Such changes include: an increase in the chemicals and receptors that transmit signals between nerves; an imbalance between pain signals coming into the brain and the brain suppressing those signals; and a change that makes nerves that don’t normally relay pain signals into ones that do.

There are different types of neuropathic pain.  An exaggerated response to a painful stimulus, such as a pin prick, is called hyperalgesia.  Pain from a normal stimulus that shouldn’t be painful at all, such as a light touch, is called allodynia. Hyperpathia is increasing pain after repetitive stimulation, which includes continued pain after the stimulus is gone, and pain that radiates to adjacent areas.

People who experience  neuropathic pain describe it as “a pins and needles sensation,” tingling, burning, itching, numbness or cold, and sometimes feeling as if they had received a small electric shock.  Grades of neuropathic pain that have been established in human medicine are definite, probable and possible.

Pets cannot describe their pain to us but we believe it’s likely to be like what people have.  Neuroma formation in horses is known to cause definite neuropathic pain.  A neuroma consists of an abnormal sprouting of nerve endings from a severed nerve, and affected horses develop lameness or an abnormal gait. 

An example of probable neuropathic pain in dogs is the abnormal scratching behavior that is seen in King Charles Cavalier Spaniels with a spinal cord abnormality called syringomyelia. Cats with hyperesthesia syndrome incessantly lick and attack their back, and become extremely painful when petted. Neuropathic pain may be one of the causes for hyperesthesia syndrome.

Diagnosis

Diagnosing neuropathic pain in animals involves ruling out other painful conditions, such as osteoarthritis and bone cancer, as well a thorough neurological workup. A neurological examination evaluates the different parts of the nervous system (brain, spinal cord, nerves); if those parts are not normal, further diagnostic tests are indicated.  Laboratory tests, radiographs, CT or MRI imaging, and in some cases electrophysiologic testing may be recommended to look for diseases that are known to cause neurological injury and secondary pain.  Examples of such diseases include: diabetes mellitus, intervertebral disk herniation, spinal cord or nerve sheath tumors, cervical malformation, and syringomyelia.

Treatment

In some cases treatment is started early in conditions that are normally expected to be painful to try to prevent neuropathic pain from developing.  In other cases, neuropathic pain may be the first sign.

Combining drugs that reduce pain in different ways has proven to work better than using a single drug alone.  Depending upon the species, one or more drugs may be prescribed by a veterinarian.

Gabapentin, pregabalin, dextromethorphan, and amantadine are drugs that act on the relay centers for pain within the spinal cord. Amitriptyline acts both on the brain and within the spinal cord. The antibiotic minocycline has shown potential for modifying neuropathic pain.

These agents may be combined with one or more of the traditional analgesic drugs: tramadol and codeine, narcotic drugs that modulate the brain’s perception of pain; non-steroidal antiinflammatory drugs (NSAIDs) such as carprofen, deracoxib, and firocoxib; local anesthetics such as lidocaine and alpha-2 agonists; drugs such as medetomidine that modify pain, heart rate and blood pressure.

Some veterinarians have found success using combinations of herbs, diet, exercise, and acupuncture.

It is important to work closely with your veterinarian to manage neuropathic pain. Balancing the benefit of multiple medications against side effects can be challenging. Discussing the perceived effects of medications with your veterinarian is essential for the best outcome for your pet.

Many parents mistakenly think a child-friendly dog means the dog should tolerate anything a child does. Although kids and dogs can, and often do, have great relationships, it may not be as easy as it seems. Children are unpredictable because they make loud noises and move suddenly, causing even the most mild-mannered dog to become frightened and overwhelmed. Any dog, even one who loves kids, can bite if they feel threatened, especially if they can’t escape the situation. Research shows that kids are most often bitten by a dog they know. In these situations, adults may not be watching or believe their dog would bite.

Prevention

Adults should actively engage with the children and dogs. When direct supervision is not possible, separate the dogs and children using barriers. Provide your dog with their own space. This should be a closed room or secure crate with everything your dog needs. Baby gates can be used to set up this safe haven. Teach your dog to love their special place and teach the children to never approach when the dog is resting there.

Learn Your Dog’s Language

Children are more at risk of dog bites because they haven’t been taught how to read a dog’s body language and can’t assess the danger. Dogs will often display subtle signs of discomfort, such as yawning and avoiding eye contact, before escalating to more obvious signs such as growling. By watching for these signs, you can step in to safely manage the situation by guiding your dog away from the child. If ignored or punished, then your dog is more likely to bite “out of the blue”.

Teach your children to recognize your dog’s body language by using children’s books, videos, and coloring pages. Adults still need to manage all child/dog interactions.

Structured Interactions

Show children appropriate ways to interact with dogs so they can be safe. Structured, predictable interactions between dogs and children can build positive relationships. With adult supervision, the following activities are appropriate for children with dogs who have never shown aggression:

Fetch –
Using two or more toys, older children can play fetch without needing to take toys away from the dog. The child tosses the first toy and when the dog returns, they toss the next toy.

Flirt pole –
For dogs who love to chase, attach a plush toy to a rope and stick that your child can hold. Using the flirt pole the same way you would a cat wand, let the dog chase the toy. Always finish the game with a treat.

Training –
Involving kids with the dog’s training can help create a strong, positive bond between them. Start training sessions with cues the dog already knows, like “sit”.

Tossing treats or kibble –
Another simple but effective game is to have kids toss either treats or kibble across the room for the dog.

Teach your child to freeze in place if your dog starts chasing or jumping at them. More movement or noise from children will encourage the dog to continue. If you have taught recall or “touch”, call your dog to you. If your dog does not come when called, they should be leashed.

Visitors

Avoid Punishment

When creating happy, peaceful relationships between children and dogs, punishment is never appropriate. In scary situations, punishing a frightened dog can ruin relationships and doesn’t change the underlying issue.

Safety is the priority when managing relationships between dogs and children. If you are having a hard time creating positive interactions or your dog has shown aggression, contact a behavior professional for assistance.

Dental Care

Bad breath isn’t an accident; our pets get it for the same reasons we do, and one of those reasons is poor oral health. However, the need for dental care goes far beyond the importance of treating “bad” teeth that are painful and thus can make pets reluctant to eat or drink. The bacteria involved in the infection can travel through the body, causing problems in other organs. You can help to prevent dental disease by brushing your pet’s teeth regularly at home with a toothpaste made for pets, not humans, and by making sure your veterinarian checks your pet’s teeth at every appointment. Your pet may need a dental cleaning under anesthesia for such concerns as gingivitis, periodontal disease, or tooth resorption.

Exercise

While exercise helps prevent obesity, preventing weight gain is not the only reason to provide exercise. Our pets aren’t meant to live a life of dull luxury hanging around on the couch. Exercise also gives them a reason to sleep soundly at night and to have social time (particularly dog play dates). It deepens the human-animal bond, and just plain makes our friends feel good all over. Just going for a walk to check out the smells and sights makes your dog’s day, and interactive cat toys will keep your cat’s mind and body sharp. 

