Recessed/Inverted Vulvas and Chronic Infections
Some female pups can be born with what is called a recessed or inverted vulva (RV), sometimes termed an “innie” or “tipped” vulva. Please see the pic above to compare to your pup. Please note: this pic is of a RV pup, not a normal vulva.
This allows urine to pool in the valley around the vulva and the resulting bacteria can be the cause of chronic urinary tract infections (UTI) or bladder infections. This should not be confused with puppy vaginitis which will usually show in a slight mucusy discharge. Vaginitis is not a bacteria or infection but is something that its best to wait for first heat cycle as maturity/puberty will often put a stop to it. Just wiping the vulva with warm water and cotton is the best you can do until it clears up. Antibiotic will not help vaginitis. See this link:
http://www.greatdanelady.com/articles/vaginitis_puppy_acne_demodectic_mange.htm
If you suspect your new puppy has a RV there are holistic ways of preventing infection. It is also very important that this pup is not spayed until she has her first heat cycle because most times the vulva will correct itself as a result of that heat cycle (sometimes it takes 2 cycles to correct but most often only one cycle). If you spay prior to the first heat you could be subjecting the pup to a lifetime of infections. Be sure and ask your vet if they have ever dealt with this as there are vets who have never seen a case and would not know what they are looking at. If that is the case please seek out another vet so you are not advised to spay your pup prior to first heat.
For those afraid to wait to spay because they have read about cancer and infections, please see this link. The risk starts to go up after age 2.5 and most dogs will have a first heat by 1 year, although some will go a bit beyond that.
http://www.naiaonline.org/pdfs/longtermhealtheffectsofspayneuterindogs.pdf
A reputable breeder will inform a buyer of a RV and instruct on holistic treatment to prevent infections. As a breeder I write a letter to the buyer’s vet informing them of the RV and the need to allow first heat cycle and that this time frame for spay is in my contract with buyer. This helps prevent a vet from pushing a spay prior to first heat cycle.The first time I had ever seen this condition was with a pup I had purchased from another breeder who chose not to inform me of it. My vet diagnosed it and unfortunately, since the breeder had ignored the condition, pup had a very severe infection that took over 6 months and in excess of $600. to get rid of. The breeder was aware of the condition and admitted it to me after I had it diagnosed. Thankfully my pups RV corrected on her first heat cycle.
For the health of my pups I would never consider withholding this condition, or any other condition for that matter, from a potential puppy buyer. I instruct my pup buyers to take a urine sample to the vet at their 72 hour vet check and if pup has an infection I will pay for the first round of antibiotics if they are necessary. Buyer must then be diligent in following my holistic instructions below. Because of what I went thru with my pup I now know how to handle this and it is really a non issue because I start holistic treatment immediately to prevent infections.
I have had 3 pups from my own litters with RV and started them on cranberry capsules daily at 6 weeks of age. This should continue “every day” until pup has her first heat and vulva corrects. The cranberry adheres to the bladder wall preventing bacteria from sticking and causing infections. I also recommend checking urine PH weekly at home. Normal PH is 5.5 – 7. If PH is elevated double up on crancaps (a.m. and p.m.) for a week (or two if necessary) and recheck PH. Once PH is in normal range drop back to single dose. If it remains elevated for two weeks take a urine sample to the vet to be checked as antibiotics may be necessary if it is a severe enough infection.
Collect urine first thing in the morning before any food or water and in mid stream for best sample. I use a tuperware lid. Take dog out on a leash first thing in a.m. prior to food or water. When she squats wait a bit so she is in mid stream and just stick a tupperware lid under her butt from behind and pull it out real quick. You only need a small amount to test.
If she stops going don’t worry just walk her around so she squats again to empty her bladder, she will eventually get use to it.
Put in a small tupperware container or jar and take to the vet. When testing PH at home just dip a strip in the urine and compare the strip to the chart on the box while the strip is still wet.
Here is a link to purchasing the PH strips.
http://www.amazon.com/ColorpHast-9588-5-10-Test-Strips/dp/B003TV3GTE
Be sure and order the 5-10 PH range strips.
