Jada and Incontinence

[LindaD]

Jada is now 9 years old. She's a Doberman and was spayed when we got her from the rescue. I know nothing about who spayed her or how young she was at the time. Female spayed dobies often have some urinary incontinence. Of the 5 we've had, 2 have had incontinence. The typical treatment now is to give phenylpropanolamine. This used to be sold as Dexatrim in the US and was used for appetite suppression in people. But it was taken off the market for that. Now it's sold for dogs as Proin.

Jada has always dribbled a bit so she was put on Proin when we got her at about 1 1/2 years of age. The drug works by improving the tone of the urinary sphincter muscle which tends to relax after spay in some dogs. A low dose worked well until this last spring. Then she began dribbling again. Usually she would wake up in a wet bed (not ours, thank goodness). Checks for UTI were negative so we upped the dose of Proin. That helped for a while. In Sept. when she went in for her checkup, the dose wasn't working well and we had to get up during the night to take her out. That gets old very fast!!! The vet suggested we switch to Incurin, which is estriol, a human estrogen which was supposed to work well in dogs. It didn't work for Jada. Over the past 2 months we've been fiddling with the dose, combining it with Proin and still she did not have full control. Now for Jada this is traumatic as she is terribly fussy about cleanliness and gets very upset if she sees a wet spot on her bed or carpet.

So, Monday it was back to the vet for another workup. No UTI, so that was good. But the relatively high dose of estriol had other effects and it looked like she was going into "heat". So, that wasn't working and her Proin dose was as high as we used before we started the estriol. It turns out that the estriol (Incurin) is rather new for use in dogs. As I read the package insert it seemed that it didn't have a really good success rate in totally curing the incontinence. And the vet concurred that it was a problem in larger dogs and they had at least 3 now that didn't improve on it. I was really worried about Jada since it seemed that the only solution might be some surgery and that doesn't always totally cure the problem either. But the vet suggested we try DES, diethylstilbestriol. This is a synthetic estrogen that has been banned from use in humans. It results in vaginal cancers in the women who were exposed in utero. But it's use in dogs is okay, especially since this is a problem mainly in spayed dogs. My understanding was that it was in the process of being taken off the market for dogs as well, but apparently that isn't the case. She suggested we go cold turkey with the other drugs and start her on DES. I was skeptical because that was the advice given for the estriol (Incurin) and she was miserable with absolutely no control at all. But it WORKS!!! She's much more comfortable off the high dose of Proin and has had complete control! Now it's only 2 days, but it's the first time she hasn't had problems for months. She seems so nice and comfortable and confident that it's a different dog! I hope it continues and we can work down on dose. Many dogs get a dose only twice a week. And my wallet will LOVE that too. And I'll have so much less laundry to do as well. And we can have sweet dreams throughout the night.

Linda

[JGallo]

That's great news, Linda. It's good that they have medicines that can treat the incontinence. Of course there are always doggie diapers, but not all dogs will wear them.

I'm glad to hear that the new drug is working, and I'm filing that one away in my notes even though my two are young.

[LindaD]

Jill: I've been doing a lot of reading lately. It seems that there is some thinking that during spay surgery, some nerves may be injured that causes the problem. I know my vet asked where Jada was spayed (I don't know since she came through the rescue). But it does seem to get worse as they age and may show up late in life.

We had considered doggie diapers, but there is a drawback even if they will wear them. The constant wetness causes odor, rashes and irritation. I've heard of people having big problems with them when used for long periods of time.

The other interesting thing is that certain breeds are more prone to this problem including shepards and dobies.

Linda

[JGallo]

Jill: I've been doing a lot of reading lately. It seems that there is some thinking that during spay surgery, some nerves may be injured that causes the problem. I know my vet asked where Jada was spayed (I don't know since she came through the rescue). But it does seem to get worse as they age and may show up late in life.

We had considered doggie diapers, but there is a drawback even if they will wear them. The constant wetness causes odor, rashes and irritation. I've heard of people having big problems with them when used for long periods of time.

The other interesting thing is that certain breeds are more prone to this problem including shepards and dobies.

Linda

I considered using them with Amy when she was older but only at night. That seemed to be when she'd leak a little. We never did, but I can see the rash being a problem if they're left on for a long time.

[KarenA]

My aunt took DES and her children have been examined carefully for years since DES children can end up with cancers in the reproductive organs. I'm glad the drug is having a second life and is doing so much good for Jada. Fingers crossed that this continues - what a sad state of affairs it's been for your girl - I'm not surprised she's so much happier.

[LindaD]

Yes, Karen. I was born during the time when DES was used, but luckily my mother didn't take it. We were joking with the vet that we didn't really have to worry since Jada was already spayed. But then she brought up an important issue. She pointed to one of the office women, now about 6 months pregnant, and said -- don't let her have it. In fact, they usually give the medicine to the office women to give to the client when the bill is paid, but not this time. It got me to thinking about the techs handling the drugs when they count out the pills and also individuals who have to give it to their dogs. I can see why they want to get away from it's use, but if nothing else works . . . and it seems that it's the last resort. I'm just glad it's working.

