Potty Training Pointers

I'm trying really hard to follow my own advice this week as we welcomed a new puppy, a 10-week-old American bulldog, to our home. It has been over seven years since I potty trained a dog, but I offer advice regularly to new puppy owners in my practice. These tips have been bumping around in my brain at 4:00 a.m. as I stumble around in the dark after my dog, so I might as well set them down in print.

Tip #1. Feed your puppy meals rather than let him free feed. Doing so makes it easier to predict when the puppy will have to defecate (usually about 30 minutes after eating). So far, I'm failing at this. We've had our dog for less than 3 days. He was used to grazing whenever he felt like it and wasn't eating when I set the food out. However, he is starting to eat more aggressively, so I will start to feed regular meals soon.

Tip #2. Reward your pup for going to the bathroom NOT for coming back to the door. Even though it's inconvenient (and darned chilly), I am wandering around the yard each time my pup goes out to the bathroom. This way I can praise the heck out of him when he lets it rip outside. I've met too many puppies who quickly learn that they get a reward when they return to the house after their bathroom break. They ask to go outside so they can come back in and don't always do their business while they are in the yard. This is because they do not associate the reward with the behavior of going to the bathroom in the designated place. They associate the reward with going out and coming back in. Upon returning to the house they have an inside "accident".

Tip #3. Use a cue word. Most of us probably do this anyway. We want our pup to go potty so we can get on with life. We need to be careful not to distract puppy from his real business when it is bathroom time. No playing until the business is done. Once the pup starts to urinate, you can use your verbal cue one time so he associates that word or phrase ("go potty", "get 'r done", etc.) with the act of relieving himself. Once he's peed and pooped, he gets lots of praise or his training treat.

Tip #4. Walk the pup in a little circle to stimulate defecation. You've doubtless seen dogs of all ages do it, circle a few times in place and then squat to go #2. I find it helps get things moving in the right direction to encourage my pup to walk in a "tight" circle, as if triggering an instinct.

Crate training our puppy

Tip #5. Use an appropriately-sized crate or kennel. A crate is a helpful tool for many reasons. It keeps puppy safe from harm when you can't watch him and protects your stuff from him too. It can be a haven for when pup needs to get away from it all. A crate also helps with potty training. The crate should be big enough to sleep in but not big enough for bed and bathroom because even puppies avoid spoiling their "nest" with their own waste.  Whenever puppy wakes up or you're ready to let him out, get him outside right away to go potty. If he doesn't go to the bathroom, put him back in the kennel for 15 minutes more before trying again.

Tip #6. Do not hit, scold or punish for accidents. It's not going to help. Your puppy is not going to the bathroom in the house out of spite. And even though he may "act guilty" after an accident, he's not feeling guilt. He may be apprehensive because last time you found a puddle he got hollered at. The fact that he made the puddle is not part of the equation. If you catch your puppy in the act, it is okay to startle him with a loud noise. Doing so may momentarily stop the toileting and give you time to get him outside. Some puppies are obvious about needing to go out: they may whine or scratch at the door (EdGrrr always got the hiccups). Others are more subtle, circling an area or sniffing at the floor. You might try teaching your pup to ring a bell near the door when he needs to go out (beware the dog who learns to rings the bell just to go chase squirrels). Another technique is the "umbilical cord trick" where you keep puppy on a long leash inside the house so you notice his signals.

Tip #7. Sometimes pooping in the house is a sign of illness. Not all diarrhea is an explosive, watery mess. My rule of thumb is if you can't pick up the turd without leaving a grease spot, it ain't right. Diarrhea in puppies is extremely common and has many causes: intestinal worms, viruses, bacteria, protozoal parasites, food allergies, stress and dietary indiscretion. Puppies with soft stools often cannot control their bowel movements and will have accidents in the house. Contact your veterinarian and save a stool sample for testing. My puppy is currently being treated for worms with secondary diarrhea. Not surprisingly, we have not seen a single worm in his stool but he tested positive for roundworms on a fecal float. Unfortunately, his diarrhea has put a major hitch in our potty training progress.

I am impressed with my puppy's progress so far. Very quickly he learned the cue "go potty". He still does have urine accidents in the house. This is partly my fault. I am not watching him closely enough and need to crate him more often when I'm busy with other tasks. But even the most rigorous potty training protocol will have slip ups. It typically takes months of consistent effort to completely potty train a puppy. *sigh*

The Skinny on Intestinal Worms

One day last summer my fearless sister-in-law plucked a "slug" from her cat Izzie's bottom and sent me a video of the little bugger crawling around on her desktop. Sarah launched into a tangle of theories of where Izzie could have picked up a tiny slug. I suppressed a giggle. "Uh, Sarah, that's not a slug. That is a tapeworm."


