Recessed/Inverted/Hooded Vulvas and Chronic Infections


The original pic here was hijacked by Photobucket so if you need to see a pic of a RV pup please email me and I will send one.  In the mean time I am working to get my pic back up here.

(All my pics on photobucket have been hijacked O/A  7/1/17 – I own these pics and can no longer use them unless I want to pay photobucket $300.  This is outrageous!  If anyone knows a way around this please email me with help.  I can not find a phone number to contact a person on their site.  Thanks

PLEASE NOTE:  This blog will remain here but due to administration (that I have no control over) I will not receive email notice of your post on this blog.  So please, if you need help contact me via email or phone thru my web site at I am sincerely here and willing to help.

Some female pups can be born with what is called a recessed (RV) , inverted or hooded (flap of skin covering all or part of the vulva) vulva, sometimes termed an “innie” or “tipped” (not recessed all the way around the 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:

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.

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 one cranberry capsule 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 (1 in a.m. and 1 in p.m. meal) 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.

Be sure and order the 5-10 PH range strips.

A few people have been telling me that Amazon is out of this product.  All you need is a PH urine strip that will show a 5-10 range.  You can get this at your pharmacy or do a google search for:

buy ColorpHast 9588/3 Test Strips, 5-10 pH (Box of 100)

I’m sorry for this but I have done my research and can’t find another vendor.

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 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 Snowco Labradors)

Note: (6-19-13) The crancaps have been discontinued and Progressive is diligently researching for a new provider of a quality crancap.  You can try their other UT product called U-Tract or U-Tract Complete.  Go to the website and choose Urinary Tract Health on the left side of the screen to see these products.

This is D-Mannose which some posters have used with success.  Progressive has veterinarian customers that use this product for cats and dogs.  You can call and talk to Nancy at extension 149 for further info and dosage.   I would recommend the powder if using the Complete (the capsule form has a lot more ingredients and not sure about them for dogs).

****I have not used this product or any form of D-Mannose so can not comment on its effectiveness.****

GNC product (crancaps) instead: (2 capsules = 1000mg).

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.

Author: patty

Franklin Lakes, NJ

285 thoughts on “Recessed/Inverted/Hooded Vulvas and Chronic Infections”

  1. Deborah,

    Glad she is doing better. Let me know the resuts of biopsy. I pray its just inflamation and nothing more.

    This is something I have never heard of with narrowing of the urethra so I am intested in all you find out.

    Update when you can


  2. Patty, thank you so much for your reply, I appreciate it.
    If there are no bacteria present into her urine would she benefit from crancaps and probiotics? would that be a good regime to put her on regardless?
    thank you

  3. Brigitte,

    Crancaps adheres to the bladder wall preventing bacteria from taking hold.

    so if there is bacteria in her urine the crancaps would help.

    If there is no bacteria in her urine causing the outward vulva infections crancaps most likely would not help. However, it can’t hurt to give them to her and see if you get results. Talk with your bet about it and ask them to keep an open mind about holistic care. Let your vet read my blog if necessary to see that it does actually work for UTIs.

    Even with no bacteria in her urine I would put her on the probiotics to put good bacteria in her system.

    You may also talk with the vet about boosting her immune system a bit to see if that can help ward off these outward infections.

    Vit C is an immune booster and one reason I start pups on it at 8 weeks of age: ( Note: I give 125 mg./25 lbs of weight (C with bioflavanoids for better uptake) (not Ester C, that is calcium and no good for a growing Lab pup or other large or giant breed dogs). By one year of age I give 1000mg daily. )

    Do you give fish oil? Be sure and buy a product of fish “body” oil (not liver oil) that contains vit. E. If it doesn’t you need to also supplement with E to prevent defficiency.

    Taken from: (while this is a newsletter on cancer it talks about immune boosting)…immune-system/

    “Omega 3 Fatty Acids

    These essential fatty acids are thought to help fight inflammation, help support the immune system, help coat and skin integrity”

    Turmeric is listed there to and I have read that it too can help with immunity.

