You may have been told by other pet parents, or even by your vet, that you should not take your dog off Proin all at once for fear of negative consequences. At the same time, you don’t want your pup to be continually burdened by the oft-maligned incontinence medication.
So, you’re probably wondering quite rightly, “Can I wean my dog off Proin?”
The truth is that the right answer is different for every dog. There have been many cases where owners suddenly and completely halted Proin administration– and their dog was none the worse for it.
There is also the slight possibility that very slowly weaning a dog off Proin that is working won’t cause it to revert back to a state of urine leakage.
This will be largely dependent on the underlying reason for the incontinence, which can range from neurological issues, to prostatic disease, to urinary infections.
Though Proin is prescribed mostly for long-term, indeterminate periods, a decrease in dosage may be possible if successful results warrant it.
Rather than completely wean a dog off Proin, it may be better and more effective to manage any urine leakage through a combination of medication and lifestyle changes.
Proin is not the only incontinence medication for dogs, and others such as estrogen can be substituted if your vet finds that it is causing significant negative side effects. There may even be some more natural options that can also help your pet with this troubling issue.
Regardless of the chemical used, prognosis for incontinence treatment in dogs is generally very good– so it may pay to explore and test out different solutions!
- First Things First: How Did My Dog Become Incontinent?
- How Long Does It Take For Proin To Work?
- How Long Can Dogs Stay On Proin?
- Is Proin Bad For Dogs?
- What Are The Alternatives To Proin For Dogs?
- In Summary
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Incontinence is relatively common in dogs– affecting, in particular, many female dogs that were spayed before 6 months of age. It is also more common in larger breed dogs than in smaller breeds.
Incontinence can arise from a wide variety of other issues as well, such as:
- Old age
- Diminished bladder function
- Bladder, kidney, and urinary tract infections
- Bladder and urethra abnormalities (stones, tumors, inflammation)
- Increased thirst
- Anatomic, spinal and nervous issues
- Neurological disorders
- Hormonal problems
All of the above issues may lead to weakened or overloaded sphincter muscles around the urethra, which will then result in an inability to hold urine properly.
Once the urethral sphincter, which normally acts like a stopper, no longer works as it should, it becomes only natural for leakage to occur. Frequently, involuntary urination occurs during rest time, during sleep or or even when your dog leisurely walks around.
Before a dog is placed on a medication like Proin (PPA), a vet will need to conduct tests such as urine analysis, x-rays, and blood panels to rule out unrelated factors and to make sure that the use of the medicine will be relevant and effective.
Proin usage will be most effective in cases of incontinence that is induced by hormones or spaying/neutering. Most dogs that suffer from leakage with these causal factors respond well to PPA treatment.
Proin contains the chemical phenylpropanolamine, which works by stimulating certain stress hormones and neurotransmitters to increase smooth muscle tone of the urethral organs. In turn, this should help to reduce urine leakage as the bladder neck is able to close more readily.
Proin should only ever be given to a dog under vet advice and instruction. It should only ever be given to dogs for which it was properly prescribed.
Before Proin is considered as an option for treatment, the root cause of the leakage should be established so that unrelated factors such as kidney or bladder infection can be ruled out.
The accurate, correct dosage needs to be consumed by the dog in order both for the medicine to be effective, and to reduce the likelihood of unwanted side effects.
It may still take several days from the initial dose of treatment before any improvement to urinary leakage is shown.
The recommended dosage of Proin is 0.91mg per pound of body weight, twice a day in half-tablet increments.
If a dose is missed, give it as soon as you realize. However, if it is close to the time for the next dose, skip it entirely and instead fall back to the regular dosing schedule. Never give two doses of Proin at once to make up for a missed dose.
Be careful not to leave a bottle of Proin open, or leave pieces lying around, as the medication is flavored and appealing to dogs.
There have even been reported instances of dogs chewing through closed bottles to get to the pieces- so make sure you keep them far out of reach!
A study has shown that Proin is safe and effective for dogs for at least a 28-day period. Throughout the clinical study, Proin was demonstrated to be effective in controlling leakage based on the significant reduction of urinary accidents per week.