Cats and dogs share our beds and kiss our babies. They also prey on rodents, scavenge dead animals, eat stool and lick their bottoms. Yep. It's gross. Limit the grossness by regularly giving your pet a dewormer. There are more types of wiggly intestinal worms than you probably care to imagine with different types of medicines necessary for each. Here's the low down!


Tapeworm

• Tapeworms are a common small intestinal parasite in cats and dogs.
• Cats and dogs pick up tapeworms by eating infected fleas or rodents.
• Signs of infection are seeing tapeworm segments (e.g., grains of rice, sesame seeds or slugs!) in the stool or around the anus. A fecal float is rarely helpful in diagnosis unless the technician finds tapeworm segments in the stool sample.
• Some tapeworm species are contagious to people and can cause intestinal problems or dangerous neurological disease.
• It may be necessary to treat for flea infestation at the time of tapeworm diagnosis.
• Tapeworm dewormer is notoriously expensive and not included in most heartworm preventatives -- make sure you ask your veterinarian for advice on treating tapeworms.  

Whipworm

• Whipworms are a common cause of large bowel diarrhea in dogs.
• A heavy infestation can cause bloody stool, weight loss, anemia and dehydration.
• Whipworm infections are tough to diagnose on routine fecal floats because egg production is small, shedding is intermittent and the eggs don’t “float” well. Therefore, even with a negative fecal float, your veterinarian may still recommend aggressive deworming if suspicion is high.
• Whipworm eggs can remain hidden in the soil for up to 7 years! That means you must keep your dog on a monthly whipworm dewormer for a very long time to avoid reinfection.
• Whipworm dewormer is not found in most heartworm preventatives, but there are some that include it so ask your veterinarian.

Hookworm

• Hookworms are commonly found in dogs and cats.
• Hookworms feed on intestinal tissue causing blood loss and inflammation in the GI tract.
• Severe infection may lead to anemia, debilitation and even death, especially in young animals.
• Hookworms can infect people (Ewww!) by penetrating the skin or by being accidentally ingested. Infection in humans can cause an itchy rash or inflammation within internal organs.
• A routine fecal float performed by your veterinarian is used to diagnose hookworm infections.
• Many monthly heartworm preventatives also control hookworm infections, especially when used year-round. 

Roundworm

• Roundworms are the most common intestinal parasite of dogs and cats. Assume every puppy and kitten has a roundworm infestation even though worms are rarely seen in the stool. Some animals with very bad infections will pass "spaghetti-like" worms in the stool or vomit. 
• Adult worms live in the intestines depriving the host of nutrients. 
• Common signs may include diarrhea, weight loss, swollen abdomen, vomiting or no signs at all.
• Dogs and cats pick up roundworms from their mother or from infected feces. The potting soil in houseplants is a reported source of roundworm eggs for indoor-only felines! 
• Humans can accidentally ingest roundworm eggs. Infection in humans can cause blindness or organ damage (yikes!).
• Many heartworm preventatives are helpful in treating roundworms, but may need to be used year-round to be most effective.

Heartworm

• Not an intestinal worm, I know! Heartworms live in the heart and lungs of infected dogs and cats.
• Mosquitoes transmit immature heartworms from infected animals to healthy dogs and cats. Even "indoor only" dogs and cats are at risk...have you never been subjected to the whiny nighttime hum and nip of rogue indoor mosquitoes?
• Untreated, heartworm disease is fatal and treatment itself can have dangerous side effects. 
• In dogs, signs of infection may include coughing, difficulty breathing, sluggishness or no signs at all. Cats usually have signs of respiratory disease (similar to asthma), vomiting, lethargy or--you guessed it--no signs at all.
• Heartworm infection can be diagnosed with a simple blood test.
• Heartworm is easily prevented with a variety of safe medications that can be given orally or applied to the skin once a month. As discussed above, many heartworm preventatives do double duty as an intestinal dewormer and some also treat fleas! Your veterinarian can help you sort out the options.

The take home message is that parasites are almost never diagnosed by the naked eye. I hear it time and again: "My dog doesn't have worms. His poop looks normal." You will generally only see worms if your pet has tapeworms or has a really, really bad roundworm infestation! Next, almost all intestinal parasites require multiple courses of deworming medication to be effective. Like fleas, certain stages in the worm's life cycle are resistant to treatment, so you need to deliver the punch repeatedly! Finally, some parasites are contagious to people (especially children and immune-suppressed individuals) making preventative deworming that much more important in certain households.

