Submissive Urination. How To Not Scare The Pee Out Of Your Pup.

Lucy, my heart is always captured by those eyes,
but the ears seal my fate.

I see quite a few dogs with submissive urination problems. For parents it can be very frustrating as they try to convince their pups to not pee when they are already peeing. I was just asked this exact question on Pawbly. So, I thought it would be a good opportunity to share my advice and my clients experiences.

Here is the question that Nicole asked;

My female dog who is 22 months old is submissive urinating. Has anyone else ever had this issue and how did you go about fixing it?

Every annual exam should look like this..

Here is my answer;

There are a few things that should be discussed with your vet to help identify the source of the problem.

Here's where I would start;

1. Breed
2. Anatomy. Look for inverted vulva, an anatomical defect that affects urination/UTI. Look for a urinary tract infection. Check a first morning urine sample.
3. A good physical exam.
4. A good behavioral exam.
5. A long discussion on how housebreaking went.

Here is my experience with these cases; IF, everything above is normal and no problems are found it is usually a problem with over stimulation. This "over stimulation" can occur as either;

Submission, i.e. a threatening or intimidating person/presence gets too close to you. For me this is the Cocker Spaniel cowering in the corner of the exam room. As soon as I get to within about 3 feet they pee. "Ooops, and sorry," we both say. Submissive urination occurs because a timid insecure dog is bowing in deference to an adult or top dog. This can be you, a family member, a strong adult figure and even another dog.

Aura, a beauty, no doubt.

OR,

Excitement. The four month old lab who is throwing herself all over the room as if I am her long, long, long, lost mom who just returned from a 4 year trek to Machu Picchu.

I see these pets most commonly urinating when the parent comes home, new people arrive at the house, excessive excitement, etc. I also saw it recently in a family that was reprimanding their puppy because she was doing it. Please note that there is a difference between "submissive urination" and "excitement urination."

It is important to know which behavior your pup is eliciting. BUT, in general, both are a result of over stimulation. So I am going to try to simplify it for those of you who aren't sure which your pup is exhibiting and what to do about it. In general, people with absent-minded peeing pets just want the peeing to stop.

Excited for a treat or a belly rub.

The key to conditioning your puppy to not get soo over stimulated/excited is to go back to basic housebreaking rules. Re-start from scratch your training EXCEPT this time there is only mild, calm gentle praise for GOOD behavior. NEVER EVER reprimand bad behavior. It causes stress and stress exacerbates the condition.

Willow sits safely, but confidently, next to dad.

Here's where people fail. They can't become robotic calm parental guides. Their stress, anger, frustration, etc is passed onto their pet and the snowball effect occurs. Don't be anything but a gentle kind guide for your pup. Don't let or encourage your pup to get over excited or over anxious. Both are ends of the emotional spectrum which prohibit your pup from being a happy, healthy, emotionally secure independent individual.

I always also discuss how the housebreaking is going. Some have failed in the adequate complete housebreaking plan. This needs to be addressed as the discovery process to the root of the problem is explored. Here are my simple tips to successful housebreaking;
While housebreaking your puppy she is NEVER out of your control. She is either;

1. In her crate,
2. Outside potty training on a leash, treats in tow, gentle praise and commands . Even this has to be structured, not just let loose outside. You aren't training unless you are participating.
3. Tied, yes, tied to you. So, that if she starts to pee you can pick her up and carry her outside to finish going. And praise her (calmly/quietly) when she does finish peeing outside. 

I wrote a blog with more of my housebreaking tips. It can be found here; Housebreaking. And one on Crate Training, (JIC).

Zeus, the epitome of a secure dog.

Your first stop should be at the vets office. Try to find someone who also specializes in gentle behavior modification. The most detrimental thing for a submissive pup is a threatening, forceful, or intimidating person. 

Best of luck,

Krista

If you have advice for this pup you can add it to the question here. And, Thank You for helping pets!

