Bowel management in incontinent pets
Bowel management in incontinent pets is easier than you think. You can provide a good quality of life for your pet and your family.
You can learn how to stimulate a reflex to cause your pet to empty the bowel at a convenient place and time. (This is called expressing the bowel.) You can adjust your pet's diet to produce stools that are easy to clean up. You can work with your pet's natural elimination schedule to avoid surprises. And you can use diapers or protective clothing on your pet for extra security.
Most of the following information is reprinted from messages posted on the HandicappedPets Discussion Board at http://www.HandicappedPets.net. We welcome you to post your questions and concerns there!
Expressing the Bowel
Poop on demand
This may be a subject that makes some people squeamish. If so, do NOT read on...
My doxie has been incontinent since February. Recently Critters posted something that made me think that I could also get my pup to "poop on demand".
I hold him with my left arm crook over the open lidded toilet with his backside facing the wall behind the toilet. Using my right hand, I form my fingers as if picking up a penny. Grasping the anus, I pull in an outward motion to stimulate the appearance of feces/aka "poop". Within 3 -5 grasping motions, he will present feces and they plop into the toilet. Neat, clean, no messy hands, and NO more poop in his bed overnight! (You quickly learn how to feel feces in the rectum.)
This has REALLY simplified my life. He can be expressed of bladder and NOW he can be expressed/forced to "poop on demand". AHHHHH.........
Use a light spray bottle, mixing chlorhexadine solution (disinfectant) w/water, and I spray his butt w/it. He puckers up his anus repeatedly, and if I do it enough (along w/ some very gentle stroking of the area w/a moist soft baby wipe), he poops on demand, onto a paper towel. It's not fun, but a lot better than picking up after an accident. I learned this at the vet, as they had to change a dressing on his butt from an abscess that happened soon after his surgery and had to be treated for almost TWO months. Every time they cleaned him, he pooped. Almost instant reaction.
I stimulate poops twice a day, and he'll occasionally have a BM between times. The stimulation technique is just squirting water on his little tush, and out pops the poop. This has helped immensely since Spike's pacing and circling behavior means that he keeps walking through the poop over and over and tracking it on everything. I might add that the water in the squirt bottle should be cold (not out of the fridge, but not warmed) so it shocks the tush enough to make it pucker. As long as you use the technique when you know the pet is "full", it works great.
The simple way. Lift his tail up, and place an ice cube on his sphincter and hold it there. When it gets pushed out of the way, he's going.
As far as the bowel movements, a bit of Vaseline on the tip of a cotton swab and inserted just a little in the anus will stimulate your dog to have a bowel movement if it is needed. Choose a time that is similar to when they would have done this like after a meal or in the morning etc., so you can partially control when it happens and start to take care of accidents.
I can now just kind of rub around her anus in small circular motion with a baby wipe and she'll pretty much poop "on demand" with that.
Lotion and glove
The last thing that i do, and this really helps, is to "make" him poop twice a day. I do this by puting a glove on my right hand,puting some lotion on my fingers for lubricant, puting him over a paper or taking him outside, I live in cleveland so we're pretty much indoors now, and stimulating his anus. I do this by rubbing his butthole (excuse the gross reference) and then pulling at it gently. It usually takes less than 2-3 minutes, and he poops. I do this in the morning and at night before bed. You can wrap up the poop and throw it away, PRESTO no poop in my bed (hubby was ready to put him down over the poop in the bed thing, can't imagine why.)
Rubbing the abdomen
Now, here is how I empty Jaime's bowel. <snip> I put Jaime into an upright position and rub behind her back leg. She then begins to kick that leg and I continue to do this for a while until I see her tail begin to rise. Then, I place her on her back and rub her left side vigorously for several minutes. As I am doing this her vent begins to open so she can poop. Then, I begin vigorously rubbing her abdomen in a downward motion. If she is particularly constipated I will also move her back legs as I am stimulating her. Jaime seems to have to have leg spasms to poop. If she is on muscle relaxants she doesn't move her legs as vigorously when stimulated and doesn't poop as much.
Use your fingertips to gently press and feel the soft tissue in a circular area around the anus. By pressing on the soft tissue, you may feel something firm inside the rectum. Spread your thumb and forefinger about 1 1/2" apart, lay them on either side of the rectum, press inward on the soft tissue a little, and grip the stool right through the skin. Now you've got a good amount of skin and soft tissue pinched between your fingers and in the center of it is a piece of stool. If you pinch harder, the stool will break off within the rectum and the anus will open at the same time, and it naturally begins to come out. The beauty of this is that usually the remaining stool moves forward into position and you can repeat the procedure. Repeat until there is nothing inside the soft tissue. One thing I try to be careful about is not pinching too hard. I read somewhere about damaging the mucosa lining the colon. I also don't want to prolapse the rectum. I keep a box of kleenex on the expressing station, and each time a piece of stool drops, I drop a tissue over it, which reduces the odor. You may go through a lot of kleenex this way, but I feel it's worth it.
Fecal incontinent kitten
Just wanted to add my 2cents about your fecal incontinent kitten. I would not go with the diaper, it creates more of a mess on the kitty. You can learn to feel the stool in the colon by feeling her lower abdomen, it takes some practice but it works. The last piece of colon is the easiest to feel when it is full of stool. Gently press on it to help push the stool out. I'd do this twice a day, trying to keep it at the same time every day. This will empty her colon and reduce the amount of landmines she leaves for you.
