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Thread: Hormone-responsive urinary incontinence

  1. #1
    Join Date
    Oct 2016
    Location
    Houston, Texas
    Posts
    23

    Default Hormone-responsive urinary incontinence

    If your dog has been treated for this I would like to hear about treatment. In particular using PPA. If you have been through this you will know the details so brevity I will not reiterate them here.

    Thanks for. Any help!

  2. #2
    Join Date
    Nov 2013
    Location
    Monroe Georgia
    Posts
    304

    Default

    Proin therapy worked well on the incontinence issue for my favorite GSP that my wife insisted we spay prior to my open heart surgery.

    Then complications from it killed her with a stroke I wouldnít give that stuff to a rat I wanted to kill

    Iím very bitter about this issue

    My vet claimed itís a rare thing and heís a good competent vet but I wasnít told it could happen

    They took the shit off the market in Canada and here for humans I think it was in soft drinks

    My advice is find something else

  3. #3

    Default

    I have an almost 14 year old spayed female Brittany on an incontinence drug. It has worked absolutely wonderful. She used to urinate in her sleep. That has stopped.

    Her prescription (one pill every 3 - 4 days at this point). She has been on the meds for about 4 - 5 months.

    Diethylstilbestrol (DES) is a synthetic female hormone that is used to treat urinary incontinence in spayed female dogs. It mimics the effects of the natural female hormone, estrogen. DES is also used in the treatment of some cancers in both male and female dogs.

  4. #4

    Default

    Urinary Incontinence
    By Patricia M. Dowling, DVM, MSc, DACVIM, DACVCP, Professor, Veterinary Clinical Pharmacology, Western College of Veterinary Medicine, University of Saskatchewan

    Systemic Pharmacotherapeutics of the Urinary System
    Overview of Systemic Pharmacotherapeutics of the Urinary System

    Urinary incontinence is most commonly caused by urethral sphincter incompetence. It is most common in large breed, spayed female dogs (11%–20% incidence) but may be seen in intact females, male dogs, and cats. Estradiol-17β concentrations decrease after ovariohysterectomy in bitches, resulting in deterioration of urethral closure within 3–6 mo. Currently, there are no approved drugs to treat incontinence in animals, and most of the human products traditionally used have been removed from the market because of toxicity concerns. Some estrogen compounds and α-adrenergic drugs may still be available to veterinarians through compounding pharmacies (see Table: Drugs Used to Treat Urinary Incontinence).

    Drugs Used to Treat Urinary Incontinence
    Drug

    Dosage

    Diethylstilbestrol

    Dogs: 0.1–0.3 mg/kg/day, PO, for 7–10 days, followed by 1 mg/dog/wk

    Phenylpropanolamine

    Dogs: 1.5–2 mg/kg, PO, once to three times daily

    Ephedrine

    Dogs: 1.2 mg/kg, PO, bid-tid

    Cats: 2–4 mg/kg, PO, bid-tid

    Pseudoephedrine

    Dogs >25 kg: 30 mg/dog, PO, tid

    Dogs <25 kg: 15 mg/dog, PO, tid

    Testosterone propionate

    Dogs: 2.2 mg/kg, IM, every 2–3 days

    Testosterone cypionate

    Dogs: 2.2 mg/kg, IM, every 30–60 days


    Diethylstilbestrol (DES) is a nonsteroidal estrogen derivative that closely resembles the natural estrogen, estradiol. Because it is inexpensive and infrequently administered, it is the first choice to treat urinary incontinence in female dogs. It is orally bioavailable and reaches peak plasma concentrations in 1 hr in dogs; it has an elimination half-life of 24 hr because of enterohepatic recirculation. Estrogens sensitize the urethral sphincter to α-adrenergic stimulation; therefore, DES therapy is synergistic with α-adrenergic drugs. DES is given as a daily loading dose for 7–10 days and then reduced to once weekly dosing, if possible, to avoid toxicity. Treated dogs are susceptible to bone marrow suppression from estrogen, typified by early thrombocytopenia and potentially fatal aplastic anemia. Hematopoietic toxicity is rarely seen in cats. Other adverse effects seen in dogs include alopecia, cystic ovaries, cystic endometrial hyperplasia, pyometra, prolonged estrus, and infertility. When used once weekly in spayed female dogs, adverse effects from DES are rare.

    α-Adrenergic agonists such as phenylpropanolamine (PPA), ephedrine, pseudoephedrine, and phenylephrine act directly on smooth muscle receptors to increase urethral tone and maximal urethral closure pressure. Although often more clinically effective than DES, their action is short lived, usually requiring dosing bid-tid. Of this class of drugs, PPA is the most effective and results in fewer cardiovascular adverse effects. Previously available in over-the-counter cold medications and appetite suppressants, it was withdrawn from the human market because of toxicity associated with overuse as a diet aid. Ephedrine, pseudoephedrine, or phenylephrine may be tried but are less efficacious than PPA. Adverse effects of α-adrenergic drugs include excitability, restlessness, hypertension, and anorexia.

    In male dogs, testosterone injections are used to treat urinary incontinence but are generally less effective than estrogen therapy in female dogs.

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