If you have a pet question you can ask it for free at Pawbly.com. Pawbly is a place  for  all pet people to  ask questions, share experiences, and build stronger relationships with their pets.

You can also find me on Twitter @FreePetAdvice, at the clinic, Jarrettsville Vet, or sitting ear buds in place in some dark Baltimore coffee shop glued to a laptop.

And please always be kind.

The Power Of The First Impression

I got a call from a client last week. I called her back the same day as any respectable success business minded fellow human being would do.

Winston's pyoderma on the tail.
We call it a hot spot.
First place to start with these cases is flea prevention.

"Thank-you so much for calling me back!" I could hear that she was troubled, jittery, and grateful in her over-expressive preface. I have known her for many years. She is a smart articulate doting mom; always a need, a worry, and a barrage of questions with every examination. She travels a great deal and always finds home back in our little town. She would be intimidating and over bearing to others but she allows me to be my honest, forthwith self, and it is abundantly clear that she loves her dog, so I accept her abrupt inquiries with ease.

"We moved full time to Atlanta a few months ago and we have yet to find a real vet here so we need your help." So began the second line to the phone call.

"Molly had a rash on  her belly and private parts and a bought of facial swelling last week. We thought it might pass, but after a few days it appeared that she needed more than the Benadryl we were giving. We looked on the internet and thought this was the correct treatment so we waited,,,and after all you are her vet and we aren't comfortable anywhere else."

Zeus visits for hives.

Zeus is a pup with life long skin challenges,
Ugh, those white Boxer/Pitties they are a dermatologists daily planner. 

I jotted  few notes in her chart and a few in my head.

The chart contained;

• Owner moved,
• Rashes on ventrum, inguinal and perineum regions,
• Facial swelling three days duration last week,
• Non-responsive to Benadryl with accompanying dose.

My head contained;

• Why did they wait?
• Why did they diagnose with the internet?
• When did they think they needed to find a new vet?

And then there was Molly. My worries with any swelling or rash are the following;

1. Root cause? 
• If it is allergies the swelling can progress to causing life threatening breathing difficulties.
• If it is NOT allergies, is it lymph nodes? Could this be cancer or infection? 
2. Time delay.
• ALL of these need IMMEDIATE INTERVENTION for optimal outcome.

Lucy demonstrates her relaxation technique while waiting for  her annual exam.
We are very good friends.

The third part of her phone call was even more troubling...

"I also went online to find a vet. I was looking for someone close who had been in practice for some time. I found a vet who had been in business for over 30 years. I figured he had to know what he was doing and be good. I made an appointment and went the next day. It was an awful experience. When I arrived the technicians immediately took Molly away from me. I thought I don't know you, you don't know my dog. I was very uncomfortable. Sometime later she re-appeared. They told me that she was having an allergic reaction and they were prescribing some medication. I thought, 'Where is the doctor? I haven't even met him yet?' He arrived a little while later. When he came into the room he didn't introduce himself. He didn't greet Molly. He went on to say he was prescribing medications. When I asked 'Why she had gotten the rash?', he replied, 'Well, you know girls don't always wipe from front to back.' I was so dumbfounded I didn't know what to do."

The redness on her belly and inner thighs is from licking and laying frog-legged in the dirt.

I swallowed hard. Trying to choose my words carefully I said, "Well, that is indeed pretty awful, I agree. I think that if you are ever uncomfortable with anything being done you should speak up and remember that you know Molly better than anyone else. If you didn't want her to be taken away you can tell the technician that you want to be with her. That's a perfectly acceptable request. If you have questions you are paying for his time and his expertise. He should be happy to answer your questions. And, as far as the wiping comment goes, I have no descent excuse for that. It's immature, unprofessional and inappropriate. I don't know how you are feeling now, but as a practice owner I would want to know if anything like that was happening here. It might benefit another pet and another client if you called them and voiced these same concerns to the hospital owner or practice manager. And, certainly only go to a veterinarian and veterinary clinic that you trust and feel both comfortable and well taken care of. Maybe it would be  better to ask your co-workers and neighbors for a veterinary recommendation?"