    The E will also help with immunity: 200iu daily with the fish oil would be fine. If you choose a fish oil with only about 25iu of E already in it I would consider giving additional E to further help the immune system.…&ct=clnk&gl=us

    I hope the above helps. Curious as to what your vet has to say.


  4. I talked to my vet and he agrees with CJ being on cran caps and probiotics. He seems very well versed in the hollistic tmt which is great. Cj was placed on royal canin urinary so this summer because of thec crystal oxalate. These can occure because of diet or can be caused by uti as well. It’s the chicken and the egg, not sure if she got crystals from uti or uti from crystals. I strongly suspect the crystals from uti because of or inverted vulva and infection. I’d like to put her back on a better more complete diet but my vet is concerned about the crystals returning. This is the reason why I’d like her to take cran caps daily regardless.
    I’ll talk to my vet about fish oil, vit C and tumeric as well.
    Funny thing: this is the regiment I’m on (
    onus the cran cap and probiotics )

  5. Patty…been throught the ringer the last couple of weeks.Bella had a vaginal scoping and they found that her uretha was severly inflamed and fiberious almost like going through hamburger meat is how my critical care vet discribed it. Her bladder was fine just the urethra a sample was taken and sent to the lab results were no cancer at this time.But ther literally is no uretha canal it is really damaged and sometimes she cannot eliminate. We also recieved confirmation that her kidneys never developed and are severly deformed.(which her BUM always came back too high as a pup) so damaged kidneys,urethraits,chronic uti…her sprits are good she looks fine and is as playful as always. We just had to take her in yesterday again and more tests kidney functions elevated more and just recieved a call she has another UTI…
    and they are waiting for the urine culture to come back…Currently she is taking antiobiotic,proxicam(for inflamation)mistoproprol(?)for her stomach and pepcid ac or ad for her stomach…also pain medication for her discomfort especially when elimanating.They also are wanting us to transition to a renal diet….canine renal mp? would love to hear your suggestions and commets..
    We also have been prepared to talk about a stint for her uretha which is not a cure just a temporary fix.My research is not good on the stint do you know anything???? but we are not at that point yet…as long as she eleminates…thank you for being there Patty….Deborah

  6. Wow Deborah,

    You sure are dealing with a lot. I don’t have experience with this but would suggest a specialist/urologist for a second opinion before you do any type of sugery or treatment.

    For now at least, with all the antibiotic I would get her on a good live organism probiotic given 2-3 hours away from the meds to put good bacteria back in her system that the meds are killing off. And continue those probs after meds are finished for a good 2-4 weeks.

    I wish I had more to offer. I pray for you and your girl in this. Poor kidney function and deformed kidneys are not a good sign.

    I would consider a kidney regime along with everything else. May not help but can’t hurt IMO. See my blog on KF for natural supplements and low phosphorus food. And see this link for info on feeding good “quality” protein for kidney function (even for compromised kidneys).

    Make sure the renal food they want you to use is not a corn based food as most are. corn is much harder on the kidneys than meat based high quality protein. If they push a corn based food absolutely get a second opinion (maybe a holistic vet with kidney experience)

    I pray for you and your girl in all of this. Please keep me posted. I know its awful what you are going thru but posting back here may help someone else from what you learn as you go along.

    Hugs to you and your girl big time. I will keep you both in my prayers and hope for positive updates from you.


  7. Deborah,

    PS: have you gotten her on crancaps? I don’t have experience with her urethra issue and it sounds almost like scar tissue so to speak.

    But if the urethra issue is causing her to not be able to eliminate all urine and causing a build up for bacteria to form than the crancaps may help that.

    In your case, I would give her a dbl dose daily and certainly be checking her urine PH weekly at home to keep up on things.