Regular Checkups

Your pet should have at least an annual checkup with your veterinarian. It’s the equivalent of your annual physical. (Some pets may need more frequent checkups, due to on-going health problems, age-related diseases, etc.) Your pet’s doctor will do a physical exam and feel the skin, muscles, bones, etc. for problems; check his teeth; and make sure his health appears to be good. Finding a potential problem sooner, rather than later, is always best for your pet’s health. (And often, it saves you money over the long run.) The older your pet gets, the more important this preventive care becomes.

Microchip

While the system of scanning for microchips is not perfect, having your pet chipped still increases the odds that you will get him home, if he gets lost. It doesn’t matter whether he got lost while you’re camping or if he simply bolted out the door. Tags can fall off collars. Collars can break. (In fact, cat collars are designed to break away, for safety.) In the aftermath of natural disasters, microchips can be invaluable.

Nutrition

Your pet needs a balanced diet created for his species. The price of a pet food doesn’t necessarily equate to the best food for your pet and his health needs. Check the food packaging to see if the food is approved by the Association of American Feed Control Officials (AAFCO). This group tests commercially available pet food and tells us if it meets our pets’ nutritional needs or not.

Also, your pet needs fresh water every day.

Parasite Control

Internal and external parasites can make your pet (and, in some cases, your family) sick, so using preventatives can keep your pet comfortable and save you a lot of money. It is important to control fleas, ticks, tapeworms, ascarids, other intestinal worms, and heartworms. An infestation of fleas can suck so much blood that your pet can become anemic.  They also can cause skin problems. Ticks can transmit Lyme disease, Rocky Mountain spotted fever, ehrlichiosis, babesiosis, and Cytauxzoonosis. Heartworm disease kills pets every year; heartworm prevention medication is much less expensive than treatment.

Kidney transplants are something everyone has heard of for people, but may not have considered possible for pets. In fact, while transplants are confined to specialized facilities with experienced surgeons, successful kidney transplants in cats have been going on since the mid-1980s. Canine programs have been less successful but are also available in limited facilities.

To the uninitiated, the impression may be that once someone receives a new kidney, life is renewed and all the kidney problems are solved. In fact, this is hardly the case. There are immune-suppressive medications needed to prevent the new organ from being rejected, not to mention potential for infection, on-going screening tests, and other issues.  A kidney transplant is a very big deal regardless of the species, and not every patient is even a candidate, so let’s walk through the main considerations.

These cats are classified as “specific pathogen-free,” which means they are free from infectious diseases. They are matched by blood typing and potentially by tissue typing, depending on the transplant program. A research cat is selected, and a kidney is removed for the recipient. After the procedure, the owner of the recipient cat must adopt the donor.

Some transplantation programs allow the owner of the recipient cat to provide the donor. Donors must be young adults, generally at least 10 pounds in size, be free of infectious diseases such as feline immunodeficiency virus, feline leukemia virus, and toxoplasmosis, and must have excellent kidney function. Basic blood testing and urine cultures must be normal.

You enter the program with one cat and leave with two cats.

Is Your Cat a Candidate?

Kidney transplantation is not a procedure that is left until all medical therapies have been exhausted. The best candidate is free from other medical problems besides kidney disease.

Typical screening includes:

1. Basic blood panel (including thyroid level) and urinalysis
   
2. Urine culture (elimination of latent infection is crucial, and often a trial of immune-suppressive drugs is used after an infection has been cleared to ensure that the infection does not come back)
   
3. Feline leukemia virus and feline immunodeficiency virus screening
   
4. Ultrasound examination of the heart (heart diseases that involve high blood pressure development can damage the new kidney)
   
5. Screening for toxoplasmosis (the immune suppressive drugs needed to maintain the new kidney could reactivate a latent infection with this parasite). A positive test for Toxoplasma does not preclude the transplant but a positive donor must be selected. Recipient cats testing positive for Toxoplasma are generally kept on clindamycin for life. Recipient cats testing negative will be periodically screened for Toxoplasma for the rest of their lives.
   
6. Blood typing
   
7. Blood pressure monitoring
   
8. Urine protein to creatinine ratio to evaluate glomerular disease/renal protein loss.
   
9. Teeth cleaning (performed under anesthesia)

Different programs may have additional required screening tests such as kidney biopsy, intestinal biopsy to rule out inflammatory bowel disease, test doses of immune-suppressive medications, etc. Obviously the details would be provided by the specific program being considered.

If the cause of the kidney failure is felt to be something that would lead the new kidney to fail as well, this may disqualify the patient from the program. Such conditions would include renal lymphoma or other cancer, amyloidosis (a malignant protein deposition), and pyelonephritis (a deep kidney infection, although if the infection is truly felt to have been eliminated, the patient might still qualify). Again, each program will indicate what conditions might serve to automatically disqualify a recipient.

An additional problem for dogs worth mentioning is intestinal intussusception. Imagine a telescope. Unfolded, it is basically a cylinder, but folded, and one segment collapses inside an outer segment. Now, imagine this happening to a piece of the intestine. A life-threatening obstruction results. A procedure called enteroplication is given in conjunction with the transplant. In this procedure, the intestines are tacked down with sutures into a formation that precludes any telescoping motions. This procedure, along with proper pain medication post-surgically, seems to prevent intussusception.

Cats with relatively early kidney failure are not yet candidates for transplantation. Cats with advanced kidney failure are not good candidates either, although dialysis (available at advanced critical care facilities such as those that perform kidney transplants) may improve the values.

The best candidates are those with an acute cause of kidney failure (such as a poisoning), cats who do not respond well to the usual medical management, or cats with a creatinine greater than 4.0 mg/dl. The cat should have a decent appetite and be as strong as possible prior to this major surgery.  Again, each transplant center will have its own criteria.

Prior to surgery, the recipient cat should be made as stable as possible. Usually, a blood transfusion is needed to correct the renal failure-associated anemia. Sometimes dialysis is also needed.

Is your Dog a Candidate?

Recipient screening is similar to that for the feline patient though heartworm testing is needed. Blood clotting tests are also needed for dogs. Similar conditions will also rule a patient out as a candidate (no cancer, heart disease, amyloidosis, or inflammatory bowel disease.) The adrenal hormone excess known as Cushing’s disease also precludes getting a kidney transplant. Kidney transplants for dogs are generally not as successful as for cats, so be sure you understand what you are getting into and the likelihood of obtaining the outcome you are hoping for.

What Kind of Home Care Will the Recipient Require?

The recipient is going to require suppression of his immune system for the rest of his life. This not only requires a substantial financial commitment for the medication but also the ability to give the cat oral medication at least twice a day for the rest of his life. The heart of this therapy is a medication called cyclosporine, a medication that has revolutionized organ transplantation for humans. Prednisolone, a commonly used cortisone derivative, is typically used as well, at least to start.

