Dear Doctor

Letters to the Tufts Veterinarians


The puppy won’t stop piddling indoors

Q I have a 14-week old yellow Lab named Benelli. We’ve had her since she was seven weeks old, and from the beginning she did great with housekeeping. Unfortunately, she developed worms at about 11 weeks. The medication makes dogs’ bowels loose, and she had many accidents throughout the house. The worms have long cleared, but it has continually gotten worse to the point that she will squat and urinate where she is! If she is on the couch, she will actually squat and pee right there — the bed, her crate, anywhere. I know she can hold it because she does not urinate in the house all night long, and she doesn’t go in her crate when we are away from home. It’s only when we are in the house that this goes on. We have tried taking her on a leash inside the house, gone for longer walks outside, used a different lead, gone to different areas in the neighborhood, and also tried all kinds of lab testing, ultrasounds, hormone pee sticks, potty training classes, and nothing has worked or given us any answers. Is there anything else you can suggest? Our home is becoming wrecked with urine odors, and my husband, at his wit’s end, has told me that if I don’t get this under control soon she will become an outside dog, and I do not want that.

Lizzi Conklin

Muskegon, Michigan

Dear Ms. Conklin,

AThis one does present a puzzle. The most vexing part is that Benelli doesn’t urinate in the crate when you are away from home. That makes it sound like a behavioral problem rather than a medical one but even so, it’s not clear that all medical causes have been ruled out.

One thing that is clear is that the deworming medication did not lead to this problem. Deworming causes a decrease in loose stools, not an increase, and should have no effect on urination, at any rate. And although you list a number of diagnostic techniques to rule out medical issues, without your specifying what the tests were for, it’s very possible that not every medical stone has been unturned, so to speak. There are many conditions that can cause a dog to house soil, and while some are easy to detect and treat, such as urinary tract infections, others, like an ectopic ureter that doesn’t empty correctly, are more complicated. A visit to a veterinary internal medicine specialist may be warranted.

If it turns out truly not to be a medical problem, then it must be behavioral, in which case certain basics of housetraining must be followed religiously. They involve thorough cleanup, avoidance of punishment, consistency in training, proper timing, and high-value treats.

The best way to insure thorough cleanup is to prevent accidents from happening in the house in the first place. This can be accomplished via crating or leashing. The crate must be large enough to allow the puppy to turn around comfortably but small enough so that he cannot move to the other side of the crate to avoid standing in his own urine (or feces). It also must not have bedding in it that can absorb the urine and make the pup feel as if he is not standing in it. Most puppies do not like to stand in their own waste and will not pee if it will cause them to do so. Likewise, when the puppy is leashed, the leash should be short enough so the pup cannot walk away from the mess. But it’s not enough just to have the leash contain the dog. You have to watch for signals that Benelli wants to urinate — sniffing, circling, getting a little agitated — and rush him outside as soon as you see any of them. There will be signs, though they may be subtle.

Areas that are already soiled must be cleaned with enzymatic cleaners to eliminate the odor completely. Products such as Nature’s Miracle or Anti-Icky Poo can work, and Zero Odor is yet another option that some people report works better. Go around with a black light to make sure that every soiled area is thoroughly cleaned. If there is still an odor, your puppy will continue to get the olfactory message that the home remains an acceptable location for elimination.

Never punish Benelli for mistakes, and that includes never speaking harshly or angrily to him. That will only make him nervous and unable to think straight about where his “bathroom” should be. It will set you back rather than push things forward.

Do reward appropriate elimination behavior — every single time until the dog really has the hang of it — with lavish praise and a most delectable treat, like a bit of freeze-dried liver or a tiny piece of cheese. While it currently feels good to Benelli to urinate anywhere, treating appropriate elimination with praise and prized food will make eliminating worth waiting for.

Remain meticulously consistent in your training. Take your puppy to the same designated spot frequently. Wait several minutes and let him sniff to his heart’s content. If he doesn’t relieve himself, take him back inside — without rancor — and put him in his create or hold him close by you on his leash. After 15 minutes, repeat. Stay calm. It may take several tries, but it will work. After a night’s sleep is an especially good time to try this.

Consistency in your dog’s feeding schedule might help, too. A regular eating schedule, as opposed to feeding ad libitum, should lead to a regular toileting pattern, which can improve your timing in taking the puppy out. It may prove helpful to keep a diary to pick up patterns.

Hates needles but needs to keep her dog alive

QMy dog has been diagnosed with diabetes, and my vet says I have to give her an insulin injection twice a day, every day for the rest of her life. What should I do? I don’t think I’m going to be able to handle it. Needles literally make my knees shake.

Ann Winfrey

Canton, Michigan

Dear Ms. Winfrey,

AWe once had a woman who came to us for a second opinion about her dog. He had been diagnosed with diabetes, and she said she wanted to make sure that was really the problem. But it turned out that wasn’t the case. What she actually wanted was for us to prescribe pills for the dog’s diabetes instead of insulin injections, the way some people with diabetes can take pills for their condition.

But dogs don’t respond to the medications that a lot of people with diabetes take by mouth to stimulate insulin-producing cells to work harder. Once a dog has diabetes, he lacks enough insulin-producing capacity to work with and needs insulin via a needle.

Don’t worry. Scary as it sounds, you’ll be able to handle it, if for no other reason than that you love your dog and want her to live many more years without feeling sick. Besides, just as it went with that woman who was so fearful of injecting her dog, inside of a week you’ll feel like you were doing it your entire life — handling the needle, the syringe, the vial. It’s just a subcutaneous injection right under the skin, and the needle is very small. Your dog’s vet will teach you to administer it in the floppy skin a little bit behind the scruff of the neck, between the shoulder blades. Many dogs don’t even notice they’re being given a shot. And dogs themselves don’t have phobias about needles, so yours is not going to start barking or whimpering or showing other signs of resistance that will make you feel more upset about this than you already do.

Some people are instructed to practice on an orange before they inject their dogs. If your veterinarian advises that, go for it. It will help familiarize you with the process. What also helps, once you inject the actual dog, is pinching her skin for a minute to kind of deaden it or using an ice cube on the spot for the same purpose. Not all dogs need it, but it will certainly make you feel more comfortable as you get used to the process.

You might never feel totally comfortable giving injections. But we feel very confident in telling you that you’ll get to a point that you’re much more comfortable seeing your dog feeling well again than uncomfortable about what you have to do to keep her that way. A dog with diabetes can live many high-quality years with proper treatment.

Note that you will not have to put your dog on a carbohydrate-restricted diet, as is the case with people. Most canine diets are relatively limited in carbohydrates in the first place.


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