    Again I have no experience with your specific issue but don’t see my suggestions interferring. See what your vet says and keep me posted please


  8. Patty
    I have very sad news. I had to put down my beautiful girl and my heart is breaking. It has been 1 week today. We had to take her back in to the vets because she couldnt eliminate again and they had to cathaterize her again to drain her bladder and extracted 1 liter. She was pretty unconfortable and had to be monitored overnite. The next day they took her off and she was unable to eleminate even with drugs to encourage her bladder to do so. We had at our vets recommendation taken her as of november 1 to an animal critical care internal medecine facilitie about 40 min away from our home. I think we have been 3 or 4 times and gave her the best doctors that money could buy. What they found was kidneys that never developed, diseased urethra, that biopsy came back no cancer but the doctor said she wasnt satisfied with that because of what she saw when she did the vaginal scoping. Also, the doctor’s theory was that her rear end was very weak(which it was she walked cross legged kind of cute though but not for a shepherd) and because of her spinal column not being supported by her back end the peeing could have been neurological. The bladder when the urge to pee wouldnt release so medications came into play to relax the bladder and sphinter to eliminate and to rid her of the feeling she had to go when she went. My problem with this was she was only on the medication for less than 24 hrs. But we have been battling this issue since november and watching her strain to pee was pathetic. It got really bad and when i think back I think this was going on since june. On the outside she was I am always told the most beautiful petite female german shepherd anyone has ever seen. So much personality and I feel at 5 yrs she was robbed. Also her uti they had her on one of the strongest antibiotics. Her last day alive they took another culture and I am curious of the outcome but what does it matter now? We were told that putting her down was the most humane because she couldnt live on a cather forever….and there were so many things stacked up against her. our only other options was a stint and they are fairly new in dogs doctor said she didnt recommednd it becasuse we would be putting it in the dieased urethra tissue and she could be in an incredible amount of pain. So my husband tool Bella for a walk a pretty long walk and she nipped at his hands in anticipation as they started.. I watched as my lovely girl steped out with her papa and we spent time outside with her and then took her inside to see the doctor one last time as we held her and love her good bye.It was the most awful thing i have ever done and i cant see my keyboard now because of the tears..sorry…I only wish I could have had one more day to see if the bladder med would have worked. One more day …when we got home and looked at the 8 different medications and the renal diet food…she was very sick we just couldnt see it. I just saw her strain to pee and on some days you could tell she didnt feel good.. but last weekend we had the best time. She was feeling her oats and I was loving it she played with every squeeky toy she owned..I wish i would have found your site sooner. We never even addressed the recesed vulva issue there was so much going on. Sorry this turned into a cry session thank you for all that you do to help people…Merry Christmas

  9. Oh Deborah,

    I am so, so sorry for your loss. I too am crying as I read your words.

    You did the best you could for her please know that. And you gave her the best gift of all by taking away her pain, as hard as I know it was for you and your husband.

    Take solace that she is now at Rainbow Bridge and completely healed. She is running free with no pain. You will see her again some day. Of that I have no doubt.

    When you are ready please see this link:

    Prayers for you and DH in your loss and grief – for your hearts to heal.

    If you need anything or just to talk don’t hesitate to call me. My number is on my web site.

  10. Thank you Patti
    It was truly an expiernce I never want to repeat but I know in opening your heart to an animal it is the risk you take and Bella was mine for 5 years and we live it good. I just have to get past the what if we did this or that or waited one more day.. that is what is eating me now. I have to put some faith in the Doctors and they loved Bella too..everyone was sad.. we thought this was an easy fix. Well her ashes arrived today and she is home again and we move on. And in a couple of months I hope to have a new four legged family member bouncing around here…Thank you for talking to me and I will call you sometime…Merry Christmas

  11. It is an awful experience I know. And one you will go thru again at some time in your life.

    Don’t beat yourself up. The doctors would not have given you the advice they did if they thought they could help her. Putting a dog down is the worst part of their job and they would not do it if they didn’t feel it was best for Bella.

    Sending you hugs to get thru this difficult time.


  12. Hey, Just wanted to let you know that your site isn’t loading properly on my iPhone. Do you know if there’s some setting I need to use to make it show properly? Everything is out of line.