Cyclosporine is typically given twice a day with the lowest blood level of the day being approximately 500 ng/ml around the time of surgery and lowering to 250 ng/ml after a month or so of recovery after surgery. (Rejection of the new kidney occurs when levels dip below 200 ng/ml.)

Cyclosporine has some disadvantages that include:

• Expense
  Cyclosporine is expensive. Concurrent administration of ketoconazole, a medication normally used to treat fungal infection, has the added benefit of “potentiating” cyclosporine. This means that less cyclosporine is needed to achieve the desired effect. As long as ketoconazole is well tolerated, it may become possible to dose the patient only once a day rather than twice. Approximately 30% of transplant patients will not be able to utilize this protocol due to the development of excessive cyclosporine levels or liver enzyme elevations from the ketoconazole.
    
• Expenses for Monitoring
  Periodic blood level monitoring is needed to check that the right dosage is being used. For most drugs, “what you swallow is what your body gets.” For other drugs, there are individual variations in how the medication is absorbed, and cyclosporine is one. When two patients take the same amount of cyclosporine, they may not achieve the same serum levels; some individual fine-tuning is needed.
     
• Long-term use of cyclosporine increases the risk for the development of cancer, specifically lymphoma. At the University of Wisconsin Renal Transplant Center, a 14% incidence of malignant tumor development is reported for cats with post-transplant time (and thus cyclosporine use time) of greater than one year.

In dogs, the chemotherapy agent azathioprine is also regularly used for its immuno-suppressive properties. It’s usually given every other day long term. Medication costs for dogs can vary from $150 per month to $2000 per month depending on the dog’s size.

What are Potential Complications for the Recipient?

• Infection from immune-suppressive therapy is the second most common cause of transplant-associated death (rejection being the first). In cats, Toxoplasma infection is of particular concern, and while preoperative testing may have already been negative, some cats turn positive after the immune suppression begins. Also, in cats, old viral upper respiratory infections can be expected to recur, and they can be severe. In dogs, life-threatening infections can emerge in any organ system.   
• Stricture (narrow scarring) of the ureter, which is the tiny tube that carries urine from the new kidney to the urinary bladder. If this occurs, another surgery is needed to trim the scarred area and re-attach the ureter to the urinary bladder. The original kidneys are generally not removed unless there is a reason to do so. The new kidney is simply an extra one. There is an approximately 21% incidence of this complication in the first 62 days post-operatively in cats. Mostly, males are affected.
• The risk for developing diabetes mellitus increases by approximately five times after a kidney transplant.

What Kind of Survival Time Can You Expect?

In a recent study of feline kidney transplants, 59% of renal transplant patients were still alive 6 months after surgery and 41% were still alive 3 years afterwards. Apparently the first 6 months is a somewhat crucial time in determining long-term survival.

The University of Wisconsin Renal Transplant Center reports 70% survival at 6 months for cats and 50% survival at 3 years. Of the cats that survived to be discharged from the hospital (i.e. they did not succumb to problems directly related to the surgery), 96% survived to 6 months.

The picture is not nearly as bright in dogs. The University of California at Davis program had a success rate of about 40%. 

Kidney transplantation is an expensive undertaking. The University of California at Davis program, for example, required a deposit of $11,000 for cats and $13,000 for dogs. Transplantation involves the adoption of a donor and long-term medication and blood testing for the recipient. If this is something you are seriously considering, be sure to discuss the procedure with the transplant center closest to you as well as with your regular veterinarian.

An uncomplicated kennel cough runs a week or two and entails frequent fits of coughing in a patient who otherwise feels active and normal. Uncomplicated cases do not involve fever or listlessness, just lots of coughing.

Numerous organisms (some of which may be prevented by vaccination) may be involved in a case of kennel cough; it would be unusual for only one agent to be involved.

Infections with the following organisms frequently occur concurrently to create a case of kennel cough:

1. Bordetella bronchiseptica (bacteria)
2. Parainfluenza virus
3. Adenovirus type 2
4. Canine distemper virus
5. Canine influenza virus
6. Canine herpesvirus (very young puppies)
7. Mycoplasma canis (a single-cell organism that is neither virus nor bacterium)
8. Canine reovirus
9. Canine respiratory coronavirus.

The classical combination for uncomplicated kennel cough is infection with parainfluenza or adenovirus type 2 in combination with Bordetella bronchiseptica. 

Infections involving the distemper virus, Mycoplasma species, or canine influenza are more likely to progress to pneumonia, and pneumonia can readily result in any dog or puppy that is sufficiently young, stressed, or debilitated.

Not sure what a Coughing Dog sounds like?

Dogs can make assorted respiratory sounds. Usually, a cough is recognizable but it is important to be aware of another sound called a reverse sneeze. The reverse sneeze is often mistaken for a cough, a choking fit, sneezing, retching, or even for some sort of respiratory distress. The reverse sneeze is a post-nasal drip or tickle in the throat. It is considered normal, especially for small dogs, and only requires attention if it is felt to be “excessive”. The point here is to know a cough when you hear one. A cough can be dry or productive, meaning it is followed by a gag, swallowing motion, and the production of foamy mucus (not to be confused with vomiting). Here are some videos that might help.

Coughing Dog (with Productive Cough): Dixon has kennel cough

Note: We have received a great deal of emails from people who have viewed this video, compared it to what their own dog is doing, and concluded their dog has kennel cough. This video is meant to demonstrate coughing in general. It is important to note that there are many causes of coughing and the nature of the cough does not generally reflect on its cause.

Reverse Sneezing Dog: Maggie reverse sneezes

How Infection Occurs

An infected dog sheds infectious bacteria and/or viruses in respiratory secretions. These secretions become aerosolized and float in the air where they can be inhaled by a healthy dog. Obviously, crowded housing and suboptimal ventilation play important roles in the likelihood of transmission but organisms may also be transmitted on toys, food bowls, or other objects.

The cilia beat in a coordinated fashion through the lower and more watery mucus layer called the sol. A thicker mucus layer called the gel floats on top of the sol. Debris, including infectious agents, gets trapped in the sticky gel and the cilia move them upward toward the throat where the collection of debris and mucus may be coughed up and/or swallowed.

The mucociliary escalator is damaged by the following:

1. shipping stress
2. crowding stress
3. heavy dust exposure
4. cigarette smoke exposure
5. infectious agents (as listed previously)
6. cold temperature
7. poor ventilation.

Without this, a fully functional mucociliary escalator or invading bacteria, especially Bordetella bronchiseptica, the chief agent of kennel cough, may simply march down the airways unimpeded.

Bordetella bronchiseptica organisms have some tricks of their own as well:

• They can bind directly to cilia, rendering them unable to function within 3 hours of first contact.
• They secrete substances that disable the immune cells normally responsible for consuming and destroying bacteria.

Because it is common for Bordetella to be accompanied by at least one other infectious agent (such as one of the viruses listed below), kennel cough is a complex of infections rather than infection by one agent.

