[cherylmartin]

Melknight,

Please find an alternative!!

[CorkyMax]

Treating incontinence in dogs

Question: Dear Dr; I have a dog with spayed female incontinence. For over a year I have treated her with ppa (acutrim) with total success. Unfortunately, this drug is now unavailable. Hormonal tx is out of the question since she has liver disease. My vet has no answer for me, and I am at my wit's end. Any suggestions? Thanks in advance Annette

Answer: Annette-

I am sorry for the delay in replying to your question. There are several medications that are currently being used to treat incontinence in dogs in an effort to find one that replaces phenylpropanolamine (PPA). They are:

1) Diethylstilbestrol (DES), which is a synthetic form of estrogen. There is some fear of bone marrow suppression when using DES but I do no recall ever experiencing this problem in practice, so I presume it is rare. I know of no reason that DES can not be used when there are changes in liver function, but your vet may know something that I do not. DES is currently only available from compounding pharmacies but all the ones that we deal with have it, so it is readily available.

2) Imipramine (Tofranil Rx), a tricyclic antidepressant, causes urine retention in some patients treated with it, so it is being used in the hopes this effect will occur in patients with incontinence. Initial reports are encouraging, but that is often the case when people are looking for a substitute for a medication and want to have good results.

3) Pseudoephedrine (Sudafed tm) causes similar effects to phenylpropanolamine but has not been used extensively. The dosage is 30mg for small dogs and 60mg for big dogs. I have been using 30 lbs. of bodyweight as the dividing line between large and small. I have not had enough reports back from owners yet to know if this is working at all.

4) Some compounding pharmacies still have phenylpropanolamine powder and can custom make capsules with the appropriate dose for a patient who needs this medication. It is worth calling around to the various compounding pharmacies (or checking online for veterinary compounding pharmacies) to see if one of them has this medication. Your vet should know of some of these, as well. There are several that advertise nationally.

Good luck with this. I hope that one of these suggestions is helpful if you have not already found a solution to the problem.

Mike Richards, DVM 1/8/2001

Phenylpropanolamine's alternatives

Question: Hi, Dr. Mike -

I'm sure I won't be the first, nor the last, of your clients/correspondees to ask just what you will recommend to take the place of the now-defunct phenylpropanolamine. I am just sick that I can no longer obtain Dexatrim, or other OTC meds, to control BOTH Trudi's and her Boxer-sister-Fanci's (Fanci's is the typical spayed-female-leakage, brought on by advancing years) incontinence.

A brief note on our CRF gal, Trudi. Twenty-two months after the original diagnosis of chronic CRF was handed down, she is still doing remarkably well. The herbal iron tonic I discovered about 4 mos. ago has really created a huge improvement in her looks, stamina, eating patterns, demeanor. We continue to have small episodes of pancreatitis, which (so far) can be controlled by removing all food for 24 hrs. Strangely, although she LOOKS so great, her blood chem values have changed little; outwardly, the only sign that she's a CRF gal is her constant-and-profuse shedding.

Dr. Mike, I sure hope you'll be able to give us a tip as to what (either OTC or Rx) we can use to control the incontinence from now on. Thanks in advance.........your advice has always been valuable to us!

Regards, Rozanne

Answer: Rozanne-

Phenylpropanolamine is still available from some compounding pharmacies. I know of at least two in our area that still have the powder to make this medication and I believe that it may remain available through compounding pharmacies.

There are alternatives to phenylpropanolamine. The one currently being talked about the most on the Veterinary Information Network (Veterinary Information Network (VIN) - For Veterinarians, By Veterinarians, a service for veterinarians only) bulletin boards is impramine (Tofranil Rx), 1 to 2mg/kg of body weight every 12 hours, up to 15mg twice a day. I have not used this medication because we have had good success using diethylstilbestrol (DES) and have been able to obtain this medication from our local compounding pharmacy. We usually use 0.5mg per day for 5 days for small dogs, or 1mg per day for large dogs. We then try to lengthen the interval, usually reaching a once weekly or twice weekly dosage in most female patients. We usually try testosterone in male dogs but generally have to combine this with something else, such as phenylpropanolamine, so when our supply of this runs out, we will have to consider other options for our male patients, probably. I am hoping that when we run out of phenylpropanolamine the compounding pharmacies will still be able to get the medication.

