Urinary: Does anyone here express in a cart?

[CarolC]

Is there anyone here who has a wheelchair pet that they express while the pet is in the cart? If so, could you describe how you do it?

[BethT]

Hi Carol,

I express Waffles in his cart. I don't know how well I can describe it but I will try.

I stand behind him with my legs on each side of his wheels (he uses an Eddie's cart). 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. Let me know if you need more details.

Also if I could ask you a question--it took me so long to figure out how to express him. It is easy now but I still catheter him before I go to bed (I express first then immediately catheter to see how much urine is still in him). There is always about 6 or 7oz left. Do you ever total empty a dogs bladder? Do you have any suggestions on how to get those last few ounces out? Thanks Carol. Beth

[CarolC]

Hi Beth,

I think maybe it's one of those situations where you have limitations I don't(?) My dog is female. I understand expressing males is more technically challenging because of the curves in the urethra. If I had your dog, I'd probably be catheterizing him too. I wish I had a better answer. I've never tried to express a male dog.

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.

The first half a year, she was *hard* to express, but a month or two after she started physical therapy that got better. I will never forget the Sunday morning I was very tired and wanted to sleep in, but I set the clock and got up to express her to keep her on schedule, intending to go back to bed afterward. We had such a hard time, it took 23 minutes, and I was pretty wide awake by then.

Fortunately, after PT, or perhaps simply after she had more time to heal (don't know which) she became able to assist (I think?). If I could overcome the sphincter, she could help push the urine out. I feel that most of the time we get her as empty as if she was not paralyzed.

The only thing I can think on your dog is, can you dig into his sides and get your fingers any higher up toward the ceiling of the bladder? If he's like my dog, he will not feel you digging.

If I describe this, it wouldn't make sense to most people, but maybe it will to you. By pressing on her sides I can tell where her bladder is. There is a trigger point, and when I hit it I can tell because she raises her tail. If I squeeze there, she will empty if I don't lose it. Also, I learned to fish her bladder down into position. Sometimes it is in an accessible spot for squeezing. Other times is it nestled so high up near her spine and back by her tail that I have to really dig my fingers into both sides of her abdomen and fish it down into position. It sounds awful, but I'm careful when I maneuver the bladder down, and it makes it possible to get a proper grip and do a complete express. I fish her bladder down so the bulb of the bladder is in my palm and my thumb and forefingers are actually near the exit end of the bladder, not the ribs end (which seems counter-intuitive). However, it seems that her need is not for someone to squeeze on the big full end of the bladder near the ribs, but rather to squeeze closer to the sphincter so it will release.

In answer to your question, I was wondering if you would be willing to describe it in as much detail as possible. That would be fantastic. MarkR is making a webpage on expressing, and two things it is lacking are someone who expresses a big dog and someone who expresses in a cart, to share how it is done. Right now it has pictures of expressing a dachshund and a chihuahua, as well as two very clear descriptions of expressing a cat. But nothing for the big dogs, and those are the people that could really use some help, don't you think?! If you think you could write it up, I'm sure MarkR would add it to his comments section of the webpage.

Also, I'm not sure if he is interested in a link to catheterizing, but I know MurphysDad had to cathetherize Murphy, and you are having to catheterize Waffles, and it seems like that info might be something to include on the express page. I found a website showing how to catheterize a dog. It shows photos, therefore is quite graphic. Do you think this is a good representation of catheterizing? Would it be helpful to someone if there were a link to it? I'm not familiar with the procedure, but since you are maybe you could evaluate it.

http://courses.vetmed.wsu.edu/samdx/urinary.asp CLICK HERE for catheterizing demo

[CarolC]

Hi Beth,

Here's a link to the webpage so far. It needs the input of someone with a bigger dog, don't you think? He's added Sandy's experience with expressing her 85-lb male dog where it says Expressing Station (a great idea). That's all there is on large dogs. Do you think you could add something that would be helpful to others in your situation?


CLICK HERE to see MarkR's expressing page

[BethT]

Hi Carol,

Thanks for all your ideas about expressing, I guess I just have to keep experimenting. It took me about 4 or 5 months to finally be able to express a significant about of urine from Waffles. For me I think it was the fact that Waffles was not producing a whole lot of urine therefore I could never feel that "balloon". Once I started to put lots of water in his food he really started to produce a lot of urine so I was able to feel his bladder. That made all the difference.