If you aren't seeing a face like this often you are missing the great joys of a pet.

Related blogs;

Why Cold Calls For Estimates Are About The Worst Way To Find A Vet

How Do Our Perceptions Lead Us?

Which Kind Of Vet Would You Be?

If you have a pet story I would love to hear it. If you are looking for some help for your pet you can find me and a whole bunch of pet friendly people at Pawbly.com. Pawbly is a free service dedicated to connecting pet people to help pets the world over.

You can also find me on Twitter @FreePetAdvice and Facebook, or book an appointment with me at Jarrettsville Vet.

Kitten Head Tilt? Maybe? Upper Respiratory Infection? Maybe? Polyp? (See the video!)

This is Louie the first exam that I saw him. In the first few photos he was about 2 months old. He, like almost every kitten we see came from a barn, or an outside colony, and was saved by a loving family from having to follow in the footsteps of his parents. There is a terrible epidemic of neglect and responsibility among too many people that think that it isn't their obligation to spay and neuter their pets. Of all of the adorable kittens I see I know there are dozens more who grow up feral, abused, or eaten by wildlife. Louie was very, very lucky, he is, as you can see, also adorable!

He had been to the clinic twice before for an upper respiratory infection (URI).URI's are one of the most common ailments that we see in young kittens. Typically they present as a sniffling, sneezing, subdued, lethargic kitten who has stopped eating. Sick kittens usually have both ocular (eye) and nasal discharge that is thick yellow green snot. Sometimes they even arrive open mouthed breathing because the nose is so stuffed. They usually also have a fever. He had been on two rounds of two very good antibiotics and yet his nose remained snotty.

Louie also had a significant head tilt to the right. Because his head tilt was so marked I wanted to see how he navigated. In itself a head tilt isn't indicative nor detrimental on its own, but it can affect the pets ability to ambulate and eat. For Louie it didn't seem to affect him at all. He could walk in a straight line, focus and hit his target, and turn both to the left and the right.

Anatomy of a head tilt. The right ear is lower than the left, Louie tilts his head to the right.

The head tilt is consistent through all ranges of head movement, looking up down and even side to side.

At Louie's exam we discussed all of the things I was thinking. I explained that I thought Louie was functioning just fine even with his trademark head tilt. I also mentioned that he still had a little bit of green snotty discharge from the left nostril, but he had no other signs of infection.

Most importantly, his heart and lungs sounded normal. He did however have a very audible consistant stertor, which sort of sounds like a low pitched snore. It occurs when there is a mechanical obstruction at the level of the larynx, or back of the throat. I was very suspiscious of Louie having a naso-pharyngeal polyp. He sounded clear and normal everywhere excecpt the back of his mouth/high trachea, he had no evidence of still having an URI expecpt the left nostril and he was happy active and playful. I suspected that he had a polyp or mas in the back of his soft palate that was occluding air flow therefore making his constant snoring sound and irritating his nose constantly so that it was goopey incessantly.

Here is where I got concerned. If I was right he and the polyp would continue to grow. Polyps can get so large that they cut off your ability to breathe. We usually wait to neuter kittens at about 6 months. That was 4 months from now. I didn't want Louie to wait that long. I was afraid that if we waited we would be risking his life. We vaccinated him that day and he returned two weeks later at barely 3 pounds for his neuter and oral cavity exploratory. I was nervous. I am always nervous. What if I was wrong and there was a problem with anesthesia, he was so little, and he had been through a lot already.

Surgery/Neuter Day;

One back rub before surgery.

As soon as I opened Louie's mouth there it was! Hiding, lurking all pink and tumor-like behind the soft palate, a big giant polyp!

