Difficulty Expressing Bladder

[SamanthaRescueDogs]

Hi! I am a foster mum in Houston, TX. I took on my first paralyzed dog named Nala who was seized by the Houston SPCA as part of a cruelty case.

She was released to our group and we were told she was paralyzed. She has a wheelchair, but prefers not to use it. We are attending rehab sessions now at a doggie rehab place in order to get Nala to walk again. She suffered an injury to her T10 vertebrae and has some "spinal luxation".

At only 5.5 lbs she has been incredibly difficult to express bladder on. Even the vet tech and my friend experienced with bladder expression haven't mastered her yet. I get "trained' 3x a week on bladder expression and am just terrible at it on her.

Last night while attempting to express her bladder I went ahead and just started to wipe her down with baby wipes and all of a sudden she was "squatting" and emptying her bladder. I continue to wipe/stimulate her vagina and she continued expelling her bladder.

Again this morning she did the same when stimulated and produced so much urine surely she is emptying out pretty well. I dropped her off at the rehab this morning and asked the ladies to try this method of stimulation on her and then check her bladder size to let me know if this is sufficient for her.

Does anyone else use this "method"? I am really hoping this is the trick to helping her empty her bladder because it's SUPER fast and easy to perform on her. Anyone can do it which makes it easier for others to help care for her.

[CarolC]

Hi SamanthaRescueDogs!



Yes, what you are doing is called external stimulation. The part where she actually squatted was new to me, though. You can see some videos demonstrating external stimulation in a dog and several cats at the end of this article.

viewtopic.php?f=5&t=16027

Another option for a dog that is technically difficult to express (where the problem is not your technique, it's just that the dog is very tight due to the nature of the injury) is medication. There is medication that can relax the sphincter and make her easier to express.

Here are examples:

Disorders of Bladder Emptying with Increased Urethral Tone

1. Phenoxybenzamine; this is an alpha-adrenergic blocking agent, which relaxes the internal urethral sphincter. A side effect is hypotension. The dose is 0.25 mg/kg PO TID (dog) and 0.5 mg/kg PO BID (cat). This drug takes 3 - 5 days to reach therapeutic levels. Other alpha-blocking agents with a similar effect on the internal sphincter but more side effects are acepromazine (hypotension, sedation) and prazocin (hypotension). Be cautious when using these drugs simultaneously.

2. Diazepam; this is a centrally acting skeletal muscle relaxant, which decreases external urethral sphincter tone and spasm. Side effects are sedation and incoordination. Hepatotoxicity occurs in cats with repeated oral administration. Other drugs with a similar mechanism are dantrolene and baclofen.

In general an injury in the lower back or tail area (a lower motor neuron injury) will result in a dog that is not difficult to express (and may leak, dribble, and need a diaper) while an injury further up like T10 (upper motor neuron injury) will result in a dog that is harder to express, and does not leak. I have had both and I really prefer the upper motor neuron bladder, you never have to deal with diapers.

She's adorable. That is one super cute dog.

P.S. Are you expressing one-handed or two-handed?

[SamanthaRescueDogs]

I am expressing her one handed. Both my friend and the tech couldn't express her the way they would a larger dog. And also you are spot on. She doesn't leak urine when she is empty. I put a diaper on her, but it's usually dry.

We stopped using her cart because she can "walk" a few steps and the vet wants her to work her legs more. Today is her third session. Each day they have great reports about her progress in water tread and other areas.

This bladder expression has just been killing me! Today when I pick her up I am going to show them the stimulation and have them confirm she is empty. If so then hoping that will be the trick to her! She will squat and pee when she is supported by me also. But that's after being stimulated. Vet is hopeful she will walk more and drag less. Not that she will be perfect, but will have better mobility for a better quality of life.

[CarolC]

It all sounds very encouraging. Waiting to hear what they say about how empty she is when you do the express check at PT. I'm thinking she may feel pleased with herself if she can do it all by herself with stimulation to get started, and that kind of matters, too.