It can take some time to learn, so be patient with yourself. Your vet can help you by guiding your hand and saying "here what you are feeling is..." Meal feeding will help, too. If she free feeds, you never know when she will have stool in her colon but if you meal feed she will be more regular. <snip>
A warm bath might also help her move things along. Running warm water on her belly can stimulate the muscles that move the bowels.
Inserting a finger
I can offer some tips for the poop problem. The first thing to try is to get a box of vinyl gloves from your local drug store. Lube up your forefinger with vaseline or any other good slick lubricant you have. Hold your baby tightly under her belly with your left arm and gently pinch/pull at her rectum with your gloved and lubed right hand. Try this several times, it often will elicite stool. If this doesn't work, lube up your pinky finger and very gently insert it into her rectum. Even in completely paralyzed animals this should stimulate a bowel movement. If your baby is very impacted with stool, you may have to "dig" some if out at first, but then it will come out on it's own. I did this in the house, in a place that my boy was comfortable, and over newspaper.
Managing the diet
Based on experience with one paralyzed dog and several senior dogs, I'd say the answer is to improve the quality of the stools. With my old dog, feeding Science Diet w/d did the trick. It produced firm, well-formed, inoffensive, non-sticky, low odor stools. If he doodled in the house I did not come home to a smelly house. Clean-up was a matter of picking it up with a kleenex and popping it into the trash can, or picking it up with TP and flushing it. Carpet cleaner not needed! If he doodled in bed and a stool accidentally rolled under his hip, it did not get gummed up in his fur. Clean house, fewer baths, happy family. I have heard of other people getting similar results with other high quality foods, you may need to experiment with what works best with your dog's digestive system. I have a senior dachshund on Science Diet Sensitive Stomach dry, and her stools are no problem when she goes in the house. My other senior dog is on Science Diet k/d for his kidneys. I went through many cans of carpet foam while he was on the k/d canned, but after I switched him to the k/d dry, I am back to the "kleenex clean-up" and no carpet spray.
I feed my boy DRIED bill-jac (the low fat stuff cause he was pretty porky,) mixed with water to make a kind of mush (he quit drinking when he got hurt so he needs the water,) if your dog still drinks u could skip the water. On top of that I put a little cut up frozen chicken breast that i've boiled, just to get his interest. This leaves his poop really solid, and like Carol said i can just pick it up, no smears and no poopy butt. He is a long haired dog, so I shave his bottom down pretty close, that really helps too. Carol calls this a sanitary shave i think.
Working with your pet's schedule
Feed on a schedule
Also, it is extremely useful to feed on a schedule. If you follow the same feeding schedule every day, and avoid switching foods, your dog should develop sort of a schedule. You will know when he is "due" to go to the bathroom. And it is definately easier to clean up the mess when it is more formed. My downer dog did well on one of the Nutro Naturals and I fed the dogs twice a day with a snack/ lunch in between.
Timed bowel movements
meal feeding and using a low residue food will help with poop control. feeding in meals will give her more regular/timed bowel movements. Low residue diets produce less poop to contend with.
Learn your dog's processing time
To know how long it takes for your dog to process food, feed a few small pieces of raw carrot or kernels of frozen corn. Veggies don't digest--watch for the BM with veggies and you'll know your pup's processing time, somewhere around 12 hours (Clark's is 14 hours). Often you will be able to park your pup's butt over the toilet and then flush away.... How easy is that!!
Some people use diapers or protective clothing on their incontinent pets for extra insurance against accidents. Other people find that by expressing the bowel, managing the diet, and working with their pet's natural elimination schedule, diapers are not needed. Information on diapers and protective clothing can be found at Diapers and male wraps.
http://users.cyberport.net/~milnerwm/Expressing.html#anchor1101367 (Bowel and bladder management)
http://www.freewebs.com/dmroster/bladder.html (Article on bowel and bladder management)
http://www.youtube.com/watch?v=Saf_kZvwClE (Squeezing method dachshund, start at 1:18)
http://www.youtube.com/watch?v=d18yUDdZVUw (Squeezing method - Popeye)
http://www.youtube.com/watch?v=6ueeTJJW9YA (Squeezing method - dog lying on back)
http://www.youtube.com/watch?v=LbVxdFyGKjs (Expressing bladder and bowel of cat in standing position)
http://www.youtube.com/watch?v=iuMZ4hrijuY (Expressing bladder and bowel of small cat in midair)
http://v.youku.com/v_show/id_XMTczNjAzOTk2.html (Vet expressing cat's bladder and bowel)
http://www.youtube.com/watch?v=HVdJI-qsOus (Expressing large male Persian (Sasha) in standing position - Part 1)
http://www.youtube.com/watch?v=KIFTKuR9-uc (Expressing large male Persian (Sasha) in standing position - Part 2)
http://www.youtube.com/watch?v=OiMJGS2O46Q (Expressing bowel of male cat on his back or side)
http://www.youtube.com/watch?&NR=1&v=XiFpsEToOtw (Expressing bladder and bowel of large female dog)