If you do have elevated PH you can also give live organism probiotics to put good bacteria in the system that will also aid in warding off infection. I give a 10 billion organism at 1/8 tspn daily for 8 week old pup. I prefer a live organism that must be refrigerated as opposed to a pill form. If you need to give antibiotics it is also advised to give the probiotics 2-3 hours after each dose of med and to continue for at least a few weeks with probiotics after meds are finished. Amount of weeks to continue would depend on dosage and length of time on antibiotics. Antibiotics kill off good bacteria along with the bad so it is important to replace this good bacteria with the probiotics. In some cases, where pups are getting infections, wiping the vulva after each urination with unscented baby wipes can help. You can purchase crancaps or probiotics at most health food stores or you can go to www.progressivelabs.com item #498 and #963. If you prefer to order on the phone go to extension 149 for Nancy. She is the rep I deal with and knows these products well. Please be sure to tell her that I referred you. (Patty at Snowcolabradors)
Note: (11/10/11) The Progressive Lab Crancaps have been changed/improved. They are now a “fruit” concentrate rather than a “juice” concentrate. And they are concentrated at 50:1. The softgels are now 150mg ea. but I would still just give one per day for maintenance. If PH is elevated give 2x/day, one in a.m. and p.m. meal or you have a UTI and are using the Crancaps in lieu of antibiotics. Once you see PH in normal range you can cut down to one capsule daily for maintenance. Keep checking PH to be sure this amount will be sufficient.
Note: Progressive’s crancaps contain soy. If your dog has an allergy to soy or you suspect it; see this GNC product instead: http://www.gnc.com/product/index.jsp?productId=2182679 (2 capsules = 1000mg).
Note: 3/9/10: I have been having success with using only one of the Progressive 420mg crancaps for maintenance and using 2 when PH is elevated. It will depend on the severity of your dogs UTIs or how often they occur as to whether you will use 1 for maintenance or 2. The dog will flush out what the body does not use.
In the case of my pups none have ever had an infection because the above regime was followed by the buyer and pups corrected on their first heat cycle. I have had adult dogs urine test positive at the vet for a UTI and have gotten rid of it by giving the crancaps twice daily for 2 weeks and having urine tested again. If the infection had not cleared up I would have considered antibiotics depending on the severity of the infection. I choose to take the holistic approach whenever possible as antibiotics can reak havoc on the system. As always you should consult your vet and I prefer to deal with a vet that will not poo poo the holistic approach even if they choose not to prescribe it to their patients.
If you find yourself in the unfortunate situation as I did with the pup I purchased from the breeder and you can not get rid of a severe infection with antibiotics it is important to do a culture and sensitivity at the laboratory to pin point the exact type of bacteria so the proper type of antibiotics and dosage can be given. It is best to get the urine sample for this c/s test thru what is called a cystosentisis which is urine drawn from the bladder via needle for the purest sample possible. This is not painful to the dog but the dog must have a full bladder so it is important to have the first appointment of the morning at the vet. Get up get the dog in the car (not allowing them to squat outside) and go.
I am not a veterinarian so I do advise having your pups urine tested at your vet the first time you suspect an infection and then make an informed decision as to the treatment you want to use. But remember, constantly using antibiotics can be detrimental to the long term health/immunity of your pup.
Vulvoplasty/Nip N Tuck: this is plastic surgery that a lot of vets will recommend to correct a RV on a dog that has already been spayed. Some will even recommend it prior to spay or at same time as spay because they do not know that a heat cycle can correct the RV. What bothers me are the vets that spayed a dog with RV prior to first heat (because they don’t know what a RV looks like), and than later when dog is having UTI issues they suddenly diagnose the RV and recommend the surgery.
I don’t recommend this surgery unless you have a dog that has been spayed and you can not keep UTI free with my method. You can not keep a dog on antibiotics for life – therefore, the surgery would be best. My first step would be the holistic approach and if it works than keep the dog on it for life to prevent UTIs.
If you have to go with the surgery please be sure to use a vet that is seasoned in this procedure. Ask your vet how many they have performed and what the success rate of keeping the dogs UTI free was. If your vet has never preformed this surgery please find one that has experience.