Mike Richards, DVM 12/4/2000

Leaking urine and accidents - medication related in Samoyed

Question: Help! My samoyed has suddenly forgotten what it means to be house trained. She is currently on medication for myositis, predinose 30mg every other day, and when she started to leak urine, she was put on phenylpropanolamine (now down to 25mg on the days she gets her prednisone). In the last week, she has started to have accidents in the house, even after she is brought in after being out for a while. I let her out several times during the night and still she slips. Is this related to the medication? Thanks. P.A.

Answer: P.A.-

It is very likely that there is a relationship to the medication with the sudden change in urinary habits. Sometimes prednisone can make it easy for bladder infections to occur, so it would be worth having her checked by your vet for this. Bringing a urine sample that is less than 4 hours old can be helpful, just in case it isn't possible to get a urine sample at the vet's office. Prednisone can also sometimes push a dog with a tendency towards diabetes into exhibiting signs of that disease and the urine will help to rule that out.

If the urination problems are not related to cystitis there is still a chance that the prednisone is contributing, since it does make dogs drink more and urinate more. In that case, it may be necessary to try to find a lower dose that will control the myositis but not induce excessive urination. Sometimes it isn't possible to do that but it is worth trying.

Sometimes when dogs start to have accidents in the house for medical reasons the behavior becomes self supporting since dogs like to urinate where they have urinated before. Cleaning the area carefully with an enzymatic cleaner and working hard to catch her urinating so that you can reinforce that it is not acceptable behavior with a loud "NO" can help to restore her old and better habits.

[Mechelle]

I just said goodbye to my 13 year-old Golden Retriever, Beau. We went to the vet on Friday to see if anything could be done about his incontinence problem. The one of the vets in the clinic we go to prescribed Proin. I should have researched before I gave it to him, but I didn't think to do that. He had a dose Friday night, a morning dose Saturday, and evening dose Saturday, and another dose Sunday before I figured out he was not tolerating it well.

He was lethargic and wouldn't even hold his head up Sunday. When I tried to help him go outside to urinate, he collapsed and had diarreah. I took him to the emergency vet where he was placed on IV fluids, since the battery of tests showed he was otherwise healthy.

I transferred him to our regular vet Monday morning, where he reached the same conclusion as the emergency vet. He didn't know what was wrong because the tests were showing Beau was otherwise healthy, so they continued him on fluids hoping he would regain his strength. The vet acknowledged that the timing seemed to point to Proin as the culprit, but he said he had no reason to believe that it was. Although, if it was the Proin, the hope was that the IV fluids would flush it out of his system and he would recover.

Beau still wasn't looking good Monday night and was still unable to walk, so they kept him overnight. The vet called me at 6:45 this morning to say that Beau had taken a turn at 2:30 a.m. I was surprised that the vet was there at that hour (since this was our regular vet and not the emergency clinic) and he said that he was concerned and couldn't sleep, so he went into the clinic to check on Beau.

I went to the clinic early this morning to say goodbye and sign the euthanasia consent. I'm glad my 10-year-old daughter was out of town and didn't see him suffering.

I do believe Proin accelerated my dog's death, although, I also believe we would have lost him sometime this year anyway because of his age. We had him 12 years, but he was a shelter rescue, so we are not sure of his age. He was every bit of 13 and possibly 14. After administering the Proin, he seemed to be neurologically affected. His back legs would buckle under him and he couldn't stand.

I will be filing a report with the FDA in the hopes that others may be warned. I could have dealt with the incontinence in another way, had I known. I thought the drug was safe and I was doing my dog a favor, since he seemed so upset every time he had an accident in the house.

Rest in peace, Beau. You were the best dog in the world. I love you.

[cherylmartin]

Mechelle

I am so sorry for you loss. I know what you are going thru.