Your Pet Pooped on the Floor: Why Your Vet Can't Assume It's Behavioral

Here's the scenario. A family adopts two "teenaged" spayed female cats from the shelter. These two teeny boppers are welcomed into the household by the older neutered male cat and the family's dog. The introduction appears seamless. The new kitties cuddle with the labrador and cavort with the cat. But someone has pooped on the couch! And the rug! The owners know it's one of the cats but which one? Is it Mister, latently unhappy about sharing his digs? Is it one of the new kitties, unsure of her surroundings or just reveling in her new freedom to go where she pleases? The poops are pretty normal looking, so it seems like a behavioral issue.


As the family's veterinarian, my first response is "we gotta get a stool sample and run some tests." The only way to diagnose a behavioral toileting problem is to rule out medical causes first.  


"But how will we know whose poop is whose?"

Sometimes that matters and sometimes it doesn't. I like to run the fecal tests on the aberrant stool...one that's softer or yuckier than most or the one that's been deposited where it doesn't belong. The owner of the stool-- when we're talking cats--usually doesn't matter if the problem is infectious or parasitic. Because cats generally share litter boxes we assume that if one of them has worms (for example) they all have worms and all need to be treated accordingly.

Before long I was in possession a fresh sample from one of the new kitties. When evaluating a stool sample for abnormalities, the first test is simple observation. Yes, it's gross, but what does it look like? How does it smell? Sometimes we'll probe the sample with a be-gloved hand checking for foreign material or worms, but 3 out of 5 senses is as far as it goes! This sample happened to be soft but formed with a portion being slightly runny. 

In my veterinary practice a complete fecal test includes a smear, a float and a Giardia "snap" test. These in-house tests identify the most common causes of inappropriate defecation and outright diarrhea.

The fecal float is the test most well known. This checks for parasites such as worms and Coccidia. Coccidia are a species-specific protozoa that commonly affect young or immune-suppressed pets. As for worms, most animals with light worm loads do NOT have worms visible in their stool, so please don't get a false sense of security that your pet is worm-free just because you see no worms! The fecal float helps us identify intestinal worm infestations by showing those worms' eggs. If the worms inside the pet are not reproductively mature or simply not shedding eggs on a particular day, this test may be falsely negative for worms.

The fecal smear helps identify a bacterial overgrowth of the intestines. Every normal gut has a mixture of beneficial bacteria that help digest the food and provide essential nutrients. A wide variety of internal or external factors can destroy this delicate balance and cause abdominal discomfort and/or diarrhea. Luckily most abnormal findings on the fecal smear are not contagious to other pets and people.

Meet Giardia

The final part of the complete fecal test a Giardia "snap" test. This is a highly accurate test to identify active Giardia infections. Giardia is a contagious and zoonotic (i.e., affects people) protozoal parasite that is  common in the environment. The parasite unfortunately also rears its ugly head in shelters and breeding facilities from time to time.

Lo and behold, while the first two tests showed no significant abnormalities, the kitty's Giardia test was an obvious positive. Wow! Even though the kitty's stools have appeared pretty normal, she has an infectious and contagious medical condition. This is the most likely explanation for poop on the couch and rug, NOT a behavioral quirk. 


The good news is this kitty has a treatable medical condition rather than a behavioral problem. The bad news is all the dogs and cats in the house need treatment because of their close quarters. Shed in the feces, Giardia cysts (i.e., eggs) can remain viable in the yard, litter box, bedding and pets' fur and cause re-infection, so a thorough environmental scouring is necessary. The pets were bathed, their bedding and litter boxes washed, and the yard picked up. Each pet is currently undergoing treatment for Giardia to be on the safe side. The owners have been warned to practice good hygiene when handling the animals and to contact their physician for further advice regarding the zoonotic nature of this parasite.


It is said time and again in veterinary school, "You miss more by not looking than by not knowing." Even though the stool appeared normal and there were plenty of possible explanations for the couch poop, we discovered an important medical problem with our thorough test. Thank goodness we checked! And I'm sure the owners will feel the same way after they've completed a hellish week of medicating three feisty felines!

So You've Been Adopted by a Stray Kitty. Now What?



Larry, Day 1

Heading into the clinic after lunch Friday, a strange baby cry greeted me by the back door. A tiny, bedraggled kitten ventured toward me. Cautiously I picked him up. Immediately his little velcro claws stuck to my shirt and a disproportionately loud purr began. I was hooked.

Has this happened to you yet? So many of my feline patients began their lives as strays, the arrival of little Larry seems like a perfect time to discuss how to bring a stray into your home.

1. When interacting with a stray cat (or any unknown animal), use caution! He may not be used to being handled and could bite or scratch out of fear. Rabies does affect cats, and many do not exhibit the classic Cujo signs of rabidity.

2. If the stray is amenable to being handled, make a veterinary appointment for him as soon as possible. Until then, keep him quarantined from your other pets to limit transmission of contagious diseases and parasites. Best not to let your children play with him either until he passes veterinary inspection.

