Anything new for incontinence?

RE: Anything new for incontinence?

janine redman — Sun, 15 Apr 2018 22:30:01 GMT

WE have a border collie bitch who needed both incurin and propalin syrup and didn’t acheive 100% continence . Started enurace and has been fine for years although needs to go out frequently for an hour or so after a long walk as well

RE: Anything new for incontinence?

Julie Innes — Fri, 13 Apr 2018 22:29:31 GMT

Ha! Wasn't allowed to shave any hair for biopsy, so took it from hairless area

RE: Anything new for incontinence?

Julie Innes — Fri, 13 Apr 2018 22:29:01 GMT

Ha! Wasn't allowed to shave any hair for biopsy, so took it from hairless area

RE: Anything new for incontinence?

Beats — Fri, 13 Apr 2018 21:08:34 GMT

just wait for the hair to grow back in the area of the biopsy :-)

Then we'll be able to have a chat about the ethics and evidence for microneedling ;-)

RE: Anything new for incontinence?

Julie Innes — Fri, 13 Apr 2018 19:48:13 GMT

Update- dog came for post OP check after skin biopsy, and owners brought me wine and chocolates for " going above and beyond" in finding out all their options . They are still going to try the homeopathy but are happy we have a plan to fall back on.

So if nothing else this thread got me wine, chocolate and half an hours CPD

RE: Anything new for incontinence?

Julie Innes — Thu, 12 Apr 2018 19:26:29 GMT

Ach, they are hard work, but actually quite nice with it. Male owner is actually not bothered that the dog is bald on one side, and Mrs just wants to know why, and fix it if possible! Her worry is that dog will go bald all over, and I can't promise her it wont!

They do test my patience a little, but they do love their dog and want her to be happy. And they give good presents

At least I have a plan when, sorry if, the homeopathy doesn't work! And if nothing else I've learned lots from this thread!

RE: Anything new for incontinence?

Clive Ansell — Thu, 12 Apr 2018 18:22:27 GMT

[quote user="Anthony Todd"]

Come on, I don't think many owners would tolerate urine smell or liquid in their house and nor does any dog.!

Don't know why the owner is, in any way, to blame or criticised!

Keep trying all the suggested proven [even if n=1] and hope.

Support the owner in a very stressful, pungent, situation!!

Stale urine is not a good aroma!!

[/quote]

I was only joking my Dear

Agree on all counts, in which case continue Incurin as it works. These owners do sound like arse ache though.

RE: Anything new for incontinence?

Anthony Todd — Thu, 12 Apr 2018 18:17:59 GMT

[quote user="Clive Ansell"]

5. Rehome the dog to sensible owners

6. Refer owners to psychologist

[/quote]

Come on, I don't think many owners would tolerate urine smell or liquid in their house and nor does any dog.!

Don't know why the owner is, in any way, to blame or criticised!

Keep trying all the suggested proven [even if n=1] and hope.

Support the owner in a very stressful, pungent, situation!!

Stale urine is not a good aroma!!

RE: Anything new for incontinence?

Clive Ansell — Thu, 12 Apr 2018 16:50:10 GMT

Given that Alopecia is a reported, albeit rare, side effect of Incurin maybe moving away from an oestrogen type drug to a sympathomimetic like Propalin (try it again) or Enurace would be a cunning plan?

RE: Anything new for incontinence?

Clive Ansell — Thu, 12 Apr 2018 16:34:35 GMT

[quote user="Jo Dyer"]Makes you wonder, doesn't it? They certainly sound like stressful owners[/quote]

Yes. I was only half joking when I suggested either rehome the dog or rehome the owners.

Right dog, wrong owner syndrome.

RE: Anything new for incontinence?

Jo Dyer — Thu, 12 Apr 2018 15:24:28 GMT

[quote user="Anthony Todd"]Maybe the dog feels threatened when she is on her bed etc and urinates out of fear??[/quote]

Makes you wonder, doesn't it? They certainly sound like stressful owners, and she is a sensitive collie. Maybe this is a case where homeopathy will effect a cure...... Owners are more relaxed, are assured that she will get worse before she gets better, caregiver placebo, Bob's your uncle!

