If your dog is having difficulty or discomfort when urinating and constantly licking their urinary opening, there may be a chance they’re suffering from a urinary tract infection (UTI). Bacterial UTIs are pretty common in dogs, affecting around 14% of the canine population during their lifetime. Female dogs are more prone to UTIs than males.

While uncomplicated UTIs are usually easy to treat, recurrent or severe infections can be more tricky. And if a female dog has a condition called a recessed vulva, they may suffer from recurrent UTIs.

What Is a Recessed Vulva in Dogs?

You might hear a recessed vulva sometimes called a hooded, hypoplastic, juvenile, or inverted vulva. But what is it?

A female dog’s vulva is the external part of the reproductive tract. It has two thick folds of connected tissue (labia) that form a cone-shaped opening. Normally, the vulva sits visibly between the hind legs. The vaginal opening is located within the vulva, as is the tube that drains the bladder (the urethra).

However, with a recessed vulva, the area is sunken. It’s partially or fully obscured by excess skin, called perivulvar skin folds. Depending on the severity of this structural issue, a recessed vulva can lead to problems with infections and skin irritation.

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What Causes a Recessed Vulva in Dogs?

Recessed vulvas can occur in any adult dog (no matter the breed). But, according to Dr. Theresa Beachler, assistant professor of theriogenology at Iowa State University College of Veterinary Medicine, recessed vulvas tend to be more common in obese dogs that belong to medium and giant breeds.

“Overweight dogs are more at risk for having a recessed vulva,” Dr. Beachler explains, “as they have excess skin and surrounding tissue that compound the issue.” Studies haven’t yet proven whether there could be a genetic component to the skin fold issues.

What Are the Signs of Recessed Vulvas in Dogs?

According to Dr. Dale E. Bjorling, professor emeritus in the Department of Surgical Sciences at the School of Veterinary Medicine, University of Wisconsin, many dogs with recessed vulvas never develop any problems.

When problems do arise, Dr. Beachler says, they typically relate to inflammation and bacterial infection. “Common symptoms include redness of the surrounding skin with increased discharge or malodor in dogs affected by a dermatitis — skin infection — or vaginitis — infection and inflammation of the vagina,” she says. “These dogs may lick their vulvas frequently or scoot or drag their hind ends on the ground due to discomfort.”

Dr. Bjorling explains the affected area may also appear dark or “dirty.” That’s because the local moist dermatitis (or hot spot) around the vulva acts as a reservoir for bacteria. Secondary recurrent UTIs (meaning the UTI occurs during treatment for another infection) are common because these bacteria can gain access to the urinary tract via the vagina.

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Some other signs of secondary urinary tract infections include:

• Increased urination frequency, with possible accidents in the house

• Straining to urinate

• Dribbling urine

• Whimpering when urinating

• Fetid-smelling urine or vaginal areas

• Blood in the urine

• Fever

How Is a Recessed Vulva in Dogs Diagnosed?

Your veterinarian can easily identify a recessed vulva during a physical examination of the genital area. However, if they suspect the presence of a UTI, they’ll likely conduct a urinalysis. This involves collecting a urine sample from your dog to check for abnormalities in the urine, such as bacteria and increased white blood cells or crystals. Your veterinarian may also recommend skin testing for any active infection around the vulva.

What Are the Treatment Options for Recessed Vulvas in Dogs?

Not all dogs require treatment for recessed vulvas. When they do, whether it’s managed topically or surgically depends on the symptoms and severity of the case.

Dr. Bjorling explains that local treatment of dermatitis involves daily cleaning with gentle soap. Most importantly, you’ll need to thoroughly dry the area after washing. If the treatment is effective, your dog shouldn’t feel the need to lick and scratch the area as much. Your vet may also recommend a topical ointment, possibly containing a steroid.

Another option is a surgical correction to remove the excess skin around the vulva, known as vulvoplasty or episioplasty. However, vets only usually recommend this surgery for a recessed vulva in dogs if topical treatments don’t clear up severe dermatitis or if urinary tract infections keep recurring or don’t respond to antibiotics. Dr. Bjorling says that the bacteria in recurring or severe UTIs can become resistant to antibiotics, and there may be a risk of the infection migrating to the kidneys.

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A vulvoplasty is a relatively straightforward procedure and is usually successful. Performing it requires care, Dr. Bjorling explains, because you need to remove enough skin to eliminate the enclosed skin around the vulva. “In heavily muscled dogs — Mastiffs, etc. — the skin in this area may be tighter,” he says. If you remove too much skin, the incision may break down.

Before surgery, your vet will likely prescribe antibiotics to clear up any lingering bacterial skin infections. The antibiotics will ensure the incision heals effectively. Dr. Bjorling says your dog may also need antibiotic therapy to clear up any lingering UTI after surgery.

After a couple of weeks of post-operative rest and restricted exercise, your dog should be back to their usual self.

Will Weight Loss Correct Recessed Vulvas in Dogs?

Female dogs of any weight can develop recessed vulvas, but overweight dogs are more at risk, and obesity seems to worsen the condition. Talk to your vet about how to safely help your overweight dog get into shape.

Dr. Beachler explains that a weight loss program may reduce the severity of the recessed vulva and offer other health benefits for your dog. However, she explains, “It may not completely cure it or completely correct the underlying issues with the dog’s anatomy.”

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