3. Fleas are very common on strays. Poor Larry was covered in them. Where the black pellets of "flea dirt" (i.e., flea poop which is digested blood) had gotten wet, his white patches of fur were stained red! I DO NOT RECOMMEND GIVING A FLEA BATH. The chemicals in flea shampoos can be toxic--especially in cats and debilitated animals (which most strays are). Call your veterinarian for alternatives to flea baths.

4. After handling your new stray or his litter box, wash your hands thoroughly. If you have other cats at home, you may want to change your clothes after handling the stray to avoid transferring contagions.

At your stray's first veterinary check-up here are some things to expect:

1. The stray should be scanned for a microchip. Some strays are actually lost pets. The rightful owners will be grateful to know he has been found safe and sound!

2. Especially if you have other cats at home, a Feline Leukemia Virus (FeLV) and Feline Immunodeficiency Virus (FIV) test should be done. This is a simple blood test that can show if the stray has these viruses. Inadvertant introduction of theses viruses into your existing cat household can be devastating.Your veterinarian can explain the details of the diseases and testing.

3. The stray should be dewormed according to your veterinarian's protocol. Aside from tapeworms, most intestinal parasites are not readily obvious in the stool. Assume all strays have worms. After all, if the cat was eating rodents to survive he surely has worms!

4. Your veterinarian can treat the fleas, ticks, ear mites, lice or other external parasite(s) found. Be sure to ask if you need to clean where the kitty has been hanging out at home. Many parasites can only be eliminated after multiple treatments plus environmental decontamination.

Larry, Day 3

5. Many strays have upper respiratory infections stemming from common feline viruses. Your veterinarian may recommend vaccinating against feline distemper to help prevent complications from these infections. Depending on the stray's estimated age, your veterinarian may recommend the rabies vaccine as well.

6. Once your new kitty has been determined to be in good health, it is time to consider sterilization surgery. It is easy to tell if an adule male cat has been neutered, but much harder to tell if an adult female has been spayed. Spaying and neutering not only eliminates unwanted litters, but reduces unpleasant behaviors and future health problems.

Now that your stray kitty has a clean bill of health, you can settle down to enjoy the rare pleasures that come from feline companionship! You have been chosen by this kitty to provide the care necessary for his comfortable life. If your stray is like most I've met (including Larry), he is overflowing with affection and devotion.

The ABC's of Anal Glands

Anal glands are probably one of the most mysterious and misunderstood anatomical features of dogs and cats (yes, cats!) Barely a day goes by that I don't address an anal gland question.

Anatomy
The anal glands are little sacs just inside of the dog or cat's rectum. If the rectum is a clock face, the glands reside at approximately 4 o'clock and 8 o'clock positions.

Physiology
Normally the anal glands are emptied each time the dog or cat defecates. But as many pet owners know, anal glands can spontaneously empty of their odiferous contents--usually on the couch cushion, car seat or owner's bed--when the pet is startled or upset. This stinky secretion is yet another way animals communicate through scent, much like urine marking.

Pathology
Most dogs and cats do not need their anal glands expressed on a regular basis by human intervention. Pets that have a bout of diarrhea or chronic soft stools sometimes have anal gland problems. Occasionally a pet's unique anatomy (i.e., the position and opening of the glands internally; obesity) may inhibit proper emptying. Finally, some pets with repeated anal gland problems actually have an underlying allergy. This is a complicated issue that should be discussed with your veterinarian

Classic Scooting

Symptoms
When the anal glands do not empty fully the contents can build up. The dog or cat may lick their butt excessively or drag their bum on the ground in an effort to release the pressure. If these efforts fail the secretions become thicker and harder to expel and may become infected. Some pets with infected anal glands present with ruptured and draining abscesses on their hinder -- ouch!

Treatment
Pets that scoot or lick their behind excessively should have their anal glands checked. Gentle manipulation of the anal glands by a trained professional expresses the contents and gives the pet relief. Additional medication or therapy may be needed if the anal glands are infected or inflamed. Depending on the pet's history, weight loss, diet change or fiber suppplements may be needed.

Prognosis
Some dogs and cats have one or two episodes of anal gland difficulties during their lifetime which are easily managed. However, some pets require frequent anal gland expressions to keep them comfortable, and some pets wind up having their anal glands surgically removed.

Differential Diagnoses
Scooting is not always because of an anal gland problem. As mentioned before, allergies can cause itchy rear ends, and scooting in these animals can continue even after surgical removal of the anal glands. I have also seen itchy butts in pets afflicted with intestinal parasites such as round worms!

My Prescription
If your pet has an itchy butt, don't be shy about it. Talk to your veterinarian! Examination and a detailed history can do wonders to bring your pet relief and prevent a recurrence.