Urinary incontinence in aging pets

Proin can be an effective solution to incontinence in pets

As many pets get older, particularly in spayed or neutered dogs (being much less common in cats), the muscle tone often weakens around the urethra leading to the frustrating problem of involuntary urination and soiling of the home and pet bedding.  And while there are many factors often involved from anatomic problems, hormonal issues, and weakness of the nerves to the area, there are at least certain drugs that can help effectively control this symptom in the majority of pets.

One of the more common and effective first line choices often reached to by veterinarians is the prescription drug known as Proin.  By tightening the sphincters around the urethra, regular use of Proin can help pets better retain urine between incidences of voiding.  We will often use the lowest effective dose of Proin to control the problem, sometimes even being able to taper the dose to a few times a week down from the initial once daily to twice daily dosing often used.

Before your veterinarian places your pet on this drug, it’s important to rule out other medical disorders through a urine analysis, possibly urine culture and if indicated or needed, a blood panel and possibly x-ray studies. It’s also important, particularly in older pets to have blood pressure measured, as the increasing recognition of hypertension in dogs and cats from various cardiac and metabolic diseases can be exacerbated by the use of this drug. In fact, it was cardiac and hypertensive complications that led to the main ingredient in this drug being taken off of the human market only a few years ago.  However, in the vast majority of dogs this drug has proven safe most of the time.

When Proin fails to work, especially in spayed female dogs, the use of low doses of prescription estrogen or Stilbestrol (as it is known as) or DES, can sometimes be quite helpful in managing urinary incontinence in conjunction with Proin or by itself.  And while many of us learned in school of the dangers of estrogen therapy in dogs, I have not found in my 19 years of clinical practice many problems from using low dose hormonal therapy with estrogen to be problematic in dogs. However, these dogs all should be periodically monitored with blood work if taking DES or Stilbestrol long term.

I’ve found in my experience that some of the natural products out there like HomeoPets Leaks No More to not help most of the dogs I have tried it on. Sometimes chiropractic adjustments or acupuncture done by trained veterinarians can sometimes help those cases where weakness of the spinal nerves is involved with the urinary incontinence.

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33 Comments

  1. Dr. Michael Dym, VMD veterinarianJanuary 25, 2015 at 3:56 pm

    Thanks for sharing. Proin is often quite effective for this

  2. Hello. I have an 11 year old Airedale who has been taking proin. Unfortunately, she is still peeing everywhere. We are constantly changing her pull ups. My vet has done extensive blood work, urinalysis. Is there anything else that would help?

  3. We have a foster dog pittie mix who just turned 2. She is incontinent and has done well on proin for about 6 months. I also have her on a supplement. Suddenly she is having accidents. I know we need to check for uti since that is common in dogs with incontinence but she doesn’t have any of the tell tell signs of one. Does proin sometimes just stop working?

  4. Proin may sometimes need to have dose adjusted upward, which will need to be done by your prescribing veterinarian. Some pets will need other incontinent meds in the future as well, such as low dose estrogen therapy, etc. I would still have vet exam and urine analysis to make sure on secondary urinary infections present

  5. My 11 year old cocker spaniel has been on Proin for several years. None of the vets I’ve seen during that time have even mentioned the possibility of increased blood pressure, and they definitely never tested her BP before or after prescribing Proin. She ended up in the ER last week due to collapse. Her BP was 240. I’m furious with my vet but that’s a separate issue. I would like to know if increased BP is a lasting effect, or if it is supposed to remit once dosage is stopped. In other words, now that I’ve stopped the Proin, should her BP go down or is it too late? The flip side of that question is: if her BP doesn’t go down after she has been off Proin, does that mean something else is wrong or is it just a lasting effect from Proin? Thank you so much.

  6. YEs it is possible that proin may cause hypertension in a sensitive pet, however if blood pressure stays elevated after the drug is stopped, then it is likely a separate condition i.e secondary hypertension to other disease like kidney disease, cushings, etc although we do see high blood pressure without an underlying cause. If the high blood pressure is due to proin, then it should return to normal when drug is stopped

  7. Hi. My 6 lb female Yorkie is 13 yrs. not on any medication. She is incontinent only when she sleeps. I detected his on my bed 🙁 and when I wake up she has moved off my bed (because of the wet spot). My vet prescribed Stilbestrol. Is it common for a female dog to be incontinent only at night? I make sure she pees before bedtime. Thanks.
    Wendy M

  8. My 13 year old aussie was leaking everywhere proin started working in the first day and so far so good we are so happy for her. She knew it and was anxious about it 25 mg 2 times a day

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