If anyone has a pup with a recessed vulva and you have further questions please feel free to ask here or contact me thru my web site.
I have been having trouble getting some emails thru to people (Verizon, AOL, EDU) so if you do not get a response please feel free to call me. My number is on my web site.
I am so grateful for your website with all the valuable information and advice.
I have a Charcoal Lab puppy (Stella) who is 8 mos. old and was spayed at 5 mos. I took her to the vet last week because she was asking to go out to urinate every 1/2 to 1 hr. and her vulva appeared red and swollen (puffy ridges around the outside of it). It does not appear “recessed” or “depressed”. The vet referred to it as an inverted vulva and prescribed amoxillin 100 mg bid. He also told me to make sure to use baby wipes, especially after urinating. However, this is a puppy that was traumatized severely at age 8 weeks and has a lot of difficulties at the vets, etc., due to her fear of and resistance to being held down. I am working successfully with a wonderful canine behaviorist on Stella’s many behavioral problems, but this one has been difficult to change.
Additionally, she is guarding the vulvar area. I am working daily to get her to allow me to touch within 3 – 4 inches of the area, and then I’ll have to very slowly introduce the wet wipes.
My question is: Since I can’t yet wipe her after she urinates, is it okay to let her lick herself ? I’ve always been told to not let my dogs lick anywhere there’s irritation, post surgery, etc, but if she doesn’t lick too long or too hard, won’t it possibly help ?
Of course I’ll ask my vet what he thinks on this subject.
I already have her on good quality probiotics bid 6 hrs after each Amoxicillen tab, and I’ve ordered the ph test strips and cranberry geltabs. Meanwhile, since she loves oranges, could a couple of orange slices per day help keep her urine more acidic ?
Thank you so much.
Joanne, I am having computer problems and email as well.
please call me on the phone to discuss your pups issues.
Its not as bad as you think and I will help you.
Get my phone number thru my website http://www.snowcolabradors.com
I am always here to help. Please call me.
Patty
I have a 2 year old black lab and she has had UTI’s ever since we got her. At 6 weeks old she had crystals in her urine and was put on medication and it cleared up. We did have her spayed as a puppy (not knowing anything about the benefits of waiting till a first heat cycle). She has continued to get UTI’s. We have put her on special food (c/d for urinary tract health), but that did not help. I am now going through the process of why does she keep getting these UTI’s…but my vert did say that this could be one of the issues. I would like to know more about these crancaps and the success rate you have had with them or if there is anything else I can try before considering the option of surgery. Please email me back
Thanks!
I just wanted to comment how great I think it is that you are so open and honest with your clients with regards to RV. I bought a westie puppy from someone who is a well known westie breeder, she shows her dogs as well, her name is mentioned several times in a westie book I bought (I bought the book just before getting my puppy, she had no input on it so it’s a coincidence that I found her name in the book). 3 days after bringing my puppy home she was squatting constantly, I knew she had a UTI. I called the breeder and she asked if perhaps I didn’t give her sufficient water…as if I would mistreat my puppy. I can’t help but think after over 40 years of breeding that she didn’t know this puppy had a problem, she just didn’t feel she needed to alert me apparently, and once the puppy was home with me and sick it was not her problem. Here we are 7 months later and my puppy has had a continual e-coli UTI, she’s been on antibiotics almost the whole time since I’ve had her, we’ve now paid for 5 urine cultures, she just finished a 3rd different anti-biotic and she’s having vulvoplasty surgery tomorrow morning. She was spade at 5 months, apparently my vet didn’t know a first heat could have resolved the problem…I really love my vet, she’s wonderful and we’ve been with her for years so I can’t be bitter about it now. My vet had hoped as she grew the problem would resolve on its own but unfortunately that’s not been the case, she’s now 9 months old and pretty much full grown. My puppy also has bouts of incontinence. I am just praying this surgery will finally bring her some relief, poor baby licks and scoots all the time. We’ve got a prescription topical ointment to help and I’ve also got her on a hypo-allergenic diet, that seems to have helped the skin in that area too. Thank goodness she’s a very happy and playful puppy, I love her so much and would love it if this surgery results in her feeling good for the first time in her life.
