Phenylpropanolamine, is a pretreatment blood sample advisable?

RE: Phenylpropanolamine, is a pretreatment blood sample advisable?

Stephen Courtney — Wed, 30 Oct 2019 21:13:31 GMT

I doubt the haemoabdomen had anything to do with propalin. And I don’t that a pre treatment blood sample would have shown anything of interest.

where would this lead? Adding full bloods, urinalysis, abdo scan to every minimum data base?

what you did, I always do. The dog has likely USMI with a concomitant disease, that probably has nothing to do with the incontinence

RE: Phenylpropanolamine, is a pretreatment blood sample advisable?

Lindsey Edwards — Fri, 25 Oct 2019 14:12:41 GMT

[quote user="Neil Wheadon"]Care should be exercised in treating animals with severe renal or hepatic insufficiency, diabetes mellitus, hyperadrenocorticism, glaucoma, hyperthyroidism or other metabolic disorders.[/quote]

A thorough clinical exam should pick up indications of 'severe' issues in the above; elderly GSD with 'ticking time bomb' waiting to rupture would not really fit with the above concerns and possibly wouldn't be picked up even! An over enthusiastic dose of a sympathomimetic may have precipitated the crisis through blood pressure/cardiovascular changes but not have caused the underlying weakness?

I do insist on a urine sample prior to propalin first use to rule out other common causes of nocturia/incontinence etc; would suggest/insist on bloods if clinical picture raised concerns (pu/pd, weight loss etc) but not as a routine.

I do tend to actively raise the issue of geriatrics and the potential for multiple issues arising - like a house of cards it can take very little to destabilise and even minor symptoms and changes can be red flags! Often owners are comfortable with the palliative relief of symptoms rather than an intensive workup...would full bloods/scans etc have changed this dogs outcome?

RE: Phenylpropanolamine, is a pretreatment blood sample advisable?

Bob Russell — Tue, 22 Oct 2019 11:08:36 GMT

I waited for a number of years to find an abnormal Apoquel blood test. Still not found one. Anyone else?

If a patient is in pain then it needs relief. If owners will not blood test then note it on the records and warn that medication might lead to increased risks. Choice of pain relief might be influenced by results but surely better