I recently had the pleasure of meeting Diego for his puppy check. He won my heart. Such a little gentleman. When asking his owner how he had been they said everything was ok but they were having a lot of problems with toilet training. He would wee frequently inside, often soon after a previous wee.
I usually find most toilet training issues are caused by owners not being consistent enough in their approach, not giving frequent toileting opportunities or well timed praise for when puppies toilet outside. I was in the middle of launching into spiel about this when he started to wee. I didn't even notice he was weeing until the owners pointed it out. I didn't notice he was weeing because he was doing it standing, with completely straight legs and not squatting.
All puppies, male and female, will squat to wee. Not squatting to wee meant something was wrong. On a veterinary exam Diego was a perfectly healthy little puppy. On a specialised biomechanical examination however I found abnormalities that would cause the standing wees. A biomechanical examination looks at the motion and function of the joints, and differs from a veterinary spinal palpation which looks more for pain than dysfunction. Diego had movement restrictions in his left sacro-illiac joint and also is lumbosacral joint. These restrictions meant he could not squat to wee comfortably and empty his bladder fully. So little Diego had to stand and do small wees.
Luckily this was picked up early in life for Diego. He was treated with a couple of chiropractic adjustments. His owner was also given some rehabilitation exercises to do to keep his spine and pelvis mobile and moving properly. Following his adjustment he started being able to squat fully and do big wees to empty his bladder properly.