RE: Anything new for incontinence?

Clive Ansell — Thu, 12 Apr 2018 14:57:50 GMT

[quote user="Anthony Todd"]

To be fair, I wouldn't like an incontinent dog indoors much so you can't be too hard on the owners, particularly as vets aren't actually nailing the problem.

PS Dogs hate incontinence as much as the owners!

[/quote]

Agree. Just continue with Incurin then in this case, given that it works.

RE: Anything new for incontinence?

Anthony Todd — Thu, 12 Apr 2018 13:22:17 GMT

To be fair, I wouldn't like an incontinent dog indoors much so you can't be too hard on the owners, particularly as vets aren't actually nailing the problem.

PS Dogs hate incontinence as much as the owners!

RE: Anything new for incontinence?

Clive Ansell — Thu, 12 Apr 2018 12:50:51 GMT

Seems to me options are:

1. Live with the hair loss, which after all is just cosmetic. Maybe revisit investigation for Thyroid or refer to a dermatologist. Or just give it time and see what happens.

2. Live with the incontinence and see if the hair regrows. (Not ideal)

3. Look at other medical options. I have an old English Setter in one of my practices on Enurace which works well, and where both Incurin and Propalain haven't work.

4. Refer for evaluation for culposuspension surgery etc

5. Rehome the dog to sensible owners

6. Refer owners to psychologist

7. PTS (for dog not owners) (Bit drastic, but would relieve dog of idiot owners)

RE: Anything new for incontinence?

Julie Innes — Thu, 12 Apr 2018 12:50:42 GMT

She isn't polydipsic (I have used the boiled water trick in those guys, after reading it on here!)

I have called the owners, and they are keen to go down the homeopathy route for now.

We have a plan in reserve if that doesn't help- they would like to avoid surgery etc, so keen to trial enurace in the first instance. if we can wean her off the incurin to see whether the hair actually grows back, that would be good! If it doesn't, she may as well be on the incurin, they feel!

However I have mentioned the surgical options (I think the occlude was mentioned to them at their last referral- they said they were told she would have a pump on her leg?) and the collagen injections, which they will consider (but are worried she was "traumatised" by her catheterisation last time...

I'll let you know how it goes! In the meantime, I am off the hook

RE: Anything new for incontinence?

Anthony Todd — Thu, 12 Apr 2018 12:28:07 GMT

I suppose the bitch was totally continent before spaying?? [just a thought]

Glad to see the boiled water trick is resurfacing, [the ridicule I have received in the past....]

Let them try the homeopathy; can't do any harm and the bitch may be growing out of it, with the boiled water trick to help bladder distension, at night too.

Who cares if what ever works!!

Maybe the dog feels threatened when she is on her bed etc and urinates out of fear??

?? keep her in the clinic for a day and see how she is??

RE: Anything new for incontinence?

Julie Innes — Thu, 12 Apr 2018 12:27:23 GMT

Thanks again guys! The only neuro signs in this case are in the owners!

I will certainly go over the surgical options with them again. They do listen to me, but didn't like their experience of referral last time, but I could possibly refer them somewhere else. As I said they are keen to go down the homeopathic route, maybe I should let them get that out if their systems...( they know my views, but...) Then they might be more amenable to other medical options

RE: Anything new for incontinence?

Lucy Fleming — Thu, 12 Apr 2018 12:21:08 GMT

[quote user="gerard mclauchlan"]I just feel that in such a young dog I would be less keen to have a foreign implant given the possbility of tissue reaction etc[/quote] Thank you, that makes sense. [quote user="gerard mclauchlan"]normally causes neurological signs and haematological abnormalities[/quote] I've only ever seen two - and they presented with the more typical neuro signs/ pancytopaenia. Wasn't sure if this might be an odd manifestation of muscle weakness, but probably would have expected more progression by now.

RE: Anything new for incontinence?

gerard mclauchlan — Thu, 12 Apr 2018 12:13:44 GMT

Hi.