I intubated Louie and then used a soft tipped hook to gently pull the soft palate forward so I could get a better idea of how big and how easily this thing could be removed. Even though Louie was just going under anesthesia pulling and moving the mass caused him to cough and swallow. Removing a polyp is a 2-3 person task, one to hold the head and mouth open, another to hold a light, and me, well I need both hands to try to fit into a tiny kitten mouth..

Here is a video of us trying to get a look at the size and scope of his polyp.

Pre-op the mass is in front of the surgical elevator.

The moments of us in awe and utter jubilation that it came out! For as much as this job can be hard, demanding, and gut wrenching, there are moments like these where we all work together and make a huge difference in a patients life.

When the polyp was in the back of the throat it was bright pink. Now that it has lost its blood supply it looks white.

The polyp, at almost 2 inches long!

The rest of Louie's procedure; the neuter.

Neuter time

Waking up with the chest elevated.

The polyp is as big as Louie's face!

Looking down Louie's throat, nice, clear open airway!

Louie's endotracheal tube remains in place AND inflated as he wakes up.

 As we watch and wait for Louie to wake up I make sure the the endotracheal tube is in place and still inflated so that any blood that might have occurred as we removed the polyp comes out of his mouth instead of going down his trachea to his lungs.

I hold him with his head down and gently coupage (cup your hands and pat the sides of the thorax to break up and help expel any stuff that doesn't belong in your lungs), as he starts to wake up. We also keep a bulb syringe next to him to suck up any saliva in the back of the mouth.

 Louie wakes up smiling! And breathing quietly for the first time!

Every patient gets a kiss after  surgery, (lol, like it or not...)

Louie woke up a quiet, peaceful kid, still a little bit of a head tilt, but I suspect it will resolve a little...although it is pretty cute.. and his trademark.

For another blog on naso-pharyngeal polyps see Kiki's story.

If you have a pet question, or want to learn more about a pet illness, disease, behavior, etc.. you can ask me on Pawbly.com. If you want to share your pets life please join us in celebrating the amazing tales of our companions at Pawbly. Pawbly is a free on-line community dedicated to helping people learn about how they can take better care of their pets.

You can also find me on Twitter @FreePetAdvice, or Facebook, or at the clinic kissing my patients, at Jarrettsville Vet in Jarrettsville Maryland.

Halloween Pet Hazards.

Jekyll, the shark.
Not a fan of the costume.

It is that time year where the sun sets earlier and we are all reluctant to remove ourselves from the warm blankets to witness the frost kissed windows. The trees begin their self-preservation vasoconstriction causing their limbs to squeeze the life blood from their leaves causing them to shed like jewels from their crown in a glorious display of an autumnal ticker tape celebration. It is a magnificent time of year. The heat has dissipated, the allergens are receding to hibernate until another summer day months away, and  the cataclysmic onslaught of the offspring of those incredibly prolific breeders has taken a small break to let the reproductive organs regroup and refuel. It is fall!

The holidays are looming and the drum major of them is Halloween. The time to dress up, unleash our inner ghouls and dance in the darkness in search of high calorie, sugar laden treats! It is Halloween the gala of costumes, the parade of marauders, the display of gallantry and cacodemons. 

Ah, it is as entertaining to watch as it is to participate in. But like all haunted hallowed eves there are dangers that lurk.

Monty, (who's dad is my very good college friend), 
as Little Orphan Annie

Here's my list of Halloween pet dangers to beware of;

Costumes;

Remember these are foreign items to your pet, and most pets are frightened of them. They are afraid to be dressed in them and don't understand why other dogs turn into alligators, superheros, and cheerleaders, etc... Any frightened pet will act erratically, and erratically can manifest as cowering, hiding, fleeing, and even attacking. Do not demand more of your pet than they are capable of handling. Halloween is a one day of the year event and trying to condition them to every monster in the universe for this one day is a beneficial endeavor. Choose your battles, and know your pets limitations and tolerances. Do not leave a pet unattended with a costume on. Your pet views that costume as a scarlet letter. And as fast as a ferret they can twist, turn, convolute, and intussuscept all in an effort to escape the straight jacket you placed them in. All costumes, wigs, clothing, jewelry, and accessories can be, might be, and should not be, swallowed. To compound your dilemma they are in most cases made of synthetic unforgiving, indigestible material. The only good news is that much of it will show up nicely on either your x-ray or ultrasound. Dress your pet, snap your photos, and start leash walking to collect your booty.  Once your escapade is over strip your pet back down to their birthday suit.

