Urinary Incontinence in Dogs

Unfortunately some dogs are prone to bladder leakage or not being able to hold their bladder for long periods of time. This is called urinary incontinence. Large breed, female dogs are especially likely to experience urinary incontinence after being spayed because they no longer produce certain hormones. Some male dogs can also develop urinary incontinence; it’s just not as likely. There are a few treatment options available for your pet, but unfortunately the availability of some through VetRxDirect is changing. Please read further about this recent issue and the other possible treatments for urinary incontinence in dogs.

Hormone-dependent urinary incontinence in female dogs:

The urinary sphincter is a part of a dog’s urinary tract and tightens to form a closure when a dog is not urinating. This is what makes a dog able to hold their bladder and to not have any leakage. Spaying a female dog means removing their ovaries and most likely their uterus too. These organs are responsible for producing estrogen and progestin hormones. Sometimes, this decrease in estrogen over time can cause a female dog to become incontinent, or not be able to fully close their urinary sphincter. There are also instances where intact (not spayed) female dogs can experience urinary incontinence related to a decline in estrogen with age.

Hormone-dependent urinary incontinence in male dogs:

Male dogs may also develop urinary incontinence, and it can be caused by being neutered. The neutering process involves removing the testicles, which are responsible for producing the male hormone, testosterone. Testosterone, like estrogen, helps control the urinary sphincter and provides the dog with bladder control. Just like female dogs, male dogs who are not neutered may also develop urinary incontinence due to a decline in testosterone.

Treatment for urinary incontinence in dogs:

There are many other causes of urinary incontinence in dogs, ranging from nerve-related, physical abnormalities, and urinary tract infections. This is why it is important to go through all testing for your dog to find the cause of their urinary incontinence. For dogs with hormone-dependent urinary incontinence, the treatment options can be broken down into two categories: hormone replacement and adrenergic agonists. Below is a short list of possible treatment options for urinary incontinence in dogs, but it does not include all possible treatment options. Each dog requires a specific therapy determined by your dog’s veterinarian.

Male Hormone Replacement: Testosterone shots are a possible treatment for male dogs with urinary incontinence. Testosterone will cause the urinary sphincter to tighten and regain control again. Testosterone shots are usually given through your veterinarian, and they are not available through VetRxDirect.

Incurin (estriol) for urinary incontinence in dogs

Incurin is Available at VetRxDirect Pet Pharmacy

Female Hormone Replacement: Female dogs have two options for hormone replacement: estriol and diethylstilbestrol. Incurin is the brand name product for estriol for dogs, available through VetRxDirect, and it is given to replace estrogen levels. Diethylstilbestrol, commonly known as DES, is a synthetic drug which mimics the body’s natural estrogen, estradiol. There are no manufactured products containing DES, but it is compounded by pharmacies, including VetRxDirect. Diethylstilbestrol is usually given daily for 7-10 days and then reduced to a weekly dose. Both Incurin and DES work by acting as estrogen on the urinary sphincter, causing it to tighten and regain control over urination.

Adrenergic Agonists: Adrenergic agonists can be effective for both male and female dogs. Adrenergic agonists resemble epinephrine or adrenaline and cause the urinary sphincter to tighten, preventing leakage and controlling the bladder. There are several adrenergic agonist drugs available but only phenylpropanolamine has a veterinary approved product, called Proin.

Others: There are many other possible treatments for urinary incontinence due to non-hormonal causes. Your veterinarian will best know which medication is right for your dog based on the cause and potential side effects.

VetRxDirect’s discontinuation of Proin sales:

Phenylpropanolamine, the active ingredient in Proin, can be a precursor to methamphetamine production, so it’s sales and use are controlled under the Combat Methamphetamine Epidemic Act of 2005. Most regulatory bodies have tightened the control over the sales of Proin over the years because of its use to create meth. Due to continual changes in state reporting and monitoring of controlled substances, such as Proin, VetRxDirect has made the difficult choice to discontinue selling Proin. The decision was made by weighing the risks versus the benefits of selling Proin. VetRxDirect would like to support the Combat Methamphetamine Epidemic Act of 2005 in reducing the availability of methamphetamine ingredients in the United States to decrease drug addiction and abuse. This decision unfortunately affects our dedicated customers who have purchased Proin and seen benefits in their dog; however, Proin may still be purchased from licensed veterinarians. VetRxDirect has other treatment options to consider as listed above. We apologize for any inconvenience this decision may cause, and we hope to be a continued trusted source for your pet’s medications.

