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 "Cone of Shame": A Necessary Evil

The figure of speech "going off to lick your wounds" is okay in the metaphorical sense, but not when we're talking about dogs and cats after surgery.

Veterinarians cringe when well-meaning owners proudly announce that Fido has been licking a surgical wound in order to heal it.  Dog saliva may indeed contain compounds that numb the wound and neutralize some microorganisms. However, doggie drool and kitty spit also has potentially harmful bacteria in it, and the act of licking itself can ruin a good surgical closure.

Dogs and cats routinely create serious infection in their skin from over-licking an area due to allergies, injury or post-surgical discomfort. That's why veterinarians regularly dispense an Elizabethan collar (e.g., e-collar) following spays, neuters and other surgeries. The "cone of shame" prevents the dog or cat from licking the incision, allowing the wound to heal faster and without complication.

Sometimes, however, the e-collar is an inadequate deterrent.  I have met Houdini-like dogs who escape from their e-collars no matter how they are fastened. Some dogs figure out a way to chew through the plastic rendering the cone useless, while others ram it into things until it cracks, bends or (especially in Wisconsin winters) shatters. Many dogs act so demoralized initially that sympathetic owners can't bear to keep the cone on them at all. Most recently, I had a canine patient whose long nose poked over the edge of her cone just far enough that she managed to lick her spay wound to the point of infection and dehiscence.

Dehiscence is a fancy medical word for the splitting open of a wound. A dehiscence may be minor, involving a tiny part of the skin incision and requiring no special treatment. Or maybe a few skin staples will be placed to hold the wound edges closer together for faster healing. The worst kind of dehiscence, the kind that keeps veterinary students up all night and biting their nails following their first spay, is an opening completely down through the abdominal wall so that the animal's abdominal fat or even intestines protrude through the wound. Dogs have been known to chew on their own insides when this happens! Yikes! Thankfully, this is exceedingly uncommon.

Maddie's abdominal skin dehiscence looked a lot like this

Even Maddie, the long-snouted Springer Spaniel who managed to ferociously lick outside the cone, presented with just a partial dehiscence. While I could peer down through her subcutaneous tissue and fat to the sutures holding her abdominal wall together, thankfully the abdominal closure remained intact and her guts stayed in. Maddie's dehiscence was so severe, however, that she required general anesthesia so the dead, infected wound edges could be trimmed away, or debrided. I resutured the wound, placed Maddie on a course of oral antibiotics and gave her a larger e-collar. I expect the wound to heal normally after this, but I won't be surprised if she develops a seroma, or pocket of fluid under the skin, from bouncing around too much before the area completely heals.

Don't assume if your pet isn't licking their incision immediately after surgery that they won't. Some animals leave their surgery site alone during the early phase of healing, but attack it just as the skin finally starts to mend. If you have ever experienced insanely itchy skin as a surgical incision or even a minor cut begins healing you'll understand why dogs and cats suddenly notice their surgical wound a week after the fact!

The "cone of shame" is obnoxious, humiliating and completely necessary in most cases. Even with the cone on, however, pets can develop complications in their surgical wounds that require follow-up care by their veterinarian. Please follow your veterinarian's post-op instructions closely regarding exercise restrictions, wound care and medications. And most of all, don't let Fido lick!

Puffy Paw: One Manifestation of Cat Bite Abscess

Leave it to my cat Larry to provide blog fodder.

Out of the blue this week he limped across the driveway toward me, left front foot puffed up like a marshmallow. While all my cats have the opportunity to play outside, Larry has only recently ventured out into the yard. The gusto with which he flings himself up and down trees, pursues pretend prey, and dashes from imagined peril is delightful. Of course, cats that live outdoors face a number of real dangers as well: vehicular trauma, predators, disease from fleas and other external parasites, injury or illness from other cats.* Before I even examined him, differential diagnoses flooded my mind with trauma and infection at the top of the list. Did his paw get stepped on, run over, caught in something? Did he get bit by a fellow cat or some other animal? Are there broken bones?

Although his left front foot was nearly three times the size of his right, close examination of Larry's limb was surprisingly boring. I braced myself for biting, scratching and loud complaint as I palpated the swollen area. Nothing. Well, it clearly wasn't broken. I looked for breaks in the skin, blood or pus discharge, redness and hairloss. Nothing. I checked Larry's temperature. Normal.

An animal's history and signalment are often as important to reaching diagnosis as physical and laboratory findings, and in this case prompted my treatment. Larry is a young feisty male neutered cat. Lately he has been picking loud obnoxious fights with his housemates Cheeks and Jimi Happy. I felt a few bumps under the fur on his injured leg which raised my suspicion of puncture wounds (e.g., a bite), and I bet if I had shaved his leg I would have found some signs of injury. In another 12-24 hours, Larry probably would have a fever, noticeable pain, redness and foul discharge as the probable cat bite abscess progressed.

In this photo taken several hours after antibiotic injection,
Larry's left paw has residual swelling between the toes and
behind the large metacarpal pad.

An injection of a long-lasting antibiotic ideal for this type of infection was all it took in this case. Just as rapidly as his foot swelled up Larry's infection responded to antibiotic treatment. By the next morning Larry was walking normally and his foot appeared normal!