Classically, dogs get infected when they are kept in a crowded situation with poor air circulation and lots of warm air (i.e., a boarding kennel, vaccination clinic, obedience class, local park, animal shelter, animal hospital waiting room, or grooming parlor). In reality, most causes of coughing that begin acutely in dogs are due to infectious causes and usually represent some form of kennel cough.

The incubation period is 2 to 14 days. Dogs are typically sick for 1 to 2 weeks. Infected dogs shed Bordetella organisms for 1 to 3 months following infection.

How is a Diagnosis Made?

A coughing dog that has a poor appetite, fever, and/or listlessness should be evaluated for pneumonia.

Usually, the history of exposure to a crowd of dogs within the proper time frame, plus typical examination findings (coughing dog that otherwise feels well) is adequate to make the diagnosis. Radiographs show bronchitis and are particularly helpful in determining if there is a complicated pneumonia.

Recently, PCR (polymerase chain reaction) panels have become available in many reference laboratories. Using technology to amplify the presence of DNA in a swab, the lab is able to test for most of the kennel cough infectious agents listed. This knowledge is helpful in guiding therapy and understanding expectations.

How is Kennel Cough Treated?

An uncomplicated case of kennel cough will go away by itself. Cough suppressants can improve patient comfort while the infection is resolving. The dog should be clearly improved, if not recovered, after about a week. That said, several infectious agents in the kennel cough complex are more intense and can cause minor bronchitis to progress to pneumonia, which is a potentially life-threatening disease. Given this possibility, antibiotics are frequently prescribed to kennel cough patients to prevent or curtail pneumonia before it warrants hospitalization.

It is important to distinguish an uncomplicated case of kennel cough from one complicated by pneumonia for obvious reasons. The uncomplicated cases will not have a fever or appetite loss, nor will they be listless. As mentioned, they will seem normal except for coughing. Dogs with pneumonia appear sick.

Prevention through Vaccination

For Bordetella bronchiseptica, vaccination can either be given as a separate injection or as a nasal immunization. There is some controversy regarding which method provides a better immunization or if a combination of both formats is best.

Nasal Vaccine

Intranasal vaccination may be given as early as 3 weeks of age and immunity generally lasts 12 to 13 months. The advantage is that local immunity is stimulated right at the site where the natural infection would try to take hold.

It takes four days to generate a solid immune response after intranasal vaccination, so it is best if vaccination is given at least four days prior to the exposure. Some dogs will have some sneezing or nasal discharge in the week following intranasal vaccination; this should clear up on its own. As a general rule, nasal vaccination provides faster immunity than injectable vaccination.

Nasal vaccines for Bordetella generally also include a vaccine against parainfluenza virus and some also include a vaccine against adenovirus type 2.

Oral Vaccine

An oral vaccine is available for Bordetella bronchiseptica (but not adenovirus or parainfluenza). The idea is that it is easier to give the vaccine with a syringe in the mouth – just inside the cheek – and there is no concern about sneezing out some of the vaccine. The oral vaccine can be given to puppies as young as 8 weeks of age. The vaccine is given annually.

Injectable Vaccine

Injectable vaccination is a good choice for aggressive dogs who may bite if their muzzle is approached. For puppies, injectable vaccination provides good systemic immunity as long as two doses are given (approximately one month apart) after age 4 months. Boosters are generally given annually. Some dogs experience a small lump under the skin at the injection site. This should resolve without treatment.

Vaccination is not useful in a dog already incubating kennel cough.

Bordetella bronchiseptica vaccination may not prevent infection. In some cases, vaccination minimizes symptoms of illness but does not entirely prevent infection. This is true whether nasal, oral or injectable vaccine is used.

Dogs that have recovered from Bordetella bronchiseptica are typically immune to reinfection for 6 to 12 months.

What if Kennel Cough doesn’t Improve?

As previously noted, this infection is generally self-limiting. It should be at least improved partially after one week of treatment. If no improvement is seen after that week, a re-check exam (possibly including chest radiographs) would be a good idea. Failure of kennel cough to resolve suggests an underlying condition. Kennel cough can activate a previously asymptomatic collapsing trachea or the condition may have progressed to pneumonia. Alternatively, there may be another disease afoot entirely such as non-infectious bronchitis, congestive heart failure, or some other condition that causes coughing.

If you have questions about a coughing dog, do not hesitate to bring them to your veterinarian.

How many dogs have been relegated to back-yard living because they jump all over family and guests whenever anyone walks through the door?

Then when someone goes out to visit the lonesome dog, the jumping is worse because the dog is even more excited to see someone. Only now the dog is dirty, too. Not good! Let’s talk about how to solve this problem once and for all.

We humans encourage dogs to jump on us by petting them, starting in puppyhood, when they stand on their hind legs to get closer to our loving face and hands. This normal unruly behavior is most likely attention-seeking in nature when it’s not accompanied by aggression. They don’t mean anything bad by jumping up, but very few people like being jumped on by a dog. As the dog gets older and stronger, he may scratch people and knock people down. It’s not only children and elderly people, but bigger, stronger dogs can potentially knock adults down as well. The behavior becomes a way to get your attention, even you start pushing them off and telling them ‘No.’ The person may see this as a punishment, but your dog may not see it as aversive at all.

When a dog is still a very young puppy, the best way to handle jumping up is never to allow the puppy to even start doing it. Don’t let anyone pet your cute little tootsie of a puppy unless all four feet are on the ground. If you teach your puppy that all petting happens when four feet are on the ground, your big dog will not be jumping on people. Instead, the dog will develop sweet ways of greeting people such as laying a head lovingly against your knee.

This training is harder than it sounds because dogs are usually rewarded by someone for this behavior, and chances are you have an adolescent or adult dog who is jumping on people. What do you do now? It’s the same principle as with the puppy, only it will take longer.

Attack this problem on more than one front. Here are the ingredients for training your dog to greet with four on the floor:

1. Teach your dog to sit, even when excited. When the dog is IN the sit position, give petting, praise, and treats. Do not praise AFTER the dog has gotten up, because that is not the desired behavior. Praise and reward DURING the desired behavior, the sit. This is the crucial training step that most people miss. Teaching the dog not to jump isn’t enough. We have to teach the dog that the petting will come when the dog is doing the right behavior. Put your focus on this moment. You’ll start this training in unexciting situations (i.e. in your house without visitors) and gradually build to more and more exciting situations (i.e. your backyard, then a quiet park) until the dog is totally steady. It takes time and practice. Then start to incorporate strangers. Teaching a dog to sit in more distracting situations sounds easy, but she not only has to be able to sit, she has to be able to do it when she is highly excited, and that is not an easy feat! So don’t expect it to be all fixed in a week. Signing up for a positive reinforcement training class may be a good way to start increasing distractions and the participants will be more likely to follow your instructions of asking your dog to sit when she approaches them and ignoring jumping behavior.
   
2. Teach your dog that when she comes to you or anyone else her default behavior is to sit and not jump. People should ask her to sit every time she approaches them. Alternatively, teach her a come cuddle command (see below).
   