Please believe me when I say that those of us who have lost a loved one due to ProIn MUST stick together and complain and complain loud and hard.

I urge you to contact Pegasus Labs either email or calling them and telling them your story and please get a case number. You will need this when you file your complaint with FDA.

Please stay in touch.

Hugs,

[CorkyMax]

So sorry to hear of your loss.
Every time this thread is newly posted I am afraid it is going to be about another death because of Proin. I wonder if a link to this thread (165 posts!) was sent to Pegasus Labs would do any good or not!!? The uncaring greedy a*sh*les!!!

[cherylmartin]

Corky/Max,

Ever since joining this forum and others I am constantly encouraging 'victims' to contact Pegasus Lab, Pegasus Laboratories, Inc. - Contact Us, constantly encouraging them to file an adverse reaction report to FDA and constantly asking them to file with their State Board of Veterinary Medicine.

There was another death reported on another forum!

I will not give up the fight. I promised Jasmine.

[CorkyMax]

Another dog dies from this crap-Proin!! What does it take (Or do you even care?!!) to get this "KILLER" off the market!! You have to be pretty ignorant (or greedy) to not know what this drug does to dogs!! I am giving you a link to a thread in a dog forum I am in---If this doesn't convince you of how dangerous this crap, Proin is--then I have to believe you don't give a da*n about the dogs and it is all greed!!!! There are 165 posts in this thread----I dare you to read this whole thread and then tell me that Proin is safe!!! Here is the link: Is your dog on PROIN? READ THIS!

I now encourage/implore all of you who care to send a similar email to the address that Cheryl posted above. Brings you right to a contact page---Just click on the word email at bottom of page or call them, etc. All the info needed is right there!

[SHIRLSARGE]

I have a 15 year old pug/charpei. I put her on Proin a few months ago and about 6 weeks ago she started collapsing on her side, screeching in pain and being limp for about 10 seconds and then went rigid for about 10 seconds. This happened about twice a week inside and outside so after 4 weeks I took her to the vet. Tests were done with not results for this condition but I did find out she has renal failure. The day I took her to the vet I stopped giving her the Proin, just to see what would happen. She hasn't had an episode in 2 weeks since I took her off it.

[cherylmartin]

SHIRLSARGE,

I am sorry to hear that your beloved furbaby is now in renal failure. I do understand what you are going thru and I'm here if you'd like to talk. Pleae keep us posted.

Hugs

[debbiedennison]

Hello,
I wanted to add my story, as I believe the more we get the word out, the more seriously the vet community will take our anecdotal evidence that ProIn is causing serious issues with our dogs.

We lost our older Newfoundland girl last month. She received just one dose of ProIn. Her symptoms were similar to others I’ve since read about, including death.

We were getting ready to head to a dog show Friday, June 11th and I had Misty checked for a UTI as she had peed inside the house a few times at night. The test came back negative, and her vet gave me ProIn. Agitation was the only potential side effect that was mentioned. So I gave her a dose and we all headed to the show. (She was running around in the backyard, very excited to be coming along, acting completely normal.)

Within a few hours, we stopped at a rest stop and that’s when we realized she was having very acute, odd symptoms. She was shaking, stumbling as if drunk, panting excessively, arching her back, etc. We called the vet and after she said those weren’t known symptoms of ProIn, we decided to turn back. When we got home she was pacing in and out, couldn’t drink enough water, and also threw up outside. I was worried about bloat and took her to the ER vet (this was Friday PM). X-rays showed she wasn’t bloating.

Over the next 2 days she had a very high BP, high heart rate, high fever, very high sodium levels, low blood sugar, was dehydrated, etc. Her white blood count was normal. I kept hoping for a diagnosis so we could know if what she had was treatable or not, (all the vets were stumped) but shortly after one of my visits on Sunday evening, June 13th, I got the call that she was arresting. After hearing her recent blood work showed even worse numbers, I told them to stop CPR.

