How JustAnswer Works:

  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.

Ask PetDr Your Own Question

PetDr
PetDr, Veterinarian
Category: Veterinary
Satisfied Customers: 68
Experience:  PetDr has been a veterinarian for 13 years and working as a medical director in one of the best hospitals in NJ.
74969252
Type Your Veterinary Question Here...
PetDr is online now
A new question is answered every 9 seconds

We have an 11 year old, female mixed breed (dachshund + terrier),

Resolved Question:

We have an 11 year old, female mixed breed (dachshund + terrier), 21 pounds, spayed. She has been incontinent since January, and is on Paxon and Prion. Along with the above, the vet has treated her for a urinary tract infection and she seemed to get a little better. A urinalysis has showed a little blood and elevated protein levels in he urine. She is incontinent when she sleeps or just sitting there. If she is nervous, she is worse. We have spent about $1500 on her since January. They did the expensive blood tests to check her hormones and it did not seem to show any abnormalities. They do not find any lumps when they examine her manually. She has never had puppies and she does not seem to be in pain. The Vet is competent, but seems to be out of ideas that we can afford. Any ideas?
Submitted: 1 year ago.
Category: Veterinary
Expert:  PetDr replied 1 year ago.

I'm sorry to hear Ginger has not feeling good.

There are several important causes of incontinence and most of these are ruled in or out with a urinalysis and urine culture. The urinalysis reveals cell types and biochemical elements in the patient's urine while the culture isolates the bacteria growing in the urine. The bacterial species grown are identified and tested for their sensitivity towards different antibiotics, the end result being confirmation of the presence of infection and a list of appropriate antibiotics. Since Ginger was treated for urinary tract infectin and got a little bit better maybe it just cured the infection part of her bladder problem.

Most Cases of incontinence are due to:

  1. Infection of the urinary tract (usually bladder infection)
  2. Excessive consumption of water
  3. Weak bladder sphincter (especially common in female dogs)
  4. Spinal cord disease.

Aging, obesity, reduced sensitivity of neurologic receptors in the sphincter and possibly other factors all contribute to this condition which is especially common (up to one in five affected) in female dogs. Once other more serious conditions have been ruled out, the weak sphincter may be treated symptomatically with one of several medications.

Estrogens:
It is not entirely clear how estrogens are helpful in this treatment. Originally, estrogens were given to post-menopausal women with urinary incontinence and the treatment was simply extrapolated to dogs. It is possible that estrogens are important in the maintenance of neuroreceptors in the bladder sphincter and without estrogens the receptors become unresponsive to the transmission of the storage message from higher neurologic centers. (In other words, the message from the brain to hold the urine does not get through to the bladder.) In dogs, diethylstilbestrol (DES) is the most common estrogen used, though it is now only available through compounding pharmacies. Other estrogens that have been used include estriol (Incurin®) and conjugated estrogens such as Premarin®. Regardless of which product is used, the basic process is the same. A higher dose is utilized to begin therapy and, if it is effective, the dose is tapered to the lowest dose needed to maintain effect. For DES, dosing every couple of days is typical while with estriol most dogs end up dosed once daily.

In male dogs, testosterones seem to be more effective than estrogens, possibly through action on the prostate which sits at the neck of the bladder and incorporates the sphincter.

Alpha-Adrenergic Agonists:
These medications act by enhancing release of the neurotransmitter chemicals that act on the receptors of bladder sphincter. Effectively, they turn up the volume dial on the "hold it" message from the high neurologic areas. The usual medication for canine use is phenylpropanolamine, currently available in liquid and chewable tablets and is typically given two or three times daily. Ephedrine and pseudoephedrine, common decongestants, are sometimes recommended alternatively. Side effects can include irritability, appetite suppression (phenylpropanolamine was the active ingredient in many human diet pills until recently), and blood pressure changes. Most dogs, male and female alike, tolerate phenylpropanolamine uneventfully. For especially resistant cases of incontinence, estrogens and alpha-adrenergic agonists can be used together.

Anticholinergics:
Anticholinergic drugs are medications that work, not on the sphincter of the bladder, but on the rest of the bladder where urine is stored, relaxing the muscle fibers thus facilitating storage. An example of such drug would be imipramine, an anti-anxiety medication commonly used in humans. It has anticholinergic properties and can be used in combination with phenylpropanolamine in the treatment of animal incontinence. While phenylpropanolamine and DES are commonly used medications for this condition, imipramine is not but it does represent another option when a patient does not respond to the first two medications combined. Other anticholinergic drugs that might be used included oxybutynin or flavoxate.