I would be happy to try to describe how I express him in his cart in as much detail as possible. Waffles is 55 pounds and I can't imagine how any one with a larger dog could express while not in a cart. I don't know if Mark would be interested but I have a digital camera if photos would help. I would just need to know what size and format he would need them in.

I checked out the catheter page. I think that it was good but maybe makes the procedure look a little more scarey then it actually is. The catheters that I use are all kept in a tube with a solution called cold sterile. I re-use them and do not have that little finger grip thing as shown in the photo. I also do not use a sterilized hemostat to feed the catheter through. I just wash my hands well and then rub that antibacterial liquid on my hands right before I grab the catheter (that is the way I was taught by my vet). I just try to hold the catheter back as far as I can. Anyway, so I am not as sterile as those photos. Waffles has been on a preventative antibiotic for the whole time and knock wood has not had an infection yet. It would probably be good to show how far the catheter goes in and how the syringe is connected and when to stop suctioning out urine. Just little things like that for the absolute beginner. Because really, it is the beginner that really needs to see step by step photos. I am so glad that my vet started me out with cathetering Waffles. It was so much less stress (once I got over my fear of hurting him) in the beginning of his recovery. I think anyone who has a male dog should be shown how to do it by their vet.

Let me know what else I can do. I'll start to focus on detail the next time I go out to express Waffles. It might take me a couple of days to get it in writing and I would be happy to photograph it if that would be helpful.

Thank you Carol for all your time that you devote to this board. You help a lot of people(including me).

[CarolC]

Hi Beth,

Thank you! I thought those photos on the catheterizing page looked a little, er, clinical myself. Well, you'd expect that for a vet school website I suppose! I will see if I can find any other websites on the subject, and if I do maybe you could evaluate them see if they are better. Maybe we can find one that is appropriate for beginners w/o medical training. I read what MarkR said above about the pictures. I agree, that would be wonderful, and would help other dogs and their owners. Thanks!

[BethT]

Hi Carol,

I will work on photos of expressing in cart in the next couple of days (will let Mark know under his post also). As far as cathetering goes, I think it is great to have the info for people. I would have loved to have photos of it when I first started to do it just to refresh my memory(and it is a little scary at first). But I think it should be pointed out that catheterization is something that should be done only after being instructed by your vet. I wouldn't want someone to look at a site showing how to cath and then decide to try it on there own. Does that make sense? Beth

[CarolC]

I think you're right. It would either need to be left out, or included in a way that emphasizes the vet needs to instruct you on this. People pretty much have to get the equipment from the vet anyway. I haven't looked for any more websites, but still may.

Beth, on a totally different subject...does Waffles lift his tail when you express him? My dog does, but she's a female. Is it only a female reflex or does your male do it, too?

[BethT]

Hi Carol,

Yes, Waffles tail does go up while I am expressing him. Maybe not everytime but definitely when I get a good flow of urine going.

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. Have you ever heard of someone's dog doing this? 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. Any thoughts?
Thanks.

[CarolC]

Beth, that is so cool, because my dog does it too, but not as much. For example, she will be sitting on her bottom like a doll with her back legs pointing forward, and she will begin to bend one knee, then the other, bend, straighten, bend, straighten, and a few times (like maybe 5 times total?) she has actually expressed herself a little bit. I think it means she knows she needs to go, and if she really really tries, she can go a little bit. The problem is, since she is sitting most of the time, she is going to be urinating right where she is sitting, which spoils it because she feels like she has to scoot away from the forming puddle, so the panic probably interferes with her expressing herself. I wonder if down dogs would be able to get their bladder control back better if there was just some way they could urinate *when they want to* without risk of having to sit in it. You're not going to be encouraged to relearn to urinate if you're just going to wet yourself.

The other thing she does routinely is when I express her, she raises her hind feet into a dainty mid-air squat. Tail up in a sickle, feet up in a squatting position. It's very neat. I was disappointed she didn't do it for our photo shoot of expressing at the vet. She was too nervous that day.

Anway, it sounds like Waffles has some bladder control and he is exercising it. It is delightful for me to read someone else describing this. Thank you.

[markcrobinson]

Great Stuff! Thanks. I've added it to the bottom of the page. The material here is getting very complete and becoming quite valuable.
As far as photos... YES! Photos of expressing a larger dog would be great. If necessary I'll even lend you a camera.
You can email the photos or send the memory card.

Thanks again!
Mark