  13. With regards to the iphone, please email customer service and we will look into this for you. Please let us know specifically what page(s) are not displaying properly. I just went through several pages on this site on an iphone and it all rendered properly so id like a little more info to help you better.


  14. I have a 4 month old Labradoodle who I just discovered has an inverted vulva that looks like the photo you have posted. She was already spayed when I got her at 3 months. I just took her to the vet and asked about it. He gave me Animax ointment (nystatin-neomycin sulfate-thiostrepton-triamcinolone acetonide oinment) to apply twice daily for a few days. She already licks her vuvla often, and is continuing to do so after I apply the ointment. I don’t think she has a UTI, but she does often squat twice. The first time I see a regular urine stream, but can’t see if there is on the second round. The second time she squats, it’s just for a few seconds. I am obviously concerned about how to treat this and what may happen in the future. My questions are: (1) How do I know if she has a UTI? (2) What do I do in general to keep her healthy, since she has already been spayed before her first heat? (3) Should I consider surgery as a preventative measure? (4) At what age can she have the corrective surgery? (5) Are there ointments that act as a moisture barrier that you can recommend? (I read that Desitin isn’t good since zinc is poisonous for dogs.) Thanks for any help you can offer!

  15. Hi Aimee,

    The only way to truly know if she has a UTI is to test PH at home or take a urine sample to vet. collect urine the way I describe in my blog. If it is positive you may need antibiotics or dbl dose on crancaps. Be sure and test urine PH at home too since your girl may be prone to infection from the RV.

    Signs of UTI are frequent squatting, expelling or not expelling urine, excessive drinking “can” be one, accidents in the house or while sleeping. Her squating often could be a UTI, I would take a sample to vet to be sure.

    Wipe her vulva with unscented baby wipes each time she goes to remove the urine that is pooled in the valley of the RV. (I have never had to use ointment – unless your girls vulva is sore and raw looking)

    I would not consider the surgery at this point. Follow my regime even if you have to keep her on crancaps for life. If they keep her UTI free, no need for the surgery.

    The only time I would consider the surgery is if I could not keep a dog UTI free with crancaps and had to constantly use antibiotics. As for age of the surgery, not sure but I would wait till she is older.

    Also do not let a vet without a good amount of experience in this procedure do the surgery.

    not sure about ointment for moisture barrier, never used them. And she is just going to lick them off if you are not around to stop her.

    Good luck and let me know how you make out.


  16. hi Patty,
    I have my first litter of rough collie puppies and I believe one of them has a recessed vulva. They are six weeks now and I have noticed for a few weeks that her back legs are always wet from pee. Then one day I was trimming the wet fur (I thought it was an immaturity problem like she hadn’t figured out how to squat properly when peeing) and I noticed she was peeing in her sleep. I took her to the vet and she has a UTI. It is now her third day on amoxicillin and she is still wet with pee in the area around her vulva. I compared the shape of the vulva to her sisters and they all look the same to me? Could she possibly just have a UTI and NOT a recessed vulva? How common is it for puppies to get a UTI without the RV problem? Anyway I am waiting to see how things turn out. Thank you for all the information on this blog, it has been very helpful!


  17. Hi Kate,

    I have not seen a lot of cases of UTI in young pups without a RV but I think the vet may tell you it is not uncommon. What did vet say about it?

    If amoxy is the right drug for the type of bacteria she has than it should have an effect by now and I would think the leaking would have stopped, call and ask the vet. Did the vet do a culture/sensitivity to pinpoint the bacteria?

    My concern is this pup leaking urine all the time. Either it is a very severe infection or this pup needs to be checked for an ectopic ureter. This causes a pup to leak urine from birth. She may have had this problem from birth but with mom always cleaning pups you may not have noticed. Does she leak when you are holding her? Another sign of possible EU.

    You need to call and discuss this with the vet and see what they say.