Levothyroxine for Dogs Availability Updates

What is Soloxine for dogs and what is it used for?

Soloxine, also known as a generic levothyroxine, is used to treat hypothyroidism, or low thyroid hormone. Naturally, the thyroid gland produces hormones that allow the body to maintain a normal rate of metabolism. Sometimes, these hormones are not made in the amount required by the body to function normally. This can be called hypothyroidism, or low levels of hormones, or hyperthyroidism, or high levels of hormones. Symptoms of hypothyroidism include tiredness, slow movement, constipation, weight gain, skin and hair changes, and others. Generic Soloxine, also known as generic levothyroxine, is a medication used to replace these missing hormones. It is a cheaper levothyroxine for dogs. Too much levothyroxine, however, can cause hyperthyroidism, or too much thyroid hormone, often seen as unexplained weight loss, hyperactivity, and rapid heart rates.

Why does a dog have thyroid problems?

Dogs can have thyroid problems similar to humans. Most often, thyroid problems are caused by the dog’s body attacking its own thyroid gland. This can lead to the underproduction of the necessary hormones to maintain normal metabolism. This can lead to dogs having poor hair growth or coat changes if they develop hypothyroidism.

Tests needed to diagnose and monitor hypothyroidism in dogs

Blood tests are used to assess if a dog has thyroid problems. The veterinarian will test for the total T4 level. T4, also known as thyroxine, is one of the hormones produced by the thyroid gland. If the level is within normal range, the dog does not have hypothyroidism. If the level is low, this may be due to hypothyroidism, but it may also be due to other diseases. Veterinarians can perform more specific tests to assess if your dog have hypothyroidism. The FT4 test, or free thyroxine test, can be a more accurate measure of the thyroid function. Free thyroxine is the hormone that is going to enter cells in your pet’s body and maintain normal metabolism. Total T4 levels can not show how much free T4 is available and may not accurately show what is going on in your pet’s body. Other blood tests may also need to be performed by your veterinarian to rule out other causes.

Once your dog has undergone treatment or replacement therapy using Soloxine, levothyroxine for dogs, they need to be monitored to ensure that adequate levels of hormones are being maintained. It may be necessary to monitor blood levels monthly in order to assess if the dose needs to be adjusted. Longer time frames may be needed to ensure that the body has adjusted to the new dose of levothyroxine and to ensure they are at a steady blood level of the medication. After maintaining steady thyroid levels, monitoring may be less frequent as determined by your veterinarian. Follow-up appointment are crucial to the success of levothyroxine treatment and the maintenance of steady thyroid hormone levels.

How do thyroid problems in cats differ from those in dogs?

Cats can also have thyroid problems, but they most often have hyperthyroidism. Hyperthyroidism in cats can also be treated. Overproduction of thyroxine in cats causes an increase in metabolism which can lead to weight loss, anxiety, diarrhea, and other symptoms. Hyperthyroidism can be treated by using radioactive iodine or removal of the thyroid gland. Both of these treatments can lead to hypothyroidism, so other treatment options are available, such as methimazole transdermal gel. Contact your veterinarian regarding possible hyperthyroidism in your cat.

Can levothyroxine for humans be used in dogs? Can you substitute products?

When comparing the strengths of levothyroxine in humans versus the levothyroxine used in dogs, there can be a vast difference in the strengths. Humans often require less levothyroxine needed to treat hypothyroidism. Dogs absorb and metabolize levothyroxine differently than humans. As a result, they may need higher doses than seen in humans.