I just feel that in such a young dog I would be less keen to have a foreign implant given the possbility of tissue reaction etc. Just personal choice really but alot of it ultimately may come down to owner choice/finance.

Border collies have selective cobalamin deficiency due to transported mutation - normally causes neurological signs and haematological abnormalities

RE: Anything new for incontinence?

Lucy Fleming — Thu, 12 Apr 2018 11:54:41 GMT

[quote user="Julie Innes"]But my client feels there should be something else "in this day and age"![/quote]
Well, there is... collagen or an implant. But they'll need to get over projecting their own neuroses onto the dog the worry about sedation to pursue them.

[quote user="gerard mclauchlan"]The main issue with collagen is the need to repeat every 6-18 months. If cost was not an issue to the owner this would be my preferred method in a young bitch so we did not need to put a permanent implant in. [/quote]

I'm curious about this...I would have thought in a young animal, a more permanent solution would be preferable? Does the occluder have a limited life span? Or are there significant complication risks? (I'm doubly curious as I have just referred an incontinent bitch whose owner is keen to find a possible surgical solution. Incurin does control her, but only now at a dose that has ever male dog for miles around following her whenever she goes for a walk...)

Have you checked for that weird B12 absorption problem that collies get? I can't immediately link it to the clinical signs if she is otherwise well grown and not ill, but might be worth checking. Of course, then you would have to shave for a blood sample...

RE: Anything new for incontinence?

Julie Innes — Thu, 12 Apr 2018 11:50:56 GMT

[quote user="Anthony Todd"]Any signs of male attraction yet?? [re dose adjustment[/quote]

yes, this has been a bit of a problem for a while (another reason the owner would like an alternative!)

As a slight aside, has anyone ever used melatonin for these type of hair losses? Owner had read about it online, and I agreed we could possibly try it, but have never used it. Obviously might be better to see if stopping oestrogen would be the answer, but if we didn't/ couldn't any idea if this will help

RE: Anything new for incontinence?

Glenn Hodgson — Thu, 12 Apr 2018 11:50:19 GMT

After a thorough review, all I can find that may work within your clients remit of no side effects is below. And boil the water 1st so the dog does not drink as much?

https://www.petplanet.co.uk/product.asp?dept_id=5956&pf_id=69499&ptm_source=google&ptm_medium=shopping&ptm_campaign=under10_69499&campaign=324014531&adgroup=24641921891&keyword=&gclid=EAIaIQobChMIksO82Me02gIVzrftCh2MWwwOEAQYASABEgIu0vD_BwE

RE: Anything new for incontinence?

Anthony Todd — Thu, 12 Apr 2018 11:43:14 GMT

Nothing to lose by trying any drug recommended on here. Not many drugs never have side-effects though.

Any signs of male attraction yet?? [re dose adjustment]

RE: Anything new for incontinence?

Julie Innes — Thu, 12 Apr 2018 11:35:18 GMT

[quote user="Anthony Todd"]I would think that incontinence is worse than baldness [speaking personally and authoritively.....][/quote]

I would too, Anthony! But my client feels there should be something else "in this day and age"! We have tried reducing the incurin, but as soon as we do the incontinence returns. When we up the propalin the D+ returns .

Enurace- I have used it once, in my own incontinent male dog, at the suggestion of a specialist. Didn't work for him (but obviously he wasn't showing USMI!), but no side effects. In BSAVA formulary with urinary incontinence being an indication, so I guess it is one to consider. This is an owner, however , who wants a guarantee of no side effects..

RE: Anything new for incontinence?

Sarah Keir — Thu, 12 Apr 2018 10:51:01 GMT

Ephidrine and epinephrine (i.e. adrenaline) seem pretty similar to me, but I'm no pharmacologist '

http://armymedical.tpub.com/md0913/Differences-Between-Epinephrine-and-Ephedrine-Drug-Dosage-and-Theraphy-129.htm

Those pharmalogical effects seem pretty unwanted to me and you get tolerance