    If this is a UTI and not EU I would also get this pup on the crancaps for prevention. Does her vulva (or her sisters) look like the pic above? It is possible more than one pup has a RV. I had 2 in a litter.

    Please keep me posted.


  18. Hi Patty,

    I have an update on Chloe the golden retriever.

    It’s been 3 months of daily doses of crancaps (2,000 mg), probiotics (8 billion), D-mannose (1,000 mg), and 1 tblsp of raw apple cider vinegar and after 2 negative cystos, Chloe’s latest culture came back with an infection again (not ecoli). She had 2 accidents this past week, so I assumed she was having an active infection (and she was).

    At this point my vet suggests we do the vulvaplasty surgery and I concur since none of the natural methods have kept her clear. The folds around her vulva are really deep. I’m continuing her with the cranberry, etc. and she’ll start 3 weeks of cephalexan and as soon as she’s well enough, I’m going to go the surgical route.

    She’s 10.5 yrs old and not getting any younger, and I don’t want her to have to stay on antibiotics for the rest of her life, which is what this is turning into.

  19. Hi Natalie,

    I am so sorry to hear the holistic approach is not working, You must be so dissappointed.

    In a case where the only way to control constant UTIs is a life time of antibiotic, than i do agree with the surgery.

    If I did not mention to you in the past, be sure your vet has experience with vulvoplasty. Ask how many he has done and have they been successful.

    Good luck. I pray the surgery does the trick. Please do let me know how it goes and update me her recovery.

    Picks of the post OP surgery (will not be pretty) would be great to share here on my blog so others can see this and not let their vet push it without at least trying the holistic approach first.

    If you would share you can email them to me and I can download them here. Let me know.


  20. What a relief to find your website. I have had dogs all my life and have never heard of this condition. I have a rescue Collie that has had a couple of infections in a row. I am excited to try the Cran caps. Can you tell me how many mg for a 90lb, dog? Thanks, Eileen

  21. Hi Patty,

    Yes I’m *very* disappointed, esp. because I was a fanatic about making sure my dog got the right doses of supplements every day. I know though, I did everything I could from a natural supplement standpoint and really gave it a good, long try. Actually it’s been 4 months, not 3, since we started the cranberry/D-mannose/probiotic regimen. My vet was fully on-board with this approach and we even consulted the local university vet hospital.

    I asked how many surgeries the lead surgeon (who will do Chloe’s procedure) has done and he’s done many (I think they said he’s done at least 20) with good outcomes overall. Of course there’s no guarantee, but it should help to get rid of all that excess skin, fatty tissue, and give her a better chance from a structural standpoint. I plan to continue her on the supplements since they don’t hurt her and they do help flush out the bladder–perhaps I’ll eventually be able to get her on a lower dose of cranberry (she’s at 2,000 mg now).

    I’ll take pictures and share them, yes. Chloe’s surgery is scheduled for March 4th and she’s on antibiotics for now.

  22. Eileen,

    Weight does not matter. Use the amount I mention above and dbl up if PH elevates.

    Good luck, let me know how you make out.


  23. Dear Patty: I am so pleased to come across your website and see how generous you are with time and advice. What a great resource to others. So, I figured I would ask your thoughts with my dog Roxanne. Roxanne is probably around 5 years old. She was spayed when rescued about 4 years ago. Here is the nutshell version: about 2 years ago I noticed what seemed like dried crusty blood all around her vulva. along with very raw skin. All urine tests came back normal. Therefore, the blood did not appear to be coming from her urethra or a urinary condition. Either it was coming from her vagina, or it was being caused by licking. I did not think licking alone could cause the extensive irritation. A vaginal culture turned up staph. A trip to a specialist left us with antibiotics that cleared it up. However, it’s now come back about three months later. She does not have a recesssed vulva as far as I can tell, but the specialist recommended surgery as she said Roxanne’s vulva is a bit “tucked up” or something like that and this would continue to re-occur because bacteria is getting trapped around her vulva. I am not sure if this explains all the symptoms. I am going to have an ultrasound first as I keep thinking that the blood may be coming from an internal source. Other than this she is in perfect health. Strangely enough, she had severe skin irritation along her belly last year that caused hair loss and raw skin, but that cleared up after eliminating dairy from her diet. Unfortunately the diet change did not seem to improve the condition around her vulva.