Chewable Levothyroxine for Dogs

Canine Thyroid Chewable Levothyroxine Available at VetRxDirect

One possible substitute for Soloxine, indicated for use in dogs, is Pala-Tech’s Canine Thyroid Chewable tablets. These chewable tablets can be easily given to your dog, and they’ll enjoy to flavor. Checkout ThyroKare Levothyroxine Tablets as another possible substitute for the backordered Soloxine.

Many products are available for the treatment of hypothyroidism, and they are not all the same. Substitutions may be permitted if formulations are similar and on the order of your dog’s veterinarian. Ask your veterinarian before substituting any medications or supplements.

Common Side Effects of Levothyroxine in Dogs

When being administered properly, there should not be side effects from levothyroxine. Levothyroxine for dogs will help maintain normal metabolism. Adverse effects are seen when too much levothyroxine is used. These include the following:

  • Rapid heart rate
  • Excess hunger
  • Increased thirst
  • Increased urination
  • Excitability or nervousness
  • Excessive panting

Contact your veterinarian if you notice these adverse effects. The veterinarian may adjust the dose of the medication. Do not change how you were instructed to give levothyroxine for dogs without consulting your veterinarian.

Levothyroxine for Dogs Drug Interactions

Like medications used in humans, there can be medications that interact causing changes in how the medication is acting on the body within dogs. Before starting your pet on any new medication or supplement, contact your veterinarian to see if it will interact with your pet’s current medication. Below are a few drugs that interact with generic levothyroxine.

  • Antacids
  • Anti-diabetic agents including insulin and oral agents
  • Cholestyramine
  • Corticosteroids
  • Ketamine
  • Phenobarbital

*This list does not contain all medications that may interact with generice levothyroxine and the Soloxine substitute. Contact your veterinarian regarding any changes in your dog’s medications.

Is your dog on levothyroxine? Which brand and form? Does your dog readily take his or her levothyroxine? Leave your answers by clicking ‘leave a reply’ below. Thank you.

Hypothyroidism in Dogs: What to Look For

One day you notice it: your furry companion is a little less furry and a little less companionate. In fact, he seems pretty “down” and lethargic.  That combination of symptoms might point to a common clinical condition called hypothyroidism.

The thyroid gland, located in your dog’s neck, produces hormones that control key bodily functions including metabolism, growth, reproduction, oxygen consumption and immunity. If the butterfly-shaped thyroid doesn’t function well – or stops working all together – your dog can suffer from a variety of symptoms that can harm your dog’s health and reduce his quality of life. (The condition is relatively rare in our feline friends who are more susceptible to hyperthyroidism.)

What types of dogs get hypothyroidism?

Larger dogs that are between 4-10 years old are more prone to the condition. Some breeds are more likely to have hypothyroidism including: Doberman pinchers, Golden retrievers, Great Danes, Irish Setters and Airedale terriers.

What are the causes of hypothyroidism in dogs?

Changes in the thyroid gland can cause hypothyroidism. In some cases, an immune system disorder attacks the gland causing it to overproduce thyroid hormone and then become totally depleted. In other cases, age and biological processes stop the thyroid gland from producing enough hormones.

What are the symptoms of hypothyroidism?

Look for a combination of these symptoms:

  • Thinning or loss of fur on the trunk of the body
  • Thickening, darkening skin
  • Weight gain
  • Lethargy
  • Mood changes – depression, aggression and anxiety

Blood work is required to diagnose the condition and determine what level of treatment is required.

Popular Brands of Levothyroxine for Hypothyroidism in Dogs

How is hypothyroidism in dogs treated?

Dogs with hypothyroidism require hormone replacement therapy for the remainder of their lives. Fortunately, there are many excellent hormone replacement medications that regulate canine hormone levels and help the body function normally. We stock many of the leading thyroid medications.

As always, the first person you should talk to about your pet’s condition and any required treatments is your veterinarian.

If you’d like to read more about hypothyroidism, check out this comprehensive article by researchers at Washington State University.

Thank you for reading. We’re here to help you keep your pet healthy and happy!


