Today's Veterinary Practice provides comprehensive information to keep every small animal practitioner up to date on companion animal medicine and surgery as well as practice building and management.
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71 NOVEMBER/DECEMBER 2017 ■ TVPJOURNAL.COM PEER REVIEWED dogs are not allowed frequent access to an outdoor elimination site and if elimination opportunities are not offered after meals, play, and sleeping. • How does the dog eliminate? Signs of discomfort, such as straining or difficulty posturing to eliminate, suggest medical conditions, whereas signs of fear or anxiety while the dog is outdoors suggest an emotional condition. DIAGNOSTICS A veterinarian should evaluate all dogs presenting with house soiling issues. The minimum database for dogs younger than 5 years includes a physical examination, urinalysis via cystocentesis, and imaging of the lower urinary tract. Dogs aged 5 years and older should also have a complete blood count and chemistry profile. Intestinal parasite screening and a rectal examination are recommended if the dog is defecating indoors. Additional diagnostics, such as water quantitation and a urine cortisol/ creatinine ratio, may be needed depending on the patient's signalment and clinical signs. TREATMENT Lack of House Training Lack of house training can be addressed with the same methods used in prevention. Additionally, access to the dog's preferred indoor elimination site should be restricted. If this is not possible, the owner can attempt to change the function of the site by placing bedding or food and water bowls in the area. Dogs with long histories of house soiling may require several months of careful management to become completely house trained. Complete house training is not established until no house soiling episodes have occurred for 8 weeks or more. Urine Marking Castration reduces the frequency of urine marking in 50% to 80% of male dogs, regardless of age at time of castration. 9 If the castration status of a male dog with marking behavior is undetermined, abdominal ultrasound may help to identify or rule out cryptorchidism. Environmental management strategies for urine marking involve restricting the dog's access to marked sites, cleaning soiled areas with odor-elimination products, and identifying triggers for marking so they may be eliminated or reduced. Triggers for marking in dogs may include the smell, sight, or sound of other dogs or other arousing stimuli, such as mail or package delivery. Medications, such as tricyclic antidepressants or selective serotonin reuptake inhibitors, can help to reduce the marking dog's emotional arousal and decrease urine marking when combined with environmental management. Excitement and Submissive Urination Treatment strategies for excitement and submissive urination include environmental management, behavior modification, and, in some cases, medical therapy. Environmental management requires identification of triggers for urination so they can be eliminated or reduced. Triggers may include the following: • Approach of familiar or unfamiliar people • Standing, reaching, or leaning over the dog • Petting • Speaking in a loud, excited, or harsh tone Clients should be counseled to avoid these types of interactions; call the puppy or dog over to them, rather than approaching; and keep greetings calm. The dog or puppy should also be given an opportunity to eliminate outdoors immediately before the arrival of visitors and should be confined away from visitors who cannot follow the calm greeting routine. Behavior modification strategies focus on teaching the puppy or dog greeting behaviors that are incompatible with urination, such as lying down or retrieving a toy. Medications that reduce emotional arousal (tricyclic antidepressants or selective serotonin reuptake inhibitors) or increase urethral sphincter Suggested Client Resources on House Training • Horwitz DF, Ciribassi J, Dale S, eds: Decoding Your Dog: The Ultimate Experts Explain Common Dog Behaviors and Reveal How to Prevent or Change Unwanted Ones. New York: Houghton Mifflin Harcourt; 2014. • Martin KM, Martin D. Puppy Start Right: Foundation Training for the Companion Dog. Waltham, MA: Karen Pryor Clickertraining; 2011. • The Ultimate Puppy Toolkit: ultimatepuppy.com