    If you have any other thoughts, I would appreciate them! I would like to avoid surgery if at all possible. Roxanne is a marker, I think she learned that from my older dog (also female), but while she pees constantly on walks, she can hold it in all day if she needs to without any stress as far as I can tell.


  24. Hi Amy,

    ““tucked up” or something like that and this would continue to re-occur because bacteria is getting trapped around her vulva.”

    If this is the case than it is a recess but may just not be severe.

    I would get her on the crancaps to prevent infection. Although I am not sure if it will work for Staff – but worth a try (most likely will need a good amount of antibiotic to completely get rid of the staff) and than see if you can keep her infection free with the crancaps and hopefully prevent surgery.

    The only time I would consider surgery is if you can’t keep a dog infection free without antibiotic. A lifetime of antibiotic is not good.

    Also be sure and give probiotic with all the antibiotic she is on – follow my instructions in my blog.

    I don’t have experience with staff but do know it can take time to clear up so be patient before considering surgery.

    Hot spots in dogs are aggrivated from the dog licking and can be very severe. This could be the cause of your girls irritation.

    Since you don’t know the cause of the blood the ultra sound is a good idea. Let me know what it shows.

    Praying you can avoid the surgery and the US will give you answers and not show anything serious.

    Let me know if you have more questions and I will try to help.


  25. Hi Patty: thanks for the response! We were at the vet today for the ultrasound. Everything looked normal, including uterine stump, so the vet ruled out an internal cause. She said my dog’s vulva was not inverted, but her problem is more the location of the vulva–if that makes any sense. They look at her from the rear to see the location of the vulva and say “tucked up” meaning that it is in an abnormal location where it is more likely to gather bacteria, I guess. So it appears to be a skin infection, not a UTI. I know she doesn’t lick much because I work from home and would notice. I would think she could keep herself clean, but I guess that is not fool-proof! I will try the cran-caps — they can’t hurt. This vet – the general vet – did not recommend surgery. It is the dermatologist specialist that recommended it. So, I will try the cran-caps, and I guess I can give her a wipe at the end of the day to try to keep her clean.

    Thanks again for helping!

  26. Hi Amy,

    Glad the US was clear.

    Hoping the crancaps will help. and wiping her is a good idea. I would do this each time she urinates if you can.

    Let me know how she does.


  27. Thank you so much! I really appreciate your taking the time to help me and others. It is hard to find good information about this.

  28. Can’t believe that so many others have the UTI problem! My 11-yr old maltese/Pom cross has had a UTI since we got her at 4 months. She was periodically symptom and bacteria free however, of late, has developed antibiotic resistant e coli infection. She is now on a quinolone (only drug that is not resistant) but still has an odd vaginal discharge. Interestingly, her Ph is normal! And yet, the culture reads bacterial infection. She drives us crazy asking to go out at night. I don’t know what else to do at this point She has a moderate RV – not as extreme as your photo example. But vulvoplasty only works in 67% of cases. I have been washing her with antibacterial cleanser and applying triacomb (an antifungal, antibacterial, ) to the affected area to make her more comfortable. It seems to settle her down – but he infection rages on. She has hair in her vulva and a slight discharge. Would Canesten cream be better – could she have a chronic yeast infection? The vet has not suggested a swab (too hard to get a pure culture I guess). I’m worried that cran might give her an upset stomach as she smacks her lips alot (indicating acid reflux?)

    Someone must have a definitive solution – do you have any experience with antifungal creams in dogs?

  29. Hi Suzi,

    I am so sorry for all you are dealing with.

    I don’t have experience with e coli but the crancaps may help and I don’t think they would upset her stomach.