Linda

[MaryH]

Jill: I've been doing a lot of reading lately. It seems that there is some thinking that during spay surgery, some nerves may be injured that causes the problem. I know my vet asked where Jada was spayed (I don't know since she came through the rescue). But it does seem to get worse as they age and may show up late in life.

We had considered doggie diapers, but there is a drawback even if they will wear them. The constant wetness causes odor, rashes and irritation. I've heard of people having big problems with them when used for long periods of time.

The other interesting thing is that certain breeds are more prone to this problem including shepards and dobies.

Linda

Yes, those nerve problems are why my vet recommended that I do the laproscopic ovary-removal for Elsie rather than a traditional spay, as it leaves the uterine tissue in place, causing it to atrophy but prevents the nerve and connective tissue damage that typically is considered part of the problem with a traditional spay, and causing incontinence. I was THRILLED that this was even available - gee, spay my dog and she only needs to be quiet three days instead of a whole week and only has a few teensy stitches instead of a line of them up her tummy? Sign me up! I was so thrilled to have that available. Oddly, only Tilly's spay was less trouble-some - she had a tiny incision, only about half an inch long. All I can say is that her vet at the animal shelter sure knew his business - he or she was an absolute master. But yet, she too had some incontinence as she aged. Initially, we thought it was the same type of cause, but because of her kidney and liver issues, we decided to stick with a proto-estrogen compound, trying a soy supplement that was supposed to break down into estrogen. And when we tried that, and before that, the Prion, guess what happened? Things got WORSE. Whoops!! So estrogen wasn't the issue. We finally decided that it was really mostly due to her kidneys failing, and we just learned to make do - I was lucky in that she'd try to wake me when she was having a problem, or Sadie would come and get me if I was home and awake, so it became a matter of keeping ahead of the mess.

What helped me was a set of washable crate pads that are made from bed pads used in hospitals - those were a godsend. I would put these all over the house, I think I had almost a dozen of them. Anywhere she was likely to sit, lie down or just rest for a few moments. If she'd get up and it was wet, I'd toss them onto the backporch or into the basement, and wash them later that day. No fuss, just swap them for a clean one. And I always made sure I had at least four or five clean at any point in time.

-Mary

[LindaD]

Mary: I'm amazed at how some vets are so good at spays and others aren't. I have had kittens where their spay surgery is almost bandaid surgery, the incision is so small. There's a vet here who does relief work for other vets. He's got terrible people skills, but he's the best darn surgeon around. I've never had a problem with one of his spays. OTOH, one of the cats I took in and was operated on by another vet almost died because a blood vessel was cut. The poor girl had an incision about 4 inches long!

As for Jada, today is the day we start to step down in DES to a dose every other day. Up to now she has been amazingly dry! She now can hold it all night with no trouble. This is probably the first time in about 10 months that we haven't been awakened by her licking. Now we see how low in dose we can go. So far Jada seems to be so much happier and calm. I think the Proin was not good for her at that dose. I'm hoping we can eventually get to 2 X a week dosing as that will be really inexpensive too! I'm now so used to having a huge pharmaceutical bill on my credit card each month. Now without Bacchus' meds and Jada's meds getting less expensive, it will be good to see a low bill for once.

As for the bed pads, a friend has a very old dog that was her mother's. She has a 10 yr old son, they just lost their dog and she lost her husband to cancer recently. So, she's trying to keep the dog as long as possible for the son. This dog has urinary incontinence as well, but it's from old age and probably kidney issues, like Tilly. She keeps the dog confined in a small area and covers the floor in their with disposable pads such as are used in the hospital and nursing homes. Since the dog is now just sleeping most of the day and doesn't chew or scratch on the pads, it's working out quite well. She's washing beds occasionally, but the pads are doing the job. It's an alternative for dogs that are getting quite old. But Jada is too young for that and we were looking for a better alternative. It looks like we finally found one. So far so good.

Linda

[BeckyMorgan]

Sticking my nose in to say thanks for putting that link up, Mary. I was just thinking about these the other day. We have a new Breeze litter box, but the tray isn't quite up to Maine Coon volume and I hate to keep using disposable bed pads for backup (I usually get the opened packages at Goodwill for either 49 cents or a dollar, but it's the idea of extra trash.)
Wish they had they waterproof ones in a bigger size.

[MaryH]

Lol - even at sixteen, Tilly was still a master of havoc, if I used the paper pads, she'd rip them into confetti, and at the very least, scatter them around (we thought we'd control the mess by putting her into an x-pen and put a "floor" of pee pads lining the pen - yeah, we did that for only about a week before we gave up).

I'm glad that this medicine is working so well! It's nice to have the house suddenly a lot cleaner. And it's amazing that it's going to be cheaper overall, too!!

[JGallo]

Linda, when Amy was older and sometimes leaked a little I would put a garbage bag underneath wee wee pads. That seemed to work for her and at 15 she didn't bother chewing them.