Chondroprotec (Polysulfated Glycosaminoglycan) Now Available at VetRxDirect

Chondroprotec (Polysulfated Glycosaminoglycan) Sterile Solution is now available and ready to ship after your veterinarian’s prescription authorization.

Order today by visiting our Chondroprotec product page.

Many customers have called lately asking for generic Adequan Canine Injectable. While Chondroprotec in not proven as a generic bioequivalent of Adequan, your dog’s veterinarian may prescribe Chondroprotec for extra-label use. Extra-label use of prescription drugs by veterinarians is a very common and acceptable practice in many situations.

Has your veterinarian prescribed Chondroprotec? What successes has your dog experienced. Let us know in the comments section below.




Could My Dog Have Epilepsy?

Some diseases are a mystery, even to those who study them for a lifetime. The word idiopathic means “personal suffering” in Greek. It also means that medical professionals don’t know what causes it! Recurrent seizures in dogs are often caused by idiopathic epilepsy. About 80 percent of all cases are of unknown origin. There are, however, other types of seizure affecting canines.

Types and Symptoms of Epilepsy in Dogs

All forms of epilepsy result in seizures, which produce sudden attacks, spasms, or convulsions. Although they are neurological disorders originating in the brain, the causes can be difficult to pinpoint.

Often the result of structural lesions in the brain, symptomatic epilepsy can and often does cause frequent seizures. It can affect dogs of nearly any age, especially those between six months and five years old.

The term Cluster seizure is used to describe a condition causing multiple seizures over several consecutive days. In many cases, the problem is attributed to brain lesions or damage to the brain.

When the seizure occurs on an almost constant basis, your furry friend may be suffering from a condition called status epilepticus. These episodes may strike after brief periods of inactivity, which may last for a day or two.

Last but not least, there is the most common form of the chronic condition, idiopathic epilepsy. As we mentioned, the disease has no known cause. Even after exhaustive examinations, veterinarians will not be able to find any damage to the brain or visible lesions when idiopathic epilepsy is involved. They simply don’t know why the seizures are striking your pet.

Frequency of Seizures in Dogs

The more seizures your pouch has, the more likely they are to damage the neurons in the brain, which consequently makes it more likely for seizures in the future. These convulsions can harm small parts or both sides of their brain. Either type can cause damage your pet may never recover from.

Symptoms of Seizures in Dogs

In most cases, a seizure is preceded by a brief period or stage the experts refer to as an aura.  During this time, your dog may become increasingly apprehensive, even frightened. In some instances, your dog may seek attention or look dazed or discombobulated. Once the seizures begin, they are impossible to mistake for anything else. A canine who is in full seizure will turn on his or her side, become stiff, salivate, urinate, defecate, and chomps the jaws. The limbs will spartle and jerk for the entire episode, which typically lasts between thirty and ninety seconds. In most cases, they strike when your canine friend is resting or asleep, often in the morning or late at night.

Diagnosis of Seizures in Dogs

If your dog has a seizure, it is imperative a veterinarian exams your pet as soon as possible. Epilepsy of any kind cannot be diagnosed through a simple physical examination. Your pouch must undergo a battery of tests. Biochemical tests often reveal one or more of the following conditions if epilepsy is suspected: kidney and/or liver failure, low blood sugar, viral or fungal blood disease, a fatty liver, or an infectious disease of the blood.

Treatment of Seizures in Dogs

No matter the type, prescription medications often help reduce the frequency and intensity of canine seizures. If administered according to your veterinarian’s instructions, they should improve your dog’s health and wellness. The right drug may also extend his lifespan by several years!

What drugs will your pet’s veterinarian prescribe for seizures in dogs?

Phenobarbital – A traditional drug used by veterinarians for seizures of unknown causes, or idiopathic epilepsy, in dogs. Phenobarbital is classified as a schedule IV controlled substance and is best purchased through your pet’s veterinarian or through a local community pharmacy.

potassium bromide is available in tablet and suspension forms

K-BroVet (potassium bromide)

Potassium Bromide – Prescribed to pets suffering from any form of the disease, Potassium Bromide helps control seizures. The popularity of the drug is due in no small part to the fact that it can be safely combined with other capsules, such as Phenobarbital, which have proven remarkably effective at mitigating the most violent symptoms of seizures.