    I also have never used antifungal creams but am thinking of oil of oregano (an antifungal) I give it in capsule form 1 per day. Am checking with a friend on this regarding e coli and will get back to you. She knows a lot about holistic and chinese meds for dogs.

    I don’t understand why her PH is normal if there is an infection. Unless the infection is vaginal and not urinary.

    If she does have a yeast problem (discharge) than antibiotic will not help yeast, only helps bacteria. The discharge could be vaginitis. Did she have this as a pup prior to spay? May be best to have the vet do a vaginal swab to check for yeast, etc.

    I will get back to you on the oil of oregano (OoO) or any other suggestions my friend may have.

    For now I would try her on the crancaps in the hope it can help fight e coli.

    But remember cran caps work in the bladder/urinary tract so it may not help if this turns out to be a vaginal infection.

    If you do the swab and it turns out to be yeast apple cider viniger can help ward off yeast. I give 1 1/2 tspns in each meal (2 meals/day) daily.


  30. PS: talk with the vet about the apple cider viniger due to the possibility of acid reflux.

    Also ask about over the counter human meds for the acid reflux.

  31. Suzi,

    Heard back from my friend and she said she would try the Canesten cream topically, it can’t hurt.

    And, OoO won’t hurt your dog along with cran caps.

    Good luck and keep me posted.

  32. Hi Patty,

    Tomorrow is vulvaplasty day for Chloe. I’ll be dropping her off early and then waiting anxiously. She’ll stay overnight at the vet hospital and, if all goes well, will come home on Fri. I’ve still got her on cranberry and probiotics and she just finished a 3-week course of cephelexin. I will continue the supplements even after the surgery. Please say a little prayer that all goes well for my golden girl tomorrow. I’ll let you know how it went.

  33. Natlie,

    Prayers for sweet Chloe that the surgery will put a stop to her issues and that she will heal quickly.

    Hugs to you while you wait, I know the stress..

    Keep me posted when you have time.


  34. Good news! Talked to Chloe’s surgeon about an hr ago and she did great, he said. He said her folds were really deep and her condition would only have worsened with infections getting more severe, so this was the right thing to do and the right time to get it done (before things really escalated and got bad).

    He said they took pictures ‘before’ and ‘after’ so I plan to get copies of those and I will share them.

    I’ll pick her up tomorrow. She’ll have 1 more week of antibiotics. I will continue her on supplements (Cran + Probiotics) ongoing.

  35. Natalie,

    So glad to hear the surgery went so well.

    Prayers she recovers quickly.

    Look forward to the before and after pics. Thanks for sharing them.

    Make sure you give the probiotic 2-3 hours away from the antibiotic and when meds are finished continue with probiotic for 2-4 weeks. The crancaps you can give at any time.


  36. Hi Patty,

    Yep, I give Chloe the probiotic capsule with her ‘lunchtime’ meal, which is 5+ hrs after her morning antibiotic dose and 6+ hrs before her evening antibiotic dose. I give her the cranberry with her breakfast and dinner. She also gets omega 3/fish oil, glucosamine/chondroitan/MSM. I have pill containers with everything pre-measured and portioned out and ready to go so I don’t have to think about what pill to give her when. I’ve been using that approach for years (the pill containers) and it was easy to add in the cranberry and probiotic regimen.

    Oh and Chloe’s down about 5 lbs, with another 4 or 5 lbs to go to reach goal weight. She’s getting LOTS of extra low cal veggies to make up for the reduction in amount of kibble. She loves broccoli and cauliflower and carrots. I’m not joking when I say she eats better than me (certainly healthier)!

  37. Hi Natalie,

    Sounds like you are good to go and have it all under control.

    Kudos for you for all you do for Chloe.

    Keep me posted on her recovery.