Thanks again for being so honest with your clients, I wish there were more people like you.
Kate
Kate, thank you for your post on my blog.
I want my pups to have the healthiest life possible. I would never consider withholding anything from a buyer where my pups health is concerned.
I am so sorry for what you and your pup have had to go thru. I pray the surgery is successful too.
Keep in mind that her incontinence may be a result of early spay (so young) although not sure how young 5 months of age would be considered in a small breed as yours.
The surgery may not stop the incontinence (it could also be from all the UTIs – hopefully that is the case and the surgery will put a stop to it).
If not, I know people use drugs like Proin for incont. but it can have side effects.
I have heard of people curbing or curing incontinence by feeding soy milk (1/2 cup per day for a larger breed – so maybe 1/4 cup for your sweet girl). As long as the dog has no issues/allergies to soy.
I wish you all the best with her surgery. Please post back and let us know how she does.
I also suggest you print out my blog and some of the success stories with first heat cycle correcting RV to give to your vet in the hopes of educating her so she does not spay other pups with RV prior to a heat cycle.
Get a copy to your breeder too as she obviously needs educating as well. If she knew about the RV and did not disclose it “shame on her”. However, she may just have never seen one and needs educating.
My sincere prayers for a successful surgery and quick recovery.
Patty
Hi Patty, My poodle-mix is now 20 months old. We have been following your regime of cran-caps and probiotics since last April. She has been UTI free since then. We also rinse her off each evening when she gets combed and use a wipe right before bedtime. She was spayed at 6 weeks and has had the occasional leakage problem but I’ve had good luck with the homeopathic remedy Leaks No More by HomeoPet. Thank you for help. Paula
Paula,
That is great news!
Thank you so much for posting here to help others.
Patty
Patty – should a lesser dosage of the cran caps be provided to smaller breeds? I have a sheltie puppy who has been spayed but has this condition and has had UTI issues.
Hi Kim,
I give 6 week old pups (about 12 lbs) a single dose of the progressive product daily with no problems.
The body will flush out what is not needed like water soluable vitamins.
You can always check with a holistic vet but I would bet they will tell you the same thing.
Thanks Patty – she is 6 months old and about 15 pounds so it seems this should be ok for her then.
Yes I would say it is fine but again….
I am not a vet…… I am giving info from my experience with RVs and for years all has been good with what I do.
Please let all of us on this blog know how your dog does…..
It surely does help others….
Patty
I have an approximate age 1 1/2 year old maltese mix. She was a rescue dog already spayed. After reading your website I concluded that she has a recessed vulva and has had 4 bouts of UTIs since I have had her over the last year.
My first vet knew nothing about recessed vulvas causing UTIs nor did he know about probiotics and only tested her PH level and kept trying random biotics.
I found a new vet who confirmed the recessed vulva; tested her urine and said it contains struvites and he also tested the bacteria and found it was e-coli so treated her with an antibiotic that combats e-coli. He has me feeding her urinary dog food.
Based on your website, I give her cranberry drops each day and now that she is off the anti-biotic I give her probiotics and use baby wipes after her urination.
She still keeps getting UTI and I’m afraid she may need surgery. Do you have any ballpark fees for surgery for the vulvoplasty?
Thanks so much for all your information.
Our Goldendoodle just had this surgery last Tuesday. She is just over a year old and has been on antibiotics most of her life. The surgery cost $700.00. The cost of surgery was actually less than the cost of treating the infections and has not been that difficult to care for although our doodle is very patient. The surgery is actually a plastic surgery and looks ugly but the benefit can be great if done correctly. I would make sure the vet who does the surgery has some experience with it. From what I have read and after talking with our vet, it is important that there is consideration given to how much skin be removed from the vulva area. Of course time will tell how much this will help our girl but she has not had an accident since the surgery (5 days). Prior to the surgery she leaked constantly. Our main concern was the infections. Constant uti’s and bladder infections can cause life threatening conditions affecting the kidneys. Harper was spayed before we got her but we knew nothing about this condition before getting her.
I have a 55 pound 7 month old doberman, will one cran cap a day be enough. Thanks for the site it saved my baby!!