Cat bite abscesses are a common problem in outdoor cats, but I have seen a number of infected bite wounds in strictly indoor cats as well. Even play-biting between friendly housemates can result in an abscess requiring varying levels of treatment. I'll never forget the female kitty with a huge worrisome mass on her back. The owners were afraid she had some sort of cancer, but when I touched the large lump a weak spot in the skin broke open and foul smelling pus and blood spewed forth. What a delightful finding! (Really, we veterinarians live for this stuff!) I squeezed out as much of the bacteria-filled pus as possible, cleaned the wounds and administered an antibiotic. Like Larry, in a few days, she was as good as new! There is really nothing quite as satisfying to treat as a cat bite abscess.


*Yes, I know that allowing cats to roam outdoors is politically incorrect nowadays. As a farm girl, cat lover and veterinarian I believe an indoor/outdoor lifestyle is ideal for most cats' psychological health and well-being. While there are risks to life in the big wide open, sedentary indoor cats also face insidious risks to their health and well-being: obesity-linked diabetes mellitus, behavioral and medical urinary tract disease, and other stress-related problems (some of which result in relinquishment to shelters and/or euthanasia). I am not recommending tossing your strictly indoor kitty outside  -- the outside world can be intimidating and couch potato cats are especially vulnerable to danger if not accustomed to being outdoors. Exercise, proper nutrition and mental stimulation can and should be implemented in households of strictly indoor cats -- it's just that the humans must do more of the work! Pet cats that do spend time outdoors absolutely must be spayed/neutered to control cat overpopulation and prevent sexually-transmitted illnesses. They should also be kept current on all vaccinations, intestinal deworming and flea/tick preventatives. 

No Chocolate Bunnies (or Mulch) for Fido

This week I met an adorable Pit Bull mix puppy whose dining habits were making her owner nervous. "Oh, Minnie just loves to eat decaying fish," the owner lamented and she went on to list some of the other weird and disgusting items on which her puppy enjoyed chewing. Minnie's self-selected treats are mostly harmless, but the owner stopped up short when she came to cocoa bean mulch. "And I just heard that cocoa bean mulch is toxic to dogs!" she exclaimed, reminding me that this is a timely blog topic.

With the "winter that wasn't" officially over, people are tending to their lawns and gardens. Some may consider using cocoa bean mulch as a natural fertilizer. Made from spent cocoa beans used in chocolate production, cocoa bean mulch is organic, deters slugs and snails, and gives a garden an appealing chocolate smell. However, it also may attract dogs,* who can be poisoned by eating too much of the mulch.

Like chocolate, a well known no-no for pets, cocoa beans contain the stimulants caffeine and theobromine. Dogs are highly sensitive to these chemicals, called methylxanthines. Low doses of methylxanthine can cause mild gastrointestinal upset such as vomiting, diarrhea, or abdominal pain. Higher doses can cause rapid heart rate, muscle tremors, seizures, and even death.

Cocoa mulch has a higher concentration of toxic chemicals per ounce than milk chocolate. As an example, a 50-pound dog can experience serious side effects from eating more than 5 ounces of mulch. Whether cocoa mulch or chocolate, the severity of toxicity is related to the size of the dog and the amount of mulch eaten. Fortunately, to date, no fatal cases of cocoa mulch toxicity have been reported to the American Society for Prevention of Cruelty to Animals (ASPCA)Animal Poison Control Center.


If you suspect that your dog has eaten cocoa bean mulch, contact your veterinarian right away. Treatment will depend on how much cocoa bean mulch your dog has eaten, when it was eaten, and whether your dog is sick. Recommended care may include placing your dog under veterinary observation, inducing vomiting, and controlling a rapid heartbeat or seizures with medications and supportive care.

*Although dogs are most likely to chomp on cocoa mulch, cats, rabbits and other pets should not be allowed to nibble this particular mulch either.

In Search of Answers

There is nothing more frustrating than knowing an animal has a disease but being unable to identify it. All the best tests in the world -- examination, bloodwork, urinalysis, fecals, imaging (x-ray, ultrasound, CT/MRI), biopsy -- may not uncover the root cause of a pet's illness. Sure, there may be abnormalities, specific or non-specific findings that provide tantalizing clues. A veterinarian's experience combined with the animal's history and symptoms enables her to interpret the test results to come up with a logical working diagnosis and treatment options. However, there are limitations to every test and also often financial limitations that prevent a definitive diagnosis from being reached. Treatment trials may fail to bring about resolution, and when palliative care (pain management and supportive care increasingly called "hospice") no longer relieves the animal's suffering, humane euthanasia is sometimes all that remains.

Even though it may be obvious to the veterinarian and pet owner that it is time to end the animal's suffering, we are left with the nagging question of "why?" In medicine, there is one final test available to answer this important question: necropsy.* Examination of the internal organs with the naked eye paired with microscopic evaluation of each bodily tissue is essential to reaching a diagnosis and/or explain cause of death.

In the past few weeks, two separate families have committed to post-mortem examination of their deceased pets.  I am so impressed by my clients' dedication to fully understanding their animals' disease that it's all I can think about this week. After weeks or months battling an incompletely understood ailment, a pet's necropsy can provide closure to the family as well as the veterinary team. Moreover, the information gathered during a necropsy advances veterinary knowledge in general. The 2007 pet food recall involving melamine adulteration, for instance, depended on post-mortem evaluation of fatally affected pets. An understanding of birth defects, cancers, toxicities, epidemics and the aging process from post-mortem analysis has lead to better diagnostic tests as well as medical and surgical treatments.      

I wish to extend a grateful thank you to animal owners everywhere who, in their time of grief and loss, make that difficult decision to have a necropsy performed on their deceased pet.

* Veterinary professionals use the term "necropsy" instead of "autopsy" to describe post-mortem evaluation of an animal.