  38. Hi Patty, I have been reading all of these posts for hours now. I have a 19 week old G. Shep. puppy, Bella who was just spayed on Wed. We got her the end of Dec. and noticed strong urine smell, took to vet and put on Clavomax, contined it again for 10 more days and then we notice her urininating and blood drops in her urine in the snow. They went ahead a spayed her instead of the end of March to see if the nonstop infection was being caused by stones, pockets around the bladder…nothing! $1,000 later we know nothing! We are waiting for her bladder biospie to come back. WBC was high,vet said 100;s of bacteria in her vagina. Before surgery had urine testing done and it showed ecoli. Was told she has recessed vulva, not a bad case. We did not know anything about waiting til she had her first “heat”. The vet told us that it would probably correct itself in time so we shouldnt’ have to worry about surgery at this time. Not real good with dog parts, but is the vulva the larger part in picture? Bella is 19 weeks old and currently on amoxitabs til we get results from surgery. They were talking about putting her on Baytril, which looking at can cause cartlidge damage when used long term. The clavomax and Amoxitabs are not keeping the infection away. Could you pls. tell me where I can purchase Crantabs and what strength and how often we can give them to Bella. Also, she currently eats Iams Puppy Food/Large Breed…is there a better food she should be eating? Your help is very appreciated!!!

  39. Hi Nancy,

    Her vulva is not going to correct at this point. The only time I know of one correcting without going thru a heat cycle is when young pups 6-8 weeks old are too chubby (fat causing the recess) and when the pup grows a bit the vulva will correct.

    I would get her on the crancaps 1 per day and test urine ph at home as I mention above. It won’t hurt to keep her on them for life if she has issues with UTIs. I know someone that had good results using crancaps for e coli.

    There is a link to where to get both crancaps and PH strips in my blog above.

    The vulva is the round are in the pic that has the valley around it.

    Hoping you get good results on the biopsy. Keep us posted.


  40. Thank you Patty! I was not home when vet called and left message, but was told that all three biopsies had ecoli. He wants us to continue on the same Amoxitab antiobiotics she has been on. Plan to call tomorrow. Any ideas where she may of gotten ecoli? We have been battling this since we got her the end of Dec. We are switching her Royal Canine puppy food from Iams, in hopes of it being tailored for the G. Shep. it helping with any other issues! Will get the crancaps going, have been giving her a shot glass full of cranberry juice on her food twice a day for the past couple days…she seems to like it! If getting cranberry tablets from GNC what would the dosage be? I googled and saw a 400mg/20 lbs. of dog each day. My question to our vet is if she was on the Amoxitabs before and the ecoli came back or is still there…doesn’t this mean they are not working? The good thing…..this is not effecting her play or eating…she is wild!! Thank you Patti for your help. If you know the dosage pls. let me know!

  41. Patti….question…these cranberry capsules from GNC…do you open the capsule up and put in food or just put in cheese to get puppy to eat it? These on the link are 500 mg, do you recommend just one a day?

  42. Nancy,

    No idea how she got e coli but have heard of cases where the vulva is too close to the rectum and stool getting on the vulva can cause it.

    I would give her 1 crancap/day for maintenance(GNC or Progressive brand) and check PH. If elevated give 2/day for 2 weeks and check PH again as I mention in my blog.

    I put the whole capsule right in meals.

    Keep in mind that concentrate from fruit(Progressive) is better than from juice (GNC) according to my research.

    She may not have been on the amox. long enough to get rid of the e coli. I assume since they pinpointed the exact bacteria that amox. is the right med for e coli.


  43. THANK YOU Patty!! Its been pretty frustrating and just want her to be better! You have made me feel much more comfortable about everything and just wanted to say “THANKS”, it is much appreciated! Praying this ends for Bella soon!

  44. Hi Patty! Quick update, Dr. is putting her on Marbofloxin for 10 days, not sure why the Amoxicillan didn’t clear it up. Praying this will clear it up! Thanks again for your advice!

  45. Nancy,

    I have no experience with e coli but I think it can be tough to get rid of. Hopefully the new med will do it.

    I pray this ends for Bella soon too.

    Glad I could ease your mind a bit.


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