In's and Out's of Puppy Vulvas

I hope this subject and page didn't cause your jaw to hit your keyboard. If you have a female dog with an "Innie", then this can be a serious subject matter.


First, what is an "Innie" and what is an "Outtie". The graphic below should help us determine which is which.


Look closely at the picture on the left. That is a normal puppy vulva or an "Outtie". See how there aren't any skin folds around it? It seems to be popped out with no extra skin folds.

Now look at the picture on the right. That is an "Innie", also called a recessed vulva. There are folds of skin around the vulva. Looking at it, it looks "in". If you pull gently on the hair there, it will pop out of the skin folds briefly. It is those skin folds that may cause problems for the female puppy.

Many or most cases of puppy vaginitis is due to an "Innie" vulva. This "Innie" is usually formed by a flap of skin that makes the vulva look inverted or recessed. Bacteria grows in there causing the frequent infections.

Puppies who get frequent puppy vaginitis or bladder infections and have an "Innie" vulva should NOT be spayed before their first heat. To do so is to sentence this pup to frequent vaginitis or bladder infections throughout its lifetime.

In dogs with vulval involution (medical name for an "Innie"), there might be pooling of the urine in the folds of the skin which provides an excellent environment for bacterial growth. This location provides recurrent opportunity for reinfection of the urethra and the bladder even after antibiotic therapy has been administered. Additionally, because some bitches with this condition develop inflammation of the vulva, which will result in pain upon urination, these bitches will typically stop urine flow in mid-stream and have a tendency towards retaining more urine in the bladder than what is normal. Retained urine in the urethra and bladder also increases risk for bacterial overgrowth. Until the primary condition (the vulval involution) resolves or is treated, it can be expected that the bitch will continue to be at risk for recurrent UTIs. In the interim, keeping the area clean between urinations (yes, that does mean gently wiping the area clean with baby wipes after every time she goes "potty") and treating any existing inflammation (warm compresses applied to the area 3-4 times per day) may discourage bacterial growth and reduce risks of recurrence. In some individuals where the risk is high for recurrence after initial treatment or in cases of low-grade persistant infection, your vet may prescribe a maintenance (long term, low dose) antibiotic to control the infection.

When a female goes into season that vulva gets larger and kinda pops out of those skin folds. That's what you want to happen with those little girls with "Innies". Once they're out of season (heat), wait 4 weeks afterwards and have them spayed.

For those bitches whose condition may not resolve with coming into season or who are spayed prior to their first "heat" and have recurrent UTIs, a procedure known as vulvoplasty is often performed to correct the anatomical defect and prevent recurrent UTIs.

In summary, if you have a female puppy who has a recessed or "Innie" vulva, as determined by veterinary examination, please wait for that puppy to have 1 season before you spay her. By doing so, you may keep her from having reoccuring UTI's throughout her lifetime.***(see note below)

***PLEASE NOTE: If this puppy is allowed to have one season it is up to YOU the owner to make sure and guarantee that she does NOT become pregnant. Watch her carefully for 4 weeks from the start of her season (heat). If you are deligent you can determine when she comes into season. Average age for first season is 6 months to 18 months old. Prior to coming into season a female will generally have vulval swelling. You may notice feeling her nipples when you rub her chest. These are signs that she is sexually maturing.

Once you see these changes you need to wipe her vulva daily with a white kleenex. If you notice color on the kleenex, its a good indication she is in season. If you are not sure, have your veterinarian examine her.

This is when you must be on your guard. She may forget or choose to disobey any command she might have learned previously. Her goal in life is to reproduce. It is YOUR JOB to make sure she doesn't. She is never out of your site or the site of a qualified adult whether she's in the house or out in the yard. She is to go out in the yard on leash if needed. Dogs can breed through fences so just letting her out in the yard without supervision is not an option. She must be watched for 4 weeks. If you cannot make this committment to insure her not becoming pregnant, then spay her before she comes into season and put up with the possible UTI's instead. There is NO EXCUSE for an unwanted pregnancy in your dog.


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