How to Express a Paralyzed Dog's Bladder

Co-authored by Melissa Nelson, DVM, PhD

Last Updated: January 2, 2024 Approved

Dogs with spinal cord injuries (common in some breeds, like dachshunds) frequently cannot urinate on their own.^{[1]
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Research source} In a case such as this, the dog's bladder needs to be "expressed" on a regular basis by its owner, meaning that the owner needs to manually empty his or her dog's bladder. Unfortunately this requires an intense commitment from the dog's owner. However, with a bit of practice, any committed dog owner can become proficient with the techniques required for expressing a dog's bladder.

Method 1

Method 1 of 4:

Understanding the Basics

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1
Know the complications that can happen when a dog can't urinate properly. Possible medical issues that can arise in a dog that can't urinate include urinary tract infections and urine scalding, in which the shin is burned by long term contact with urine.^{[2]
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- An overflowing or leaking bladder is an invitation to urinary infections, which, if not treated, can lead to lethal complications.
- It is also important not to allow bladders to overflow because this can lead to loss of bladder tone. Then, when a dog might recover its bladder control, the bladder will not function correctly.
2
Consider the commitment involved. Deciding to help your dog urinate is a major commitment. You will have to do it about 4-6 times a day.
- Luckily it only takes about 10 - 20 seconds each time. Still, many vets do not encourage people to try expressing their dog's bladder because it takes such an intense commitment. Unfortunately, the main option other than manually emptying a dog's bladder is to euthanize the dog.
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3
Understand your dog's urinary system. With the bladder, you have to empty it often or the dog will become poisoned by its urine. Urine will not come out by itself; it will only overflow what the bladder CANNOT contain as more urine flows into the bladder from the kidneys. The rest stays put. That's one reason why disabled dogs are so prone to urinary tract infections.
- What about the poop? The poop is really different from the pee. The poop will come out on its own, without your helping, eventually. There's no risk of it staying inside and causing infection.
Have your vet give you a demo first, so that you know the correct pressure to apply. If necessary, the next day go back and express under supervision of the vet or his vet tech to make sure you have gotten all the urine out of your dog's bladder.

Method 2

Method 2 of 4:

Emptying a Small Female Dog's Bladder

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1
Squat in front of the toilet, holding the dog with its backside over the bowl, and its body resting on your left leg or knee. In this position the dog's head will be looking behind you.
- You can also do this outside over grass, but it will probably be more convenient for you to simply take your pup into the bathroom.
Then reach under her body with your right.
Feel around for something that has the dimensions of a lemon and the consistency of a water balloon.^{[3]
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4
Squeeze gently, pushing slightly toward the back of the dog. It takes some practice, but the hardest part is learning the "feel" of the bladder.
- This is the part that you veterinarian will be most helpful at explaining or demonstrating.
- Your dog may lift their tail when you have found the right spot.^{[4]
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When the urine stream goes from a stream to a trickle, the bladder is fully expressed.^{[5]
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Research source}The bladder will feel "flat" once it is totally empty. It should take less than a minute for the whole bladder to empty.

Method 3

Method 3 of 4:

Emptying a Small Male Dog's Bladder

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With a male dog, the aim is harder, so emptying his bladder into the toilet would be more difficult. You can stand or squat with the dog.
Your left hand should be supporting the dog around his rib cage.
You should feel above the base of his genitals for the bladder. Sometimes it is quite high up in the body.
The urine must make a right angle turn through the urethra, so don't worry about squeezing toward any direction. Again, continue squeezing until the bladder is flat.

Method 4

Method 4 of 4:

Emptying the Bladder of a Large Dog

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It will consist of a small ladder, a bar, and a sling.^{[6]
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Research source} In order to adjust the height of the sling handles that hold the dog's abdomen, put some nails along the bar. Securely fasten the nails (or screws) along the areas where the handles hang off the bar. You will want to be able to move the handles further apart to raise your dog's rear end up, so each nail should be a few inches apart, so that the height can be adjusted gradually.
If your dog can't walk on its front legs, then you will need to carry your dog to put it in position.
You will want to hook the handles on the nails on the bar, beginning at the positions that are closest together.
4
Adjust the sling height using the nails on the bar. Put the handles at different positions on the bar, moving one side at a time, one nail at a time, until the dog's rear end is supported by the sling. When positioned correctly, the dog's rear end should be supported but not so high that their back feet are more than a few inches off the ground.
- You should be supporting the back weight of your dog while you adjust the sling. Use one arm to hold the dog up while you use the other to move the sling handles.
Your potty station should hold the dog up securely.
6
Use both of your hands to express your dog's bladder, squeezing gently from both sides. The dog will learn to fall back and let the sling will hold it at the right position. The sling should be positioned so that the bladder is 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!).