3. When you come into the house, come in quietly. Excited greetings when you come in encourage a dog to jump on you.
   
4. When you have guests arrive, keep your dog under leash or other control (i.e. confining her to a separate room) for about 15 minutes until everyone is settled. This is the time of wildest excitement for the dog, and it will be much easier for the dog to muster self-control after this initial period. Eventually you will want to train this behavior without a leash, too.
   
5. Never let anyone pet or otherwise give your dog attention when she is standing on her hind legs. The best remedy for jumping up is to withhold attention. This is different for every dog. For some dogs you can keep your hands to yourself and turn a hip toward the dog or turn your back on the dog, but for some dogs you may have to actually leave the room (separating yourself from the dog), until your training has progressed to the point of being able to get the dog to’sit’ on cue. When the dog has been jumping and stops jumping, ask her for a couple of commands before petting to separate the jumping behavior from the reward of petting.
   This request is recommended because some dogs are so smart they will jump and then sit just to be petted.
   
6. If you are going to do anything to interrupt your dog’s jumping, keep in mind that your goal is a dog that is safe with people. Don’t fall into the trap of trying quick-fix methods for jumping up, such as stepping on the dog’s toes or whacking her in the chest with your knee. These methods cause pain, which could make her fearful of people, or worse, injure her. Any training method that punishes your dog when, in her mind, she is being friendly to your guests, could damage your dog’s good attitude toward guests, so be careful about that too. You want to give her a chance to earn praise for good behavior, not be getting in trouble when all she is trying to do is say hello.
   
7. Finally, a head collar may help as it gives you more control as you increase distractions.

People can be inconsistent about ignoring undesirable behavior and rewarding good behavior, so you may have to choose who your dog interacts with. If even one person encourages jumping, she will continue to perform the behavior.

Come Cuddle

One good way to teach your dog to greet without jumping is a simple cue to go to the person’s knees. Start by putting your open hands, palms facing outward, on the front of your knees. You’ll be bending forward to get your hands here. Tell your dog ‘come cuddle’, and your dog will likely be drawn to your inviting hands. Pet your dog. Do the ‘come cuddle’ practice over a few sessions until the dog responds quickly. Then find someone else to help you, have them take the position, point to them, and tell your dog to ‘go cuddle’. Have them encourage the dog verbally to come to them, and give petting when the dog arrives. Then you call the dog to ‘come cuddle’ to your hands at your knees.

Do a few repetitions back and forth, stopping before the dog gets bored. Repeat this, and soon you’ll find when you say ‘go cuddle’, your dog will aim for a person’s knees even if their hands are not there. Prompt the person to lean down and pet the dog at knee level – be firm with people that they must not ruin your training by inviting your dog to jump up on them!

A Note about Little Dogs

You may not mind your small dog jumping up on you, but give this some thought. You’re not going to want the dog to spoil someone’s clothing by clawing at their legs. Also, a little dog jumping and expecting to be caught can be injured if the person misses.

Safety

Many of us see no reason to teach our dogs not to jump up. We don’t mind, and if a friend or relative needs the dog not to jump, we simply put the dog on leash.

We get older, though, and our dogs age even faster than we do. Besides age, many physical problems can arise that make jumping up downright dangerous. At some point in your dog’s life, jumping will become a hazard to her. Your dog will live with less risk of pain if taught early on not to jump.

The non-jumping dog’s life will include more petting and love, because it’s so much easier and more enjoyable to pet a dog who has four feet on the ground.

Jumping on People 101 covered the long-term plan for working with a unruly attention-seeking jumper, but what if you encounter a friendly dog jumping on you right now?

If your situation is a big dog jumping up on people, you need first aid! Here are some ways to cope today until training can take full effect.

Please note that none of these techniques are enough to teach the dog not to jump on people in general, and none of them will apply to all dogs. Because dogs, people, and situations vary so much, these are options, but you’ll have to decide which ones you can use in a particular situation.

1. If you see the dog about to spring, but she is still on the ground in front of you, either ask her to sit or take both hands, palms down, and cross the hands, using them to block the path of the dog’s face from coming up. Many dogs will stop the jump if you do this.
   
2. If someone else has the dog on leash, or for some other reason she can’t come forward, step back out of jumping reach. Be careful about doing this if she is not on the ground (such as on a bed, sofa, or table). It will keep her from jumping on you, but could put her at risk of injury from crashing to the floor. Timing is important in these situations, as is the ability to read and predict the dog’s movements.
   
3. Swivel your hip to face her as she leaps on you. This shouldn’t harm her, but it will deflect the force of the jump off of the more vulnerable parts of your body.
   
4. If the dog has a collar on and you are side-to-side with (not facing) her, hold the collar without letting your wrist bend. Your grip is stronger this way. Be careful, though, because some dogs become aggressive when you take them by the collar! This response is for the friendly goober dog who just wants to lick your face.
   
5. Get closer to the dog initially, even taking a step forward, rather than moving away or even jumping away as many people instinctively do. Don’t lean your head away from her. Tilting the upper part of your body or your head backward actually induces some dogs to jump on you. You may be able to prevent the jump by simply starting your encounter with your hands at the dog’s level and petting.
   
6. Give the dog a ball or other toy to hold. Many dogs will learn to go get the toy themselves as an aid to self-control.

Remember, don’t encourage someone else’s dog to jump on you!

It’s usually unwise, though, to attempt to train someone else’s dog to stop jumping on people. Teaching this properly is a fairly long process that needs to be integrated into the dog’s life as a whole. Remember that when you attempt quick fix punishment-based training with someone else’s dog who is trying to be friendly to you (which is, after all, what jumping up on people means), you risk causing problems for that dog and owner in how the dog will relate to people in the future.

The chicken jerky treats made in China have been associated with kidney disease for a few years. Ever since the association between these products and illness was made in 2007, the U.S. Food and Drug Administration (FDA) has cautioned consumers to not give these treats to their pets.

While the treats are typically referred to as jerky, they may also be labeled tenders or strips.

Signs may occur within hours or days after a dog eats the treat. Signs include decreased appetite; lethargy; vomiting; diarrhea (sometimes bloody); and increased thirst and urination. Contact your veterinarian if the signs last for more than 24 hours, or if they seem severe.

If your dog is vomiting, lethargic, or does not want to eat, and has recently eaten these jerky treats, it does not automatically mean your dog has kidney disease from them.

Test results on affected dogs have shown kidney problems. The kidney problems are often similar to Fanconi disease. (Fanconi disease is an inherited disease in which electrolytes and nutrients are lost in urine.)  Although many affected dogs can be treated and get well, some jerky treat-related deaths have been reported.

In 2007, affected dogs were seen in Australia and the United States. That original outbreak ended in 2009 after all the affected treats had been pulled from the market. However, similar cases have been seen since then in the United States and Canada. Unfortunately, the definitive cause of the problem is still unknown.

