Frequently asked questions
For more information about urinary incontinence (UI) or PROIN ER™ (phenylpropanolamine hydrochloride extended-release tablets), take a look at our Frequently Asked Questions below. Your veterinarian can also answer any questions you may have about UI, its causes and treatments.
For pet owners
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What is urinary incontinence (UI)?
Urinary incontinence occurs when your dog involuntarily loses urine due to lack of bladder control. For example, you may see a wet spot when your dog gets up from a nap or more volume in other inappropriate places.
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What causes canine urinary incontinence (UI)?
The cause can be medical or behavioral or a combination of the two. Inappropriate urination is a complex condition, so work with your veterinarian to discover the reason for your dog’s incontinence.
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How will the veterinarian determine the cause of urinary incontinence (UI) in my dog?
The veterinarian will ask you questions about your dog’s inappropriate urination and do a physical examination. Depending on the results, your veterinarian probably will recommend tests that include a urinalysis, urine culture, blood tests, and perhaps abdominal images or ultrasound. These tests should help determine the cause of the problem.
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Are some dogs more likely to experience urinary incontinence (UI) than others?
Any dog can experience urinary incontinence, but it is most frequent in middle-aged and older spayed females. Mid-sized and large breeds are more likely than small breeds to suffer from urinary incontinence.
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What are the treatments for urinary incontinence (UI)?
The treatment depends on the cause. Possibilities include surgery, estrogen therapy, or other medications, such as an FDA-approved form of phenylpropanolamine that can strengthen urethral muscle tone. Properly treated UI is likely to resolve quickly, however medication may be required long-term — that’s why a veterinary exam and diagnosis are so important.
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My dog urinates when the family leaves the house. Isn’t that just separation anxiety?
Maybe. But separation anxiety usually results in other behavioral signs as well, such as improper chewing or scratching. And these signs are not enough for a diagnosis — schedule a veterinary checkup to be sure.
For veterinarians
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Is PROIN ER a scheduled drug?
Phenylpropanolamine hydrochloride (PPA) is not a controlled substance, although it is a listed chemical and subject to federal regulation. However, the DEA has verified to the AVMA that the requirements for tracking non-prescription PPA do not apply to veterinary dispensing of prescription drugs containing PPA. Some states consider PPA a controlled substance (Arkansas, Iowa, Louisiana and Oregon). Please check with your state pharmacy board if you have any concerns.
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Where does the flavoring come from?
The proprietary liver-blend flavoring is derived from poultry liver. There are no beef or pork additives to avoid concerns about beef and pork allergies.
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Does PROIN ER interact with anesthesia?
When preparing a dog for anesthesia, please follow the normal procedures that you would in your practice. PROIN ER is no different from immediate-release Proin, in regard to using the same precautionary measures that you feel are necessary.
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Can I use PROIN ER with NSAIDs?
Although the PROIN ER package insert does provide a precaution for dogs with pre-existing liver disease and kidney insufficiency, this does not mean there are drug-to-drug interactions with NSAIDs. In fact, in the Clinical Field Study that evaluated safety, dogs were allowed to use NSAIDs concomitantly with PROIN ER and showed no additional adverse effects.
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What is the “washout” period between Proin and PROIN ER?
The Clinical Efficacy Study reviewed by the FDA and included in the PROIN ER package insert had no washout period and demonstrated that 99% of pet owners believed that their dog either “stayed the same” or “improved” when switching to PROIN ER.
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Will I see better efficacy than with Diethylstilbestrol (DES) or Incurin?
There have never been head-to-head trials with Diethylstilbestrol (DES) or Incurin. However due to the ease of dosing, high efficacy and safety of PROIN ER, it would be appropriate to prescribe PROIN ER first line for at least 30 days to evaluate whether another option should be explored.
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Will PROIN ER cause high blood pressure?
In the PROIN ER package insert, there is precautionary language regarding hypertension, and it should be used in caution with patients with pre-existing heart disease. In the Clinical Field Study, a percentage of dogs (12.6%) did develop hypertension; however, 21 dogs with hypertension were enrolled in the study and they showed no more adverse effects than did those dogs without hypertension.
Is PROIN ER right for your dog?
Since urinary incontinence may be new to you, here’s a helpful list of questions your veterinarian may ask to help in the diagnosis (along with performing tests like urine culture, blood tests, abdominal imaging, or ultrasound). Answering these questions before the first appointment could be the first step in managing your dog’s leaking issues.