera with one hand, so couldn't get it all into one shot!

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This kitty has balance and coordination problems. (She is also missing her hind leg and tail.) She is easy to hold because she weighs only 5 lbs. Here is a basic hold, supporting her over the litter box before expressing.

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Here the bladder is being squeezed with the right hand while she continues to be supported with the left. The bladder has been trapped against the hips.

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Notice how far the bladder is being compressed as it empties.

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Male cat

It took me a long time to figure out how to express. He is a boy cat and apparently boys are harder because they have a long urethra. Finally I saw a different vet and they explained that with boys, you have to find the bladder and then gently move it up (in the direction of their head) for about 1/2 inch and then give it a squeeze. Moving it forward a 1/2 inch straigtens out the urethra so it is not kinked up and therefore the stream can come out without trouble or discomfort.

Kitties may protest being expressed

We've been expressing Mimosa for almost three years now, she STILL complains loudly. RRRRROOOOWWWWLLL!!!!!! She no longer thrashes like she used to. Legume complained with growls & scratching, but his bladder was painful. Mimosa's bladder isn't.

(Note: If your cat has bladder control but has difficulty using a standard litter box, see also
http://www.handicappedpets.com/mediawik ... capped_pet
http://www.handicappedpets.com/mediawik ... _litterbox

Catheterization

Catheterization may be an option for your male dog. It is more complicated with females and usually must be done by a vet. Your vet can instruct you on how to catheterize your dog at home, and can provide you with the appropriate equipment. Do NOT perform this procedure without the support of a vet! Improperly done, this can seriously, perhaps fatally injure your dog.

Using sterile procedure

I used ky gel from a tube but I read some where that you can get indiviual packets of it so that the KY would be sterile each time you opened a new packet. I would put the KY on a clean plate. You could probably put it on a sterile gauze if you think that is cleaner. I always had that pump antibacteria gel soap that you don't rinse off right next to me. Also, I had a second tube with cold sterile in it. I would keep track of which tube I was pulling caths from and when I finished I would put the used cath in the other tube. This way I never used the same cath on the same day and I knew that the caths were very sterile because they were in the cold sterile for at least 24 hours before I used them again. I had about a dozen caths that I had rotating from tube to tube.

I would wash my hands, get everything layed out including Waffles, then wash my hands again. I would wipe Waffles with a baby wipe. I never used anything harsh because I did not want to dry or irratate him. I would use the antibacteria gel on my hands. I would pull back the sheath. When you get more practice you will be able to pull it back with one hand or at least hold it back with one hand and then I would pump some more antibacteria gel just on my fingers of my right hand and rube the gel around with my fingers and thumb. Then shake my hand so that it would dry. If you could set up your catheter tube in some type of stand so that you could have it upright with the top off so that you can grab a cath with your clean hand without having to touch the tube again that would be helpful. I would shake the cath out for a long time to make sure all the cold sterile was off (if your vet said to rinse then do that). If I hit the wall or anything while shaking the cath then I would take out a new one. After I was sure the cath was dry then I would carefully drag the cath though the KY gel (I would coat about an inch) holding the cath as far back as possible then begin inserting.

Stimulating urination

There is another way to empty the bladder that works for some pets. It may be useful on a short-term or emergency basis, however there are some dogs and cats who are emptied this way for the long term. It involves external stimulation of the pet's genital area to encourage urination as a mother cat does with tiny kittens. Expressing the bladder does not require contact with the pet's genital area and cannot introduce germs into the urethra. External stimulation can get germs in the urethra and cause a [[Urinary tract infection]]. If your vet has shown you how to express your pet and you are unable to do it properly, ask for another demonstration. If you are in a situation where your pet's bladder needs to be emptied and you have not been shown how to express or catheterize your pet, this method may help temporarily until you can see a vet.

Female cat

One night I was sitting at the table trying to express Jaime and I was so down. I couldn't feel her bladder and I was too tired to take her to the emergency vet. I started rubbing the thigh of her leg and she peed alittle on my hand. Then, I progressed upward and rubbed her genitals she began peeing more and more. My vet and I were amazed. I used this technique for several months. When I used this technique I would rub her vigorously. I would rub her and then, let her rest and continued off and on for about 10 to 20 minutes. This solution was like a God send until I learned to express her. I couldn't continue this indefinately because she got alot of infections but it got us through until I learned to express her.

Male cat

I know from experience that if i use a warm wet wash cloth and stroke his belley, scrotum and testicles I can get him to freely squirt with no pressure from me. It seems that i must stroke...and it seems the stroking provides an alternating cold and warm environment that allows the small stream to occur. I don't think the pressure of the stroking is doing anything, but i could be wrong.

Male Yorkie

when i empty his bladder i hold him with right hand( he's small thank god) and use damp towel with left hand. i just pat the tip of his wee wee back and forth. he pees at least 3 or 4 times, more if he is full. i did this at the vets one time while she watched and she checked, bladder was empty. if it is raining outside i empty him over the tub, if pretty we do it outside ( he likes to mark his spots. lol)

Your Comments

Many of these comments are reprinted from messages posted on the HandicappedPets Discussion Board at http://www.HandicappedPets.net .
We welcome you to post your questions and concerns there!

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General Info

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. For tips on this, please see [[Bowel management in incontinent pets]].

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.

Medications

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.

Express after outings

If you take your dog someplace where she drags her bottom on unclean surfaces such as sidewalks or grass, or swims in untreated water, it is a good idea to express after the outing even if it is not time yet, and wash the private area if needed. This helps remove dirt and germs that could be a source of infection.

Expressing Completely

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.

Expressing repeatedly

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 Indoors

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.

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.

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Spasms While Expressing

Restless legs

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.