The 123 dogs placed on Proin experienced 9 urinary accidents per week pre-treatment, but in only the first week of treatment this number reduced to 3.9. By week 4 of the study, average urinary accidents had reduced to only 1.6 per week.
150 dogs continued from this study onto an even longer 180-day (6 month) study, where 2mg/kg of Proin was determined once again to be effective for controlling incontinence with only one accident a week on average. It also achieved a 98.1% owner satisfaction rating in the study.
Once it is required, Proin is designed to be taken for the rest of a dog’s life. Generally speaking, it only provides relief for as long as it is used, and it is not a cure for incontinence.
Despite its intended long-term usage, prolonged ingestion of Proin is not without its potential share of adverse side effects. These will now be explored further below.
Typically, Proin is safe for dogs that are otherwise healthy. It is used successfully in many dogs to aid in the control of urinary incontinence caused by an abnormal loss of muscle tone in the urethral sphincter.
It is however not effective for incontinence in dogs caused by other factors such as urinary tract infections or neurological disorders. The safety of Proin for pregnant or nursing dogs also has not been evaluated.
Every medication has side effects and can cause adverse reactions in certain dogs. Proin, unfortunately, is no exception in this regard.
Pet owners need to consult with their vet and be aware of all the possible negative effects so that they can make their own educated decisions.
Proin has been noted to cause a large variety of side effects, ranging from the benign to the severe. A common mild side effect is increased thirst, so it is important to always make sure that the dog has easy access to clean, fresh water.
Proin should not be taken by dogs with pre-existing heart, liver, or kidney diseases, or those with diabetes, glaucoma, or hypertension. It should also not be taken in conjunction with other medicines such as antidepressants or blood pressure drugs.
Extensive studies have shown that the following adverse reactions (listed from the most common to least) can occur during an extended period of Proin treatment:
- High blood tension (hypertension)
- Inconsistent heart rate
- Vomiting (emesis)
- Loss of body weight
- Lack of appetite (anorexia)
- Excess protein in the urine (proteinuria)
- Excessive thirst (polydipsia)
- Lethargy and weakness
- Behavioral changes such as anxiety or aggression
More serious adverse events have also been reported by dog owners since 2015. These include blood in urine, arrhythmias, seizures, ataxia (nervous system degeneration), liver failure, and even death.
Events of sudden death were often preceded by neurological signs and collapse. Internet dog forums abound with personal testimonies of Proin toxicity.
Proin is also easily overdosed, especially if the dog gets a hold of a whole bottle and swallows multiple tablets. Symptoms of Proin overdose can include arrhythmia, agitation, skin rashes, hypertension, excessive drooling, lethargy, tremors, and inability to empty the bladder.
If your dog has overdosed on tablets, or if you notice the above signs, take it to the vet immediately for examination and treatment.
At the end of the day, it is the sad truth that many drugs and medicines can and will shorten the life of a pet. It is equally true that misuse of those drugs will negatively affect a dog’s lifespan.
However, it must be kept in mind that these same drugs were developed and tested with the intention of the very opposite effect: To improve the quality and length of life.
It has not been scientifically proven that any holistic treatment can effectively treat urinary incontinence.
However, there are a few that have been said to be useful, at least anecdotally, that you may want to try with your pup:
Leaks No More from HomeoPet is a canine incontinence solution that has been around for over 20 years and has quite the following around the internet. A quick search on Amazon shows that it has a 4-star rating with nearly a thousand reviews to date.
It contains natural active ingredients such as aluminum oxide, Lytta vesicatoria (Spanish fly), causticum, gelsemium sempervirens root, and greater plantain- all of which have medicinal properties that can be helpful for urinary conditions.
‘Leaks No More’ is easily applied via dropper, and is to be given at 3 weight-dependent doses/day in the beginning. It is said to be fast-acting, and as symptoms subside the doses can be reduced.
Eventually if there are no more symptoms, use of the drops does not have to be continued! That is sure to be great news for owners who are reluctant to keep their pets constantly medicated even with natural therapies.
Since ‘Leaks No More’ is completely natural, it is safe for long-term use with no known side effects, and can be given to young and old dogs alike.
Compared to other forms of treatment, it is fairly inexpensive and may be a product worth trying, especially if you are a dog owner that is worried about the harsh chemicals in incontinence medications like Proin and estrogen.