Zonisamide – A supplemental drug used to treat chronic forms of epilepsy, Zonisamide is popular with dog owners who wish to avoid the side effects of more powerful medications such as Phenobarbital. The generic drug is affordable and readily available in most pharmacies.

Primidone – When epilepsy is the result of an infection, such as distemper or viral encephalitis, a specific prescription medication will be required to treat it. Primidone was designed to control the convulsions or seizures associated with numerous infections.  Available in tablet form, it is long-term medication administered on a regular basis. Even young dogs can benefit from this drug, as it should reduce both the severity and the frequency of seizures.

Levetiracetam – Available as a generic or as the brand name Keppra, Levetiracetam is a human-labelled drug used for seizures in dogs. While Levetiracetam appears safe for use in pets, studies of this drug’s side effects are ongoing. Be sure to report any side effects to your pet’s veterinarian and pharmacist.

Depending on a few factors including the frequency and severity of your pet’s seizures, your pet’s veterinarian may prescribe one or more of the above drugs. Be sure to ask questions and follow your veterinarian’s directions when giving your pet these drugs.

Does your dog or cat have epilepsy or any other type of seizures? Let us know what success you have experienced using the drugs listed above, or any other new therapies your veterinarian has prescribed in the comments below.


What is Cushing’s Disease in a Dog?

More commonly known as Cushing’s disease, hyperadrenocorticism is a chronic condition occuring when the body makes too much of a natural steroid called cortisol. Cortisol production is controlled by the adrenals, two small glands sitting atop the kidneys. The primary purpose of the hormone is to help the body deal with increased stress. Cortisol also helps maintain weight, skin condition, tissue structure, and performs other vital activities ensuring good health. But when the adrenal glands produce too much cortisol it can weaken the immune system and increase the risk of serious illness.

What causes Cushing’s disease in dogs?

Human beings, horses, and cats can all get Cushing’s disease, but the condition is far more commonly found in dogs. The two most common types of the disorder are adrenal-dependent and pituitary-dependent.  About 80 percent of diagnosed cases are the result of a tumor on the pituitary, a tiny gland at the base of the brain.

The pituitary is responsible for producing numerous hormones, one of which is adrenocorticotropic hormone. If a tumor develops on the gland, it can result in an overproduction of the hormone, which can stimulate the adrenals to produce more cortisol than the body can manage.

The remaining 20 percent of canine disease cases are caused by tumors in the adrenals, which can also stimulate an overproduction of cortisol. The treatment prescribed by your veterinarian may be determined by the type of Cushing’s disease affecting your pet.

Symptoms of Cushing’s Disease in Dogs

Both types of Cushing’s produce similar symptoms which can seriously affect your canine friend’s health. They include increased thirst, urination, appetite, reduced activity, excessive panting, frequent skin infections, hair loss and abdominal distention.

Which Dogs are at Risk?

Because it is a slow growing disease, most cases of canine Cushing’s occur in older dogs over the age of six.

Diagnosis of Cushing’s Disease in Dogs

Since hormones travel through the bloodstream, the most effective way to diagnose Cushing’s disease is with a blood test. Frequent blood screening is often required during the first few months of treatment and then three or four times each year after initial diagnosis. A veterinarian uses these tests to determine the medication and dosage schedule needed to manage the symptom of the disease.

Treatment of Cushing’s Disease in Dogs

The only way to cure Cushing’s disease is to excise the tumors, which can be dangerous and costly. As a result, most veterinarians do not recommend surgery as an option. They are far more likely to prescribe medications designed to manage the most serious symptoms of the disorder.  Dosage amounts and schedules may need to be adjusted from time to time, depending on your dog’s response to the treatment. Let us take a moment to review a few of the most common prescription medication used to treat Cushing’s disease.