Kicking

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.)

Spay surgery

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.

External Links

http://www.freewebs.com/dmroster/bladder.html (Article on bowel and bladder management)

Dogs

http://www.scoutshouse.com/videos/video_bladder.html Expressing four different sizes of dogs

https://www.youtube.com/watch?v=EhXQdKzAdN0 Expressing a male dachshund

http://www.youtube.com/watch?v=Saf_kZvwClE Expressing female dachshund into the toilet (1:25-1:40)

http://www.youtube.com/watch?v=SPg3Z0OIovo Expressing male dachshund onto puppytraining pad

http://www.youtube.com/watch?v=dzy7mrOBjz4 Expressing male dachshund lying on his back

http://www.wonderpuppy.net/copper/resources.htm Video and audio instructions for expressing a dachshund

http://www.youtube.com/watch?v=mb500Gtvv88&NR=1 Expressing small male dog in standing position ("Peeing" Mac: Part 1)

http://www.youtube.com/watch?v=B7l2861NTnI&NR=1 Expressing small male dog in standing position ("Peeing" Mac: Part 2)

http://www.youtube.com/watch?v=yoYWs6OEfJI Expressing small female dog standing on the counter

http://www.youtube.com/watch?v=nm9TiCg11qs Expressing male French bulldog lying on his side (2:20-4:15)

http://www.youtube.com/watch?v=6CVtjghnxn4 Expressing small male dog lying on his side (1:00-3:00)

http://www.youtube.com/watch?v=u1CTMyWClAk Expressing female dog lying down - Part 1 (good info for all sizes)

http://www.youtube.com/watch?v=rfMqtyzRb7I Expressing female dog lying down - Part 2 (good info for all sizes)

http://www.youtube.com/watch?v=R7JxBy56k_g Expressing male poodle in standing position

http://www.youtube.com/watch?v=d18yUDdZVUw Expressing medium large dog in standing postion with external stimulation

http://www.youtube.com/watch?v=Hp1u_sC4Ad8 Expressing medium large dog in standing position indoors (2:20-4:10)

http://www.youtube.com/watch?v=M9EslzNS6xE Expressing large (over 50kg/110lbs ) male dog with bare foot (caregiver has disabled shoulder)

http://www.youtube.com/watch?v=PlbYCoZ5HqI Expressing large male dog standing

http://www.youtube.com/watch?v=oHD0L2rJAcw Expressing large male dog lying on his side, cupped hand

http://www.youtube.com/watch?v=bEHSxUf2Nb8 Expressing large dog using closed fist technique

http://www.youtube.com/watch?v=lw6_T2FewZM Expressing large pitbull in a wheelchair (4:00-5:05)

http://www.youtube.com/watch?v=SXBkez3jxB8 Expressing a male German Shepherd dog lying down

http://www.youtube.com/watch?v=IbdPXgynVC8 Expressing large female dog over your knee

http://www.youtube.com/watch?v=yrv5Wzi1KR0 Expressing small male dog using fingertips, 2 positions

http://www.youtube.com/watch?v=758ol0nkWx4 Expressing small male dog, 2 positions

http://www.youtube.com/watch?v=CAaLdeJCIkw Expressing one-handed or two-handed

Cats

http://www.youtube.com/watch?v=QdIBtw8_7No Expressing cat into the sink (Pookie: How we care for our paralyzed cat) (0:30-1:50)

http://www.youtube.com/watch?v=QQyHrjfBzsA Expressing large cat lying on his side into a litter box

http://www.youtube.com/watch?v=HVdJI-qsOus Expressing large male Persian (Sasha) in standing position (Part 1)

http://www.youtube.com/watch?v=KIFTKuR9-uc Expressing large male Persian (Sasha) in standing position (Part 2)

http://www.youtube.com/watch?v=wkG_hFgTIO8 Expressing cat onto paper

http://www.youtube.com/watch?v=uqSQkDTMTAQ Expressing cat on back while scruffing neck

http://www.youtube.com/watch?v=2Gxd7q3zEEo Expressing cat lying on her back before surgery (does not show surgery) (4:40-end)

http://www.youtube.com/watch?v=-UHpvLzoK74 Expressing obese cat lying on her side (language PG)

http://www.youtube.com/watch?v=LbVxdFyGKjs Expressing bladder and bowel of cat in standing position

http://www.youtube.com/watch?v=VH-4vryTra4 Expressing cat lying on his side

http://www.youtube.com/watch?v=jCVZdGms5oA& Expressing frightened cat with only one person

http://www.youtube.com/watch?v=iuMZ4hrijuY Expressing bladder and bowel of small cat in midair

http://v.youku.com/v_show/id_XMTczNjAzOTk2.html Vet expressing cat's bladder and bowel

http://www.youtube.com/watch?v=k9p5j9eXZ90 Expressing a male cat sitting on your lap

http://www.youtube.com/watch?v=OiMJGS2O46Q Expressing a male cat on his back or side

http://www.youtube.com/watch?v=HhReJqnuxOA Expressing a male cat using a combination of squeezing the bladder and external stimulation

http://www.youtube.com/watch?v=TBOosHCp9OQ Expressing a male cat in standing position

http://www.youtube.com/watch?v=CnFCwDp_fL0 Expressing a female cat with external stimulation

https://www.youtube.com/watch?v=2pl7j-FTsNE Expressing a female cat while holding cat over shoulder

https://www.youtube.com/watch?v=aURHGlKv0pE Expressing a male cat on lap into toilet

https://www.youtube.com/watch?v=cIbRRsvmV8A Expressing a male cat braced against forearm

https://www.youtube.com/watch?v=X2M0Q3m795c Expressing a female kitten holding legs and using external stimulation

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