Since then I’ve started reviewing ProIn information online and found these similar stories – dogs that were fine one day, crashing soon after being given this drug – and the symptoms sound very similar. It doesn’t sound like the potential extreme side effects are generally shared with the owners or that this is being researched in the vet market. I understand that all medication, dog and human, carries risk, but I also believe that the owners should be informed when a drug can have a high risk associated as that could change whether that owner decides the risk is worth the benefit of the drug.

I have contacted the manufacturer and now sent the FDA my Adverse Reaction paperwork - it was easy and didn't take that much time. I'm also contacting my parent club's health committee, and looking into the state veterinary hospital in case they get involved in drug research. If we can at least get enough information out there and the vet community starts making their owners aware that there are serious side effects, maybe we can save a life. It doesn't bring back my Misty, but it's all I have that I can do to honor her love and memory. If you haven't already, please consider doing the same and maybe our voices can become a chorus for the loved ones who are gone.

[Yorkie Mommy]

I think it is a shame that my Mother's 13 year old yorkie was murdered by this drug!

I wonder why the "Doctor" would give it to a dog with a heart condition! Makes me wonder if the Doctor should also be the Pharmacy! I think there should be a double check system like humans have. When we take our prescriptions to the pharmacy they double check our new medication interfering with our current medications.

The vet community needs a check up! Attention Animal Rights Groups lets work on this issue and save our furry babies from being murdered with an ink pen!

[cherylmartin]

Yorkie Mommy,

OMG Not again!! I am so sorry.

Please tell us more about what happened!!
ProIn victims have got to stick together and do follow up reporting-it is vital to do this to get this drug off the market.

Please PM me and I will give you info to do this or read other posts.

We have to pursue this together.

[Yorkie Mommy]

Cheryl,

Sorry, I have not been a member long enough to send PM or E Mail so I had to post here.

My Mom said that Bre (that was the yorkie's name) started having a seizure then a stoke. She did go talk to the vet after she calmed down which took 3 days and the vet said she had no idea the side effects of this drug could have. Bre did have a heart condition so it is weird that the vet would have prescribed this drug to her in the first place. Usually my Mother (who is a registured nurse) researches everything before she gives it to her animals, but this drug was not in her PDR and she just dropped the ball on researching it. Believe me she is beating herself up over it! We have typed up a letter and will be sending it out to every vet in the yellow pages for our surrounding counties. I just hope and pray that they do read it. Any suggestions would be greatly appreciated. Thanks for you post and so sorry for your loss as well.

[cherylmartin]

Yorkie Mommy,

Please read thru all the posts after 09-09-09. I tell you how to report to FDA (Report adverse reaction report-your vet won't do this(a must do) I give you website to report to Pegasus Labs (another must do-don't believe them when they say they will report it).

My Jasmine also had a recently discovered heart murmur PLUS the onset of kideny disease/failure. I also will carry the guilt of not researching it before I gave to Jasmine.

If you cannot locate these, you can always email directly at: jasi96@hotmail.

Let your Mom know how sad I am about her Yorkie. It is a tough time.

Hugs,

[Opiesmom]

My husband and I lost our 14 year old lab terrier mix in July, one month after she was diagnosed with end stage renal failure. This dog had perfect lab work and was prescribed daily Rimadyl in June 2009 for arthritis. I never researched the potential side effects, naively believing that my vet knew best. Our old girl had her annual wellness exam in November 2009 and was pronounced a "healthy senior dog." Seven months later, she's dead. The dog began showing signs of renal disease last winter, but I was too busy with school, work, and my husband's recent surgery to notice what was going on with her. In February, I took her to the vet because she had been incontinent in bed (because she was drinking excessive amounts of water to compensate for her deteriorating kidneys). He prescribed Proin, a drug that raises blood pressure and is also bad for the kidneys. In May, O. began refusing food with the pills mixed in; it's as if she knew. Maybe she did. Over Memorial Day weekend, she refused to eat, but we could not get her to a vet until the following Wednesday. Labs showed she was in severe renal failure. She spent a combined total of 5 days in the hospital. Aggressive IV fluid therapy diluted her and improved her lab values temporarily, but within a week, she began to decline again. I spent the month of June force feeding her by syringe, trying to get calories in her and control her nausea. But her kidneys worsened and we euthanized her on July 1. Now that I am connected to an online group for dog parents whose furkids have kidney disease, I know there was so much more that could have been done for my girl. My vet still insists the medications he prescribed had nothing to do with her renal failure and that she was just old. I think that he wrote her off because she was elderly and refused my request for SQ fluids because he didn't want to be bothered. Now, I have to find a way to live with myself because I didn't catch O.'s renal failure in time. She had been a very healthy dog her whole life and I feel I poisoned her and let her down at the end of it. Please, please, beware of these drugs!