Charlie, the black sheep,
and Jekyll the bunny.

Candy;

Sorry. Any and all of it is forbidden for your pet. They are a very poor choice of calories, detrimental to the pancreas and chocolate in larger quantities can even be toxic. Not to mention the wrappers being an obstructive potential. Your two legged kids are your decision. (Don’t ask the dentist for their vote though).

Savannah, the mouse.

Light;

It is super important that the trick or treating Halloween entourage be highly visible. I like to use reflective tape. It is very safe, very effective and leaves your hands free to collect candy. The other bright ideas are glow sticks. They say non-toxic, but who wants to find out how non-toxic they are? Dogs will eat anything, especially if it dangles, flashes, and swings from your best friends body. Last note, keep your pet as highly visible and as close to you as is possible. The biggest danger to your pet is when they are about 6 feet away from you on the end of a dark leash. A driver will automatically be focused on the group of children and may not see your pet lower to the ground and not well lit.

Jekyll the pumpkin

Jack O'Lanterns;

The carved pumpkins are the harbinger of the Halloween season. Nothing says spooky like the flicker of a candle in the hollow of a carved pumpkin. The flicker glow of a candle is alluring and calls inquisitive noses and whiskers. Your glowing Jack on the porch should never be left alone with your pets.

Trick Or Treating;

This is Pandora's box on public display. My honest heartfelt advice is to leave your pet at home. Why? well, because there are too many strangers, too many opportunities for accidents, mishaps, and mischievous beings. Too many people want to approach your scared, reluctant pup and place their hands on them. It is already dark out, and a pups ability to see well is significantly lessened in low light. They know this, and they will hyper-react to stimuli because of it. So here’s what we have; First, decreased ability to see, and second, increased anxiety due to loud chaotic goblins fleeting about. The result? We have two criteria in place for a perfect storm. Add your pup to this and voila! Trifecta! Keep your pet at home.

Trick or Treaters;
Remember those little goblins at your door are intruders to your guard dogs and spooked house cats. The safest place for your four legged kids is safely is in their crate closed away from the bustling activities, or in a quiet enclosed safe room. Set them up in their safe spot early and return to them after the front porch light is off.

The old superstitions that put your pet in danger;
Black cats and stray pets. The night of all hollows eve is notoriously dangerous to these guys. Keep your pets inside under close supervision and be the advocate for them. Lastly, help dispel the superstition by adopting a black pet(s) (the lowest adoption rates is among the black cats and dog) and embracing the beauty of a pet in dire need of a friend.

Do you have any pet Halloween insights to add? Please let me know.

Oh, and another last note! Please, please send me those photos! Have a wonderful safe Halloween everyone!

My baby bunny.

 Halloween, it might be your children's favorite holiday of the year, but it probably isn't your pets. Be safe, be proactive, and be wary. There are ghosts that linger in the night.

The 2014 Halloween photos

Charlie the cowardly lion.

Jekyll the spider.

..the shark.

..the frog..

Charlie the  pirate

..the dragon.

..the other dragon..

and the boys...

Oh, and another last note! Please, please send me those photos! Have a wonderful and safe Halloween everyone!

My mom and sister. When we collectively dressed as the Addams Family.
At my house.
Which never requires too much decorating to look like the Haunted Halloween House.

If you have any pet related questions you can find me, and a whole slew of amazing people, at Pawbly.com. We are happy to help you, and we are always FREE to use! Come join us as we help people take better care of their pets. Also on Twitter @FreePetAdvice.