The FDA has prepared a “Caution” statement.

In June 2011, the Canadian government sent out notices about the about jerky treats causing Fanconi-like signs in Canadian dogs; in March 2012, the American Veterinary Medical Association sent out a new alert about Canadian cases. In May 2012, the FDA updated their public information on their concerns about chicken jerky.

The FDA continues to investigate complaints and test products eaten by affected dogs. No specific brands have been recalled as of this time because there are only complaints, not evidence. However, there are a number of dogs with some level of kidney illness who have eaten the China-produced chicken jerky treats, so pet owners should be cautious about giving those.

Anecdotal reports from veterinarians indicate similar concerns about sweet potato pet treats made in China. Although no evidence is available that these sweet potato treats cause kidney issues similar to those related to chicken jerky treats, pet owners should be aware of the possibility.

If your pet has the signs listed above, and has eaten chicken jerky or sweet potato treats made in China, contact your veterinarian. Save the treats and packaging so that they can be tested by the FDA if they are suspected to cause the illness.

Hip dysplasia is a common condition of large breed dogs. Many dog owners have heard of it, but anyone owning a large breed dog or considering a large breed dog should become familiar with this condition. The larger the dog, the more likely the development of this problem becomes, particularly as the dog ages and loss of mobility/arthritis pain become important life quality issues. 

What is Hip Dysplasia?

The bones (femoral head and acetabulum) are coated with smooth cartilage so that motion is nearly frictionless and the bones glide smoothly across each other’s surface.

See more detail on the structures of the normal joint.

When a dog has hip dysplasia, the ball and socket do not fit smoothly. The socket is flattened and the ball is not held tightly in place, thus allowing for some slipping. This makes for an unstable joint and the body’s attempts to stabilize the joint only end up yielding arthritis.

If this Disease Starts in Puppyhood why are most Affected Dogs Elderly?

As they age, they develop bony spurs along the margin of the socket, mineralization of the joint capsule, cartilage wear, and inflammatory change in the joint (i.e. degenerative arthritis) and become painful and now these dogs come to the veterinarian for an evaluation. 

Why Are There Differences in Age and Size for Patients with Hip Dysplasia?

Obviously, different individuals may have different degrees of dysplasia. A dog’s weight makes a difference (a lighter dog can more easily tolerate a more abnormal hip joint). The muscle mass supporting the joint is greater in a younger dog and helps reduce the stress directly on the bones. Still, some dogs have truly shocking radiographs and virtually no symptoms while others show relatively subtle changes and are very uncomfortable. It is not known why there is not a better correlation between radiographs and actual pain.

How Can Owners Tell if Their Dog is Having Discomfort?

Do not expect a dog with dysplasia (or any other chronically painful condition for that matter) to cry or whine in pain. Instead, discomfort is shown with reduced activity, and difficulty rising or lying down, or going upstairs. A characteristic swivel of the hips is seen from behind and classically stairs are taken in a bunny hop fashion.

What Causes Hip Dysplasia?

The primary cause of hip dysplasia is genetic but inheritance of this trait is not as simple as a dominance/recessive relationship like we study in high school biology. Normal dogs can breed and yield dysplastic offspring as the condition may skip generations. Furthermore, dogs with a genetic picture conducive to hip dysplasia still must contend with other factors such as level of exercise at an early age, nutritional factors, hormonal/neutering factors, and other environmental situations.

Preventing hip dysplasia primarily focuses on breeding dogs with normal hips. The problem with this approach is that dogs often do not develop signs of hip dysplasia until well after they have been bred. A genetic test would be of great value in dog breeding, but currently, there is only such a test available for Labrador retrievers; identifying dogs with less than stellar hip quality so as to exclude them from breeding is done via OFA and PennHip certification (see sections on registration below).

It is important to consider the breed of dog when choosing a puppy for many reasons, including potential genetic orthopedic problems. Hip dysplasia is typically a problem for large, stocky dog breeds. Small dogs and lean, slender breeds such as sighthounds rarely develop hip dysplasia. If you have settled on a breed that has an issue with hip dysplasia, be aware of the certification process of the parents. The Orthopedic Foundation for Animals publishes statistics on affected breeds. 

Other than selective breeding, it is possible to manage other factors in hip dysplasia development when raising a predisposed puppy that may help make the genetic issues less severe.

Nutrition

Nutritional factors are important in developing hip dysplasia. For example, it has been popular to try to nutritionally push a large breed puppy to grow faster or larger by providing extra protein, more calcium, or even just extra food. Practices such as these have been disastrous, leading to bones and muscles growing at different rates and creating assorted joint diseases of which hip dysplasia is one. One study showed that when puppies of hip dysplasia-prone breeds were allowed to free feed, two-thirds went on to develop hip dysplasia while only one-third developed it when the same diet was fed in meals. Another study showed German Shepherds were nearly twice as likely to develop hip dysplasia if their adult weights were above average. Studies such as these have led to puppy foods designed for large-breed puppies, where the optimal nutritional plane is lower than for small-breed puppies. After puppyhood, maintaining a lean body condition seems to be helpful in lessening arthritis signs.

Exercise

Exactly what the proper preventive exercise regimen might be is yet undefined. One study showed that puppies had an increased risk for hip dysplasia if they were allowed to freely run up and down stairs before age three months. The decreased risk was found in puppies allowed off-leash exercise, such as in the backyard, before age three months.

Neutering Age

There is some controversy about the effect of spaying/neutering before puberty. Male dogs rely on testosterone to stop bone growth and early neutered males will grow taller as their bones grow for a longer period if testosterone is removed early. This may lead to a predisposing disparity in the growth of bone and muscle. There appear to be predisposing factors for early spay as well, assuming the dog has the genetic predisposition.  How much added predisposition comes with early spay/neuter and for which breeds remains controversial. In one study, it was found that neutering before age 5.5 months was associated with a 6.7% incidence of hip dysplasia while neutering after age 5.5 months was associated with a 4.7% incidence of hip dysplasia.

How Can I Find Out if My Dog Has Hip Dysplasia?

The first step in diagnosis is an examination. Your veterinarian will likely extend the dog’s hind leg backward to check for pain as hip dysplasia causes pain on hip extension. The dog may be asked to walk around to demonstrate the possible hip swivel.

Another test involves having the dog lie on its back with a hind leg perpendicular to the body. As the leg is moved away from perpendicular to the body, a dysplastic hip will generate a pop as the femoral head slips to the center of the acetabulum. This pop, which can be felt if your hand is resting on the hip during the exercise, is called an Ortolani sign. You may hear this term used as hip dysplasia is discussed. 

The true confirmation of hip dysplasia comes with radiography. The dog must be radiographed on their back with both legs positioned straight down. This posture is painful to a dog with dysplasia so to get maximum cooperation from and comfort for the patient, sedation is needed. The seating of the femoral heads in the acetabular sockets is examined and assessed for arthritis.