Vetoryl (trilostane) for Cushing's Disease in DogsTrilostane

Dog lovers with pets diagnosed with Cushing’s disease got good news when the FDA approved Vetoryl (trilostane), the first medication that can be used to treat both adrenal-dependent and pituitary-dependent Cushing’s in canines. The prescription drug works by preventing the adrenal glands from producing cortisol. In numerous studies, most dogs experienced a complete reversal of serious symptoms. Side effects were generally quite mild and included diarrhea, vomiting, lack of energy, and weight loss. Trilostane should not be given to dogs with liver or kidney disease, take prescription medications to treat heart disease, or are pregnant.


The only other drug to be approved to treat canine Cushing’s by the FDA is Anipryl (selegiline). However, it is only effective for dogs suffering from the pituitary-dependent type of the disease. The drug has proven highly effective at ameliorating the most serious symptoms of the chronic condition.


Mitotane is used to treat the symptoms of Cushing’s disease as well as adrenal tumors. It works by reducing the level of cortisone produced in the adrenal glands. Sold in both capsule and suspension form, the drug is relatively inexpensive and highly effective in treating this disease.

Does your dog have Cushing’s Disease? Which medications has your pet’s veterinarian prescribed? Any secrets or suggestions to help those pets newly diagnosed? Please leave comments below.

What is Hypothyroidism in Dogs

Hypothyroidism in Dogs

Located in the throat bellow the larynx, the function of the thyroid is to produce hormones that regulate the metabolism. When the endocrine organ fails to deliver the necessary hormones to the body, whether because of old age or atrophy, the patient will most likely suffer a series of unpleasant symptoms. The condition is quite common in man’s best friend, the humble canine.

The chronic disease is most frequently seen in large, middle-aged dogs of any breed. However, a few of the larger breeds, such as Sheepdogs, Golden Retrievers, and Irish Setters are disproportunately affected by it. Let us take a moment to review the most common symptoms of the disorder.

Most dogs that are diagnosed with hypothyroidism suffer from one or more of the following symptoms:

  • Lethargy and listlessness
  • Mental dullness
  • Unexplained weight gain
  • Excessive shedding
  • Dandruff
  • Oily skin
  • Frequent ear infections
  •  Extreme sensitivity to the cold
  • Pimples or acne

In some cases the dog’s gastrointestinal, neuromuscular, cardiovascular systems may be compromised, which increases the risk of the following symptoms:

  • Constipation
  • Anemia
  • Infertility
  • Poor coordination
  • Diarrhea
  • Seizures
  • Irregular heart rhythms (arrhythmias)

Risk Factors of Hypothyroidism in Dogs

As we mentioned, hypothyroidism occurs most often in middle-aged, larger dogs, but it may also strike canines that are of medium size. It can and often does result in behavioral changes and a decline in physical activity. There is no known cure for the chronic condition, which means it will affect a pooch for his entire life. If you observe any of the aforementioned symptoms, it is imperative that you take him to see his veterinarian.

Diagnosis of Hypothyroidism in Dogs

Because there are so many symptoms that are common to other diseases, it can be difficult for even an experienced veterinarian to diagnose the disease. The most effective way to make the correct diagnosis is with blood screening and a full physical. All dogs that suffer from hypothyroidism have depressed hormone levels. That said, a low-normal level does not necessarily mean that your dog has the disease, which means he should not be treated for it.  Overtreatment and improper diagnoses are not at all uncommon.

Treatment of Hypothyroidism in Dogs

Although it is a permanent condition, hypothyroidism can be managed effectively with thyroid hormone replacement therapy. Most dogs respond well to the treatment and are able to lead healthy, happy and full lives, as long their owners provide daily medications and closely monitor their pet’s appearance and behavior.

Medications for Hypothyroidism in Dogs

Soloxine® Tablets

soloxine, levothyroxine for hypothyroidism in dogs

Soloxine is available at VetRxDirect.

A popular prescription medication prescribed specially for hypothyroidism in dogs is Soloxine. Sold in tablet form, levothyroxine directly treats the problem of the disease, i.e., low thyroid levels.  Dog owners must remember to always read the label carefully and to administer Levothyroxine as directed by their veterinarian.