Diethylstilbestrol (DES) is another off-label medication that can be used to treat urinary incontinence in dogs. Its use in vet medicine is primarily reserved for spayed female dogs.
DES is given in pill or liquid form, and is thought to work by increasing the sensitivity of the nerves in the smooth muscle of the bladder neck. This causes the muscle to be able to tighten more easily- thereby preventing urine leakage.
It may be suitable as an alternative for dogs that don’t tolerate Proin well. However, do be aware that DES comes with its own set of precautions and side effects.
DES should not be used by animals with a known allergy or hypersensitivity, or by animals that are on potentially contradictory medications. It should also never be used in pregnant dogs.
At excessive doses, DES and estrogens can reduce bone marrow in the body, leading to a significantly lower blood cell count. This can then result in clotting difficulties, heightened risk of infections, and anemia. Often, this damage is long-term, irreversible- and can be fatal.
Adverse symptoms of DES can include:
- Pale gums and tongue
- Abnormal discharge from genitals
- Loss of appetite
- Blood in stools.
Given the potential risks, use of DES needs to be strictly monitored by a qualified vet. Realistically, it may not be any less harsh than Proin, and should only be considered a possible alternative if Proin is not well-tolerated.
(Please note that I am not a trained vet, and the list below is only a compilation of remedies and methods that I have found across the internet that have been said to be helpful- at least anecdotally. It may be worth doing more research of your own into each of these products.)
- Apple cider vinegar: Quite commonly used as a home remedy for incontinence in dogs. A few capfuls of ACV can be soaked in bread or added to drinking water and fed to the affected dog daily. However, do not give too much as it can make the dog’s urine pH overly alkaline.
- Cranberry supplements: Beneficial for healthy urinary tract function, bladder support, and urinary tract infections. Urinary tract health can be highly related to incontinence, so it may be worth making sure that your dog’s urinary system is functioning optimally.
- Parsley: A natural diuretic, which means that it increases urine production and facilitates its rapid excretion from the body. Can be helpful for urine leakage problems as it will help to purge any residual liquid from the bladder.
- Corn silk powder: Another natural diuretic that is also soothing for any irritation or inflammation in the bladder.
- Bladder/urinary support supplements: Natural supplements that commonly contain pumpkin seed, rehmannia, wild yam, saw palmetto, soy protein extract, olive leaf, and vitamin B6 can also be helpful in resolving incontinence in dogs.
- More frequent toilet trips: Logic dictates that the more frequently you take a dog out for toilet breaks, the less urine that it will hold in its bladder. The less urine in its bladder, the less leakage there will be!
- Dog diapers: Though not a remedy in itself, dog diapers can be a godsend for dogs (and their owners) that are battling incontinence. For a complete guide on choosing the right doggy diaper for your pup, click here!
At the end of the day, Proin is a medication that is designed for long-term use for indeterminate periods of time. It is a treatment but not a cure, so there is a risk that urine leakage problems may come back if a dog is taken off the drug.
That doesn’t change the fact that it can be worrying for us dog owners when we have to consider the possibility that our pup has to take medicine for the rest of its life- especially something with potentially strong side effects such as Proin.
However, as long as the dog is not pregnant or nursing, isn’t on other medications, doesn’t have other pre-existing conditions, and doesn’t experience side effects, it is generally safe to continue dosing Proin until the situation changes or improves.
If your dog does display improvement in its leakage symptoms, it may be possible to reduce the dosage of Proin very slowly to see if that improvement can be sustained.
For dogs that do not tolerate Proin well, alternatives can include estrogen (DES) and natural, homeopathic treatments such as “Leaks No More”.
Other natural supplements such as apple cider vinegar and urinary support tablets may also be helpful, so be sure to try them out for your dog if nothing else seems to be working!
Heather Abraham is an owner of two dogs, one cat, a leopard gecko, and a parrot (who her dad still cannot teach bad words to), and an avid blogger. From the time she was a young girl, she always felt a connection with pets. She brings her love of every type of pet to you, with information on animal nutrition, medication, toys, beds, and everything else in between. Along with newly-on-board veterinarian DVM editor Elena, she puts pups first while offering other various fun tidbits along the way.