Above are two radiographs: normal hips in Image 1 and dysplastic hips in Image 2 (and severely dysplastic hips in Image 3). It is easy to see how the femoral heads are not well seated in their sockets in the dysplastic hips. This puppy in the above left has a subluxation, which means the hips are nearly out of the socket completely. Over time, the femoral heads will flatten and the sockets will become even more shallow. Bone spurs will develop around the joint capsule as the body attempts to stabilize the abnormal joint.

What is OFA Registration?

When purchasing a puppy, particularly one of a larger breed, often the parents will be listed as “OFA Good” or “OFA Excellent.” What this means is that the breeder has had the hips of the parent dogs certified by the Orthopedic Foundation for Animals. The OFA is an organization with the goal of reducing the incidence of hip dysplasia (though now it is also possible to obtain certification for elbows, thyroid function, and other issues). The idea here is that a dog for breeding can have radiographs taken at the age of 24 months. The radiographs are sent to the OFA for review by several independent radiologists where they are graded. Hips that are rated as “good” or “excellent” receive a registration number. Offspring of OFA-certified parents would be less likely to develop dysplasia themselves, however, it is important to realize that a dog with excellent hips at age 2 may not have such excellent hips at age 5, 7, or 10. OFA certification is no guarantee that a dog will not develop hip dysplasia symptoms in the future and does not guarantee that the offspring will not develop hip dysplasia but, as mentioned, until a DNA test for hip dysplasia is developed parental certification is the best we can do.

What is PennHip Registration?

Many people with potential breeding dogs do not want to have to wait two years for OFA registration. The University of Pennsylvania Hip Improvement Plan, developed by Dr. Gail Smith, allows for another way to predict if a dog will develop hip dysplasia. For PennHip certification, the veterinarian taking the radiographs must receive specific training and special equipment is necessary. The pet is anesthetized and two radiographs are taken: one with the femoral heads compressed (pushed into the acetabula as far as they will go) and one with the femoral heads distracted (pulled out of the acetabula as far as they will go). A measurement called a distraction index is calculated from these radiographs,  the idea being that a tighter-fitting hip – one allowing less distraction – is less likely to develop dysplasia. Each dog breed has a different range of distraction that is considered acceptable. Puppies can be certified as young as 16 weeks of age with this system.

Is Surgery the Best Treatment for Hip Dysplasia?

There are many surgical options for hip dysplasia and it is important to understand which patients benefit from which surgery. Some surgical procedures are controversial and some are not. All will entail a recovery period as well as expenses. Both hips need not necessarily be treated surgically; treating one hip is often enough to yield good results. Hip surgery is relatively expensive and a surgery specialist may be required, depending on the procedure. If you are considering surgery for your dog, these are the procedures to know about.

Femoral Head/Neck Ostectomy

This surgery is commonly referred to as the Femoral Head/Neck Ostectomy(FHO) and is best used for smaller dogs (50 lbs/22.7kg or less) or very active dogs. Here, the femoral head is cut off and removed, allowing the joint to heal as a false joint (just a capsule connecting the two bones but no actual bone-to-bone contact). If the dog is not carrying too much weight, a false joint is strong enough. If the dog is very active, a false joint will form quickly. The pet typically does not want to use the leg for the first two weeks but should at least be partially using the leg after four to six weeks. The leg should be used nearly normally after a couple of months. Many veterinarians are well experienced with this surgery and often a specialist is not needed. This surgery is typically substantially less expensive than the other procedures.

Triple Pelvic Osteotomy

This surgery is appropriate for young (8-18 months) dogs with dysplasia but without degenerative arthritis changes. This means that there is a window of opportunity for this surgery and if the dog develops arthritis or becomes too old, it will be too late to do this surgery. Here, the ill-fitting acetabulum is essentially sawed free of the rest of the pelvis, re-positioned for a tighter fit on the femoral head, and then plated back into place.

Many times surgery on one hip leads to positive changes in the other hip so surgery on the second hip is not necessary. Alternatively, it is possible to do the TPO on both hips if it seems clear that ultimately both will need surgical correction. Many general practitioners will not feel comfortable doing this procedure, so discuss with your veterinarian whether a referral to a board-certified surgeon or a surgeon with extensive orthopedic experience is in your pet’s best interest. Aftercare involves a good three to four months of exercise restriction. No leashed walks, except to go outside for elimination, for two months.

The biggest problem with the TPO is determining whether the patient really needs it. If the dog is not experiencing hip discomfort at the time of diagnosis, he may not experience hip discomfort until he is elderly, and should he really have an invasive procedure early as a preventive? On the other hand, if he is having discomfort at a young age, the arthritis is likely to only get worse and early surgery could help this tremendously. These are matters to discuss with the surgeon.

Total Hip Replacement

This procedure is for dogs with established degenerative hip changes. For these dogs, the best choice may be to simply replace the hip or hips with a prosthetic hip. This procedure may sound radical but it has been commonly performed for over 30 years in dogs with great success.  It is a highly invasive procedure, obviously, and infection must be avoided at all costs (no skin disease can be in the skin over the hips, extra precautions for sterility are used). In other words, when complications occur they have the potential to be severe. Complications have about a 10 percent incidence. Expect about three months of exercise restriction after this procedure. Usually, only one hip receives surgery at a time. Often only one replacement is needed and the pet does well enough not to need surgery on the other side.

Juvenile Pubic Symphysiodesis

This surgery is performed on young puppies before age five months, so it is generally done as a preventive procedure before it is known if the puppy will indeed have dysplastic hips but after hip laxity has been detected. The pubic symphysis is the cartilage seam connecting the right side of the pelvis to the left side. As an individual matures, this cartilage converts to bone and the two halves of the pelvis fuse permanently. This surgery prematurely seals the symphysis, which in turn results in rotating the developing hip sockets into a more normal alignment. This is the same re-configuring as the TPO above but instead of doing the reconfiguring with surgery, it is done by directing the puppy’s own bone growth. The window is very narrow for this procedure so if a puppy is a predisposed breed it may be worth getting screening radiographs around age 4 months even though no physical discomfort has developed. It may be worth having this preventive procedure while the puppy is still at an age to benefit from it.

No matter which, if any, procedure is selected, it is important to get an idea of expenses, recovery procedure, and what is entailed from your veterinarian and the surgeon before making a decision.

What Non-Surgical Treatment is Available?

Non-surgical treatment of hip dysplasia is essentially the same as a non-surgical treatment for any other type of arthritis. There are nutritional supplements to help repair cartilage, pain medications, and anti-inflammatory medications. Physical therapy and massage are also important and helpful in non-surgical joint therapy. 

When a dog starts having housetraining accidents, it’s easy to believe the dog is acting out of anger or some other defiant motive. That is rarely the case. Let’s look at reasons for housetraining accidents and methods for improving your dog’s batting average.

Medical Causes

Medical causes should always be ruled out first. Any medical condition that causes increased frequency, urgency, or volume in urine or stool can lead to house soiling. Having the dog evaluated by your veterinarian is a good idea. Your veterinarian may recommend specific testing such as fecal, urine, and blood tests based on your dog’s specific problems and the results of the physical exam.

