Urinary Incontinence
Urinary incontinence is an involuntary loss of urine or the lack voluntary control of micturition (urination). The most common clinical signs are urine dribbling from a recumbent or sleeping dog. Dribbling may even occur in the standing dog when not excited.
In spayed (desexed) bitches urinary incontinence is reported to have an incidence of between 11-20%. Acquired urinary incontinence occurs in 20% of spayed dogs with a strong correlation between bodyweight and the risk of urinary incontinence. Bitches with a bodyweight of more than 20kg have a risk of 30%, while smaller dogs have a risk of 0%.
Risk Factors
- Age
- Anatomy
- Breed
- Lack of circulating oestrogen
- Size or weight
- Spaying (desexing)
Urine is contained within the bladder and is prevented from leaking out by the urethral sphincter which consists largely of muscles. The activity of the muscles is both voluntary and involuntary. The sphincter normally remains closed until the animal decides to consciously urinate. If the sphincter is lax, as occurs in incontinence, urine will leak out.
Inconvenience of Urinary Incontinence
- Additional cleaning of the household to maintain a healthy environment
- Damp bedding
- Excessive licking of genital area
- Hair around external genitals is soiled with urine
- Urine soiling of furnishings and floor coverings
- Scalding and inflammation of area around genitals
- Strong unpleasant odour
Treatment
Stilboestrol
The traditional treatment has been Stilboestrol (1mg tablets). Dogs start on a high dose which is then stretched as far as possible eg. 1 tablet every 10-14 days. Stilboestrol can suppress the bone marrow so dogs should have a blood cell count done on a regular basis to ensure this does not happen. At 10-14 day intervals, this is less likely to occur.
Suprelorin
A slow released implant called Suprelorin has shown great promise in the management of incontinence in desexed female dogs. Suprelorin reduces elevated levels of circulating female hormones (FSH and LH), a phenomenon seen in desexed female dogs.
Reduction of FSH and LH has been shown to have high success rates in treating urinary incontinence. Duration of the response ranges from 21-365 days with an average of 159 days.
In those case where Suprelorin did not completely resolve the incontinence, the addition of Propalin to the regime was successful.
Propalin Syrup
Propalin relaxes the bladder wall while contracting the sphincter muscle.
Prescribing and Use Information
PropalinTM Syrup
Each ml contains: Phenylpropanolamine hydrochloride 50 mg/ml
Actions
Phenylpropanolamine increases sphincter tone.
Indication
For use in bitches in the control of urinary incontinence associated with urethral sphincter incompetence.
Directions for use
To be used by or under the direction ora registered veterinary surgeon.
Dosage
Bitches- 3 mg/kg daily in divided doses with food.
Contraindications and Precautions
- Propalin syrup is contraindicated in pregnant bitches.
- The effects of Phenylpropanolamine on lactation have not been established.
Side Effects
Sympathomimetics may produce a range of effects most of which mimic the results of excessive stimulation of the nervous system.
- Aggressiveness and restlessness have been noted in some dogs during treatment
- Lethargy and inappetence have been reported following overdosing.
- Propalin Syrup contains sorbitol which has laxative properties.
This is unlikely at the recommended dose. Treatment is symptomatic. No specific antidote is available.
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