Canine Thyroid Chewables

Because most dogs like to chew on things, Levothyroxine is also available in chewable tablets. Safe for dogs of all ages and breeds, the medication must be administered at least once a day, or as prescribed by your dog’s doctor. If possible, try to give him his medication at around the same time each day. And never give him more than directed and double the dose if you happen to miss a day.

generic Levothyroxine tablets

Often the most inexpensive option, generic tablets are no different from those sold in fancy packages by major drug makers, which makes them a popular alternative. After all, hypothyroidism is permanent and when prescription levothyroxine must be administered for several years, the costs can really add up.

Where to Find Levothyroxine for Dogs?

Since it is such a common disorder, most veterinarians keep Levothyroxine on hand.  But veterinarian’s don’t normally offer deep discounts or have sales.

Properly licensed and accredited online pet pharmacies in the U.S. can legally sell and ship medications to your door. All they need is a prescription from your veterinarian after you order your pet’s medication online.

Incurin: New FDA Approved Drug for Urinary Incontinence

Veterinarians know urinary incontinence or involuntary urine leakage is a common problem encountered in dogs. You may notice incontinence occurring at routine times, including when your dog is sleeping, or at less predictable times up to several times per day.

You should be aware of several potential causes to this problem. Questions regarding the timing and age of onset of the incontinence will help your pet’s veterinarian determine if the condition may have existed prior to or shortly after birth, shortly after being spayed, or if another reason is causing the incontinence. A thorough physical evaluation by the veterinarian may be necessary to determine proper treatment.

Urine leakage in spayed, older female dogs may commonly be attributed to urethral sphincter incontinence. This condition will usually start months to years after being spayed. The goal of drug treatment is to increase the urethral tone and continence. Estrogens and alpha-adrenergic agonists are the two drug classes identified to help increase urethral sphincter tone.

Proin, PPA Available at VetRxDirect

Proin, PPA for Urinary Incontinence in Spayed Dogs

The alpha-adrenergic agonist, phenylpropanolamine, also known as PPA (Proin, Propalin), is a commonly prescribed treatment option for urethral incontinence. Side effects of phenylpropanolamine may include restlessness, irritability, panting, excitability and increased blood pressure.  Phenylpropanolamine should not be used in dogs with pre-existing high blood pressure. Phenylpropanolamine may be prescribed alone or in combination with estrogen therapy.  The combination treatment is believed to provide a synergistic effect, meaning the combination may be more effective than either drug alone.

Estrogen therapy may also be considered for dogs who do not tolerate phenylpropanolamine. Many veterinarians are familiar with the estrogen product called diethylstilbestrol, also referred to as DES. Diethylstilbestrol is no longer made by a drug manufacturer and must be obtained through a compounding pharmacy like VetRxDirect. Diethylstilbestrol usually starts with a loading phase including five to seven days of daily treatment. In most cases, one to two doses per week are given thereafter.


Incurin: The newest drug for urinary incontinence in spayed female dogs.

A new FDA approved, veterinary-labeled, estrogen treatment option named Incurin (estriol) has recently been introduced. Incurin is made by Merck Animal Health and is available in a 1 mg estriol (sometimes referred to as oestriol) tablet. Incurin is indicated for the treatment of urinary incontinence due to sphincter mechanism incontinence (SMI) in spayed female dogs. Treatment is recommended to be started at one tablet per day for 7 to 14 days. If treatment is effective, your veterinarian may reduce this to the lowest effective dose. Always consult with your veterinarian before adjusting any medications’ dosing or frequency.

Incurin is not for use in male dogs and should not be used during pregnancy or lactation. Possible side effects have included signs of estrus (in heat), swollen vulva/teats and nausea. Rare side effects may include vaginal bleeding and hair loss. You should consult your veterinarian if you notice any side effects and keep all follow-up appointments.

If you have any questions regarding your pet’s incontinence, contact your veterinarian to schedule an appointment. If you or your pet’s veterinarian have questions about either of the drugs reviewed in this post, give us call. We here to answer any questions you have.

Shawn Roe, PharmD

Pharmacist, VetRxDirect