1. Dietary problems can cause housetraining issues. Feeding a high-fiber diet can result in the dog not being able to hold feces until the next relief opportunity, as can feeding on a schedule that just doesn’t work for your particular dog. Many dogs need to defecate within an hour after eating. Any change in food (including treats) can result in diarrhea and loss of control, too. Feed your dog carefully and consistently for the best housetraining results.
   
2. Intestinal parasites or other illness affecting the intestines such as inflammatory bowel disease or even a food allergy can cause the dog to lose control of his bowels.
   
3. A dog with a urinary tract infection, kidney failure, or urinary incontinence from other causes needs veterinary care. In most cases, housetraining problems from these causes can
   be solved or vastly improved by treating the medical condition appropriately.
   
4. Orthopedic problems can make it painful for your dog to squat for relief. The dog may wait and wait, afraid of the pain, and then lose control in the house. Sometimes the family thinks the dog’s arthritis or other orthopedic pain is under control because the dog doesn’t complain. This is especially true for older dogs, but even young dogs can have orthopedic problems such as hip dysplasia, knee, or spinal problems that result in pain. Your veterinarian can likely help your dog be more comfortable and at the same time improve the housetraining problem.
   
5. Another senior pet problem that can lead to house soiling is senility. Your elderly dog may have simply forgotten where he is supposed to go. Have him examined by your veterinarian as apparent senility can actually be caused by a myriad of medical causes. If your vet determines that the problem is senility, going back to the basics of housetraining (direct supervision or confinement when you can’t supervise and rewarding urination/defecation outside) is in order. Your veterinarian may also prescribe supplements for brain health and recommend appropriate mental stimulation to delay further signs.  

Behavioral Causes

Once medical causes have been eliminated, consider these behavior causes. Getting to the root of the problem will ensure proper treatment and the best chance for successful resolution of the problem.

• Sometimes we think a dog is housetrained when that is not actually the case. Housetraining does not automatically transfer to a new location, either. Dogs need consistent human help to keep the housetraining habits we humans want from them. Be sure not to give your dog too much responsibility for housetraining before he is ready. The general rule is that your dog should have one month without accidents before adding freedom a little at a time.
  
• Dog instincts can be overwhelmed by the scent of past accidents, whether it’s this dog’s scent or scent left by another pet. It’s imperative to remove this scent, and people often use the wrong products. The most reliable results are from bacterial enzymatic odor eliminating products.  These products actually degrade the urine rather than just cover up the smell. 
• When dogs are punished for housetraining errors, a common side effect is that they become afraid to relieve themselves in front of people. This makes it extremely difficult to teach the dog your desired relief location.
  The solution to this problem is to stop all punishment (even a harsh tone of voice) and start giving the dog rewards such as food treats for relieving himself. At first you can reward the dog for simply being in the relief area. Another step can be to move feces from an indoor accident out to the relief area and reward the dog there. Look for any opportunity to reward the dog for behavior that’s moving in the right direction. Dogs are incredibly forgiving.
  
• Sometimes dogs become afraid to go to the relief area. This can happen for various reasons, including weather conditions that scare the dog, leaving the dog outside alone too long, the dog being shocked by an electronic fence collar, a dog with a nervous temperament, other animals outdoors, humans teasing or abusing the dog outside, and frightening sounds such as fireworks or gunfire.
  
  A veterinary behavior specialist can help deal with the underlying anxiety creating the aversion to the relief area, which needs to be addressed to make your dog more comfortable in order to solve this problem.
  
• If your dog doesn’t have access to the relief area when his body needs relief, that’s a recipe for housetraining problems. Take the dog out more often. A journal of accidents can help you spot the pattern of when your dog needs to go out. These management issues can be caused by adding a new family member to the home, a family member moving out, or changing the family’s schedule, among many other causes.
  
• Causes of anxiety, such as separation anxiety, can lead to house soiling. If the dog is anxious or panicking, the stressed body needs to relieve more often. A veterinary behavior specialist can help address underlying anxiety.
  
• Fear of the crate (think claustrophobia) can cause the same symptoms as separation anxiety. Some dogs can be rehabilitated when they’ve developed a fear of being crated, while for most dogs it’s better to permanently use an alternative method. A veterinary behavior specialist can diagnose and treat this problem.
  
• Male dogs tend to mark their territory. Female dogs do too, but their drive is usually much lower. Urine marking is typically just a small amount, often on a vertical surface such as a chair leg, bed skirt, or the grocery bag you just set down. This is different than toileting, which is a large amount usually on a horizontal surface.
  
  Neutering helps solve this problem, but may not eliminate it if the dog is marking for other reasons such as anxiety or as part of a territorial display. Some causes of urine marking not related to hormones include a baby in diapers, a  baby starting to crawl, a new family member, a family member moving out, and territorial aggression to visitors or dogs, and people passing by outside the house. The specific causes need to be determined and treated for resolution of urine marking. A belly band—soft fabric around the tummy to catch urine—can be helpful in managing urine-marking as a short-term solution, but can foster infection if overused.
  
• Female dogs in heat tend to urinate frequently. Spayed female dogs don’t go into heat, so spaying is one solution for this possible housetraining issue, as well as eliminating the potential for staining furniture from the discharge.
  
• Some dogs have been raised in conditions that forced them to live in their own waste. This scenario damages their instincts to keep the den area clean. Since housetraining a dog requires that instinct, you will need to help this dog regain it. During the housetraining process, don’t use a crate or small area that forces the dog into contact with the waste. Use a larger confinement area for a while, so the dog can get used to being clean. Keep the dog’s area very clean. Eventually you may be able to use a crate with the dog.
  
• Sometimes, due to past management, a dog has a long-established habit of relieving on a surface, such as carpet or in a specific location, such as the spare bedroom, that you do not want the dog to use. It helps to keep the dog off carpeting and out of the undesired locations except when you can pay full attention to redirect any elimination behavior to the proper place.
  
• Alternatively, the dog may have an aversion to the material you prefer that he relieves himself on, such as if your backyard is made up of rocks. In that case allow your dog to eliminate on his preferred material and gradually add in the material you prefer.

Be a Detective—and a Friend

You can see from this long list that a lot of things can throw off a dog’s housetraining habit. You need to determine what could be causing your dog’s problem. There could be multiple reasons. With your veterinarian’s help and possibly the help of a behavior specialist, you can make it better.

Housetraining is a habit. The dog doesn’t understand why we want this, and yet dogs are so adaptable that most of them can be helped to develop the housetraining habit and to restore it when something has interfered. Even people have bathroom problems from time to time, so we shouldn’t be at all surprised that it happens with dogs.

One way dogs help humans to live longer, healthier lives is by needing our care. This is a day-to-day reason to get out of bed and to think beyond our own problems. You could even say that housetraining is good for us!