Gonadotropin-Releasing Hormone (GnRH)
Several studies have been performed using analogs of this hormone (such as leuprolide) in incontinent dogs for which DES and phenylpropanolamine have failed. More than half of the dogs tested regained complete continence while still more achieved improvement.

I hope my answers were satisfactory, please let me know if I can further guide you on this matter.

PetDr, Veterinarian
Category: Veterinary
Satisfied Customers: 68
Experience: PetDr has been a veterinarian for 13 years and working as a medical director in one of the best hospitals in NJ.
PetDr and 4 other Veterinary Specialists are ready to help you
Expert:  PetDr replied 1 year ago.
Hi,

I'm just following up on our conversation about Ginger. How is everything going?

Dr. N. Ezik

JustAnswer in the News:

 
 
 
Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.
 
 
 

What Customers are Saying:

 
 
 
  • It was so professional, so personally concerned (as we were) and you answered all of our questions. George and I are so happy that I found "JustAnswer" on my Google search -- you are now in my "Favorites" list! And, yes we do love our kitty - she makes our life complete! Bev & George Boca Raton, FL
< Last | Next >
  • It was so professional, so personally concerned (as we were) and you answered all of our questions. George and I are so happy that I found "JustAnswer" on my Google search -- you are now in my "Favorites" list! And, yes we do love our kitty - she makes our life complete! Bev & George Boca Raton, FL
  • Wonderful service, prompt, efficient, and accurate. Couldn't have asked for more. I cannot thank you enough for your help. Mary C. Freshfield, Liverpool, UK
  • This expert is wonderful. They truly know what they are talking about, and they actually care about you. They really helped put my nerves at ease. Thank you so much!!!! Alex Los Angeles, CA
  • Thank you for all your help. It is nice to know that this service is here for people like myself, who need answers fast and are not sure who to consult. GP Hesperia, CA
  • I couldn't be more satisfied! This is the site I will always come to when I need a second opinion. Justin Kernersville, NC
  • Just let me say that this encounter has been entirely professional and most helpful. I liked that I could ask additional questions and get answered in a very short turn around. Esther Woodstock, NY
  • Thank you so much for taking your time and knowledge to support my concerns. Not only did you answer my questions, you even took it a step further with replying with more pertinent information I needed to know. Robin Elkton, Maryland
 
 
 

Meet The Experts:

 
 
 
  • Dr. Andy

    Medical Director

    Satisfied Customers:

    2630
    UC Davis graduate, Interests: Dermatology, Internal Medicine, Pain Management
< Last | Next >
  • http://ww2.justanswer.com/uploads/VE/vetforyou/2012-6-20_33122_PearlPhoto.64x64.jpg Dr. Andy's Avatar

    Dr. Andy

    Medical Director

    Satisfied Customers:

    2630
    UC Davis graduate, Interests: Dermatology, Internal Medicine, Pain Management
  • http://ww2.justanswer.com/uploads/1I/1ISUDVM/2011-3-1_22028_Honeymoon2005075294928803490646858.64x64.jpg Dr. Bruce's Avatar

    Dr. Bruce

    Veterinarian

    Satisfied Customers:

    1656
    12 years of small animal veterinary medicine
  • http://ww2.justanswer.com/uploads/RY/rydergar/2012-6-6_192240_IMG0328.64x64.JPG Dr. Gary's Avatar

    Dr. Gary

    Veterinarian

    Satisfied Customers:

    1451
    DVM, Emergency Veterinarian, BS (Physiology)
  • http://ww2.justanswer.com/uploads/PC/pcbobber/photo.64x64.JPG Dr. Bob's Avatar

    Dr. Bob

    Veterinarian

    Satisfied Customers:

    1306
    35 years in practice
  • http://ww2.justanswer.com/uploads/doggfone1/2009-07-16_133633_vet_pic.jpg Dr. Scott's Avatar

    Dr. Scott

    Veterinarian

    Satisfied Customers:

    865
    12 years of small animal, equine and pocket pet experience in medicine and surgery.
  • http://ww2.justanswer.com/uploads/AN/andrewDVM/2012-4-27_12585_iStock000011751407XSmall.64x64.jpg Dr. Drew's Avatar

    Dr. Drew

    Veterinarian

    Satisfied Customers:

    1889
    Small Animal Medicine and Surgery
  • /img/icons/shirt.jpg Dr. Jenn's Avatar

    Dr. Jenn

    Veterinarian

    Satisfied Customers:

    1225
    Practicing small animal medicine since 2004 , also involved in working with animal rescue groups.
 
 
 

Related Veterinary Questions