The Wounds That Lie Beneath. Dog Fights and Dire Consequences

There is a certain thrill in being involved in medicine. It is the mystery of the unknown, the deep rooted feeling of being able to improve a life, assist in comforting, and alleviating pain. It takes a little leap of courage every so often to do something that you have only read about, to diagnose and treat something a bit out of your comfort zone. But it allows you to grow, it strengthens your medical or surgical skills and it broadens your resume so that you can in turn assist more patients.

There are tiny pearls of wisdom that experience teaches you. These are some of the things that I hope this blog imparts. It is no different than the budding vet students life. You read, you study, you share, and when that fateful day arises a little bell will go off in your head and you will proclaim, "I remember something about this.." and a pets life will benefit from some pearl picked up by someone sometime ago.

This is Angus, an older Jack Russell Terrier who came to see me one Sunday. He was a quiet, timid, handheld package. He had been in a dog fight and was the apparent loser. I will admit that most of the dog fights I see are JRT's, and in almost all of the cases it is an older Jack who lives with other Jack's. Almost invariably the victim is the source of the instigation and the subsequent fight. The older dog challenging the younger kid but miscalculating their size, skill, agility, strength, and swiftness.

Jack's are highly energetic, possessive, fierce little dogs. They love their parents, bond very closely with them, but have a low threshold for other dogs. And, in most of the cases I see the bruised battered Jack lives with other Jacks whom they squabble with every so often over some possession. And every so often that squabble erupts into a battle of bites. They fight quick  and dirty. A grumble turns into a snap and two seconds later someone is bleeding and limping. I have sewn up more Jacks than any other breed combined.

Such was the case with Angus.

Like a true lifelong fighter, Angus has a graying muzzle, a few scars, scratches, and a look of pain and humility in his eyes. Clearly this isn't his first encounter with a disgruntled roommate, and clearly he needs to rethink his self entitled crown.

When I first assessed Angus my first impression was he was incredibly painful. He also refused to use his back right leg. These are signs of an injury that should be seen immediately.

Angus also had a large swelling to the abdomen at the top of his right leg. Of all of his puncture wounds, lacerations, and battle wounds this was the one I was most concerned about.

Here are some of the things that you should seek immediate attention for if your dog has been in a dog fight;

1. Trouble breathing. Always an emergency.
2. Trouble standing, or walking.
3. Cries or snaps when touched. 
4. Blue tint to tongue or gums.
5. Reluctant to lay down, sit down, or move.
6. Limping.
7. Seizure. Always an emergency.
8. Bleeding that will not stop with gentle pressure for 5 minutes.
9. Large and/or deep wounds.
10. Injuries to the eye, mouth, throat, chest, or abdomen.

That wound on his right side looked like this on the x-ray. The right side of the film is normal. The ribs run down the right side to the body wall and then to the pelvis. The left side however has a bulge of soft tissue to the left of the side of the pelvis.

That bulge the to left of the pelvis is Angus's intestines. They have escaped the confines of his abdomen from a rent (tear) in the abdominal wall.

If left untreated the intestines can strangulate and this will lead to death of the intestines and death of the rest of you.

Hernias can occur anytime there is a whole in the abdominal wall. We see them most commonly in the area of the belly button, inguinal hernia, or associated with a congenital abnormality. They should always be corrected surgically if any abdominal contents can, or are, slipping out of the abdomen.

The next day Angus had his abdominal hernia closed. He was kept on pain medications and antibiotics from the time I saw him through the first two weeks post-op.

He made a full recovery and will live to see another kerfuffle. The next time, hopefully, it will only be a verbal match.

If you have a pet question, or want to help other pets with your own pet experiences please join me on Pawbly.com. Pawbly is a community of pet enthusiasts who all work together to improve the lives of pets across the world. Pawbly is free to use and open to anyone who cares about helping pets.

You can also find me at the clinic, Jarrettsville Vet, on Twitter @FreePetAdvice, or on Google plus.