[cherylmartin]

Opiesmom

It saddens me to read of another loss. I am so sorry. I do know how hard you tried to help your beloved furbaby. I really do. But when the side effects of Proin and Rimadyl start the downward sprial begin. How dare your vet state (this is what Pegasus Labs told me also) that it's because she was old. No, its because they are allowed to manufacture these killer drugs!!
Please find it in your heart to not let Opie's death go unnoticed. Report this adverse reaction to the FDA, to Pegasus Laboratory, Board of Veterinary medicine. Someone has to listen to us.

My thoughts and prayers are with you and your husband as you go through this terrible time in your life.

[Tessa]

I had posted here earlier about how I gave my dog (13 at the time) Proin for incontinence. After about a couple doses she bacame very ill (diarrhea, vomiting) I thought at first it was a virus, so I had stopped the medicine and put her on a bland diet she got better I put her back on her meds and she became ill again and that is when I realized that it was the meds not a virus. Anyway long story short I took her off the proin and she seemed better this was 10/09, but her health really went downhill from there. She lost half her body weight drank excessive amounts of water hence peeing all the time.Prior to all this she had excellent bloodwork, although she did show signs of crystals in her urine which she was put on a special diet for.

We had to put Semone down this past June she had started to go into Kidney failure, and weighed about 7lbs (she should weigh around 11). Is it possible the Proin caused her sudden decline I know she was 14 which is pretty old but she was also a pretty healthy dog.

Thank you for any information.

[cherylmartin]

First, let me say how sorry I am for your loss. And yes, what you described is An Adverse Reaction to Proin and must be reported to the FDA to Pegasus Labortories and to your State Veterinary board. The agencies will NOT know there are furbabies still dying from this drug unless, we the victims become the voice of our furbabies!

Let me know if you need any additional information to file these complaints.

Please visit my Jasmine at: Jasmine's Rainbow Residency at RainbowsBridge.com

It tells her struggles from Proin.

Hugs,

[Tessa]

Thank you Cheryl for the info regarding Proin. I intend to take action so that at least my poor little Semone's death will not have been in vain. It just kills me to think I may have a had a year or two more with her if not for trusting a new Vet. (my old vet had to leave due to illness). I am sorry for everyone here who has either lost a dog or had a dog become very ill due to this drug.

[lange]

I'm so saddened to hear all these stories of heartache. My heart goes out to you all. I may be dealing with incontinence in my dog and having read these stories, I know what to say if my vet ever suggests Proin. As someone mentioned earlier, it makes more sense to try other avenues.

I'm sorry many of you didn't get any information until it was too late. We all know that pharmaceutical companies care more about the dollar than they do you or your pet. It's is a corporation and thus thinks& acts like one. They will not take this drug off the market even if they know the side effects. Only the FDA or public pressure will force them to act.

I'm glad more people are starting to file complaints w/the FDA. Can I also suggest getting the news out through the media? I found a site called "complaint tv". It suppost to be a hub of sorts for consumer complaints thru news media. I can't post the link but a google search will lead you to it. I can't vouch for the site but its worth the try since the news media can put pressure on the gov & corp's.

I also think Facebook being so hot right now is a good online media source. You can start a consumer interest/concern "page" on Proin. Then hopefully people will find you & post their experiences as well. Since companies are gaga over FB's publicity effect, I'm betting they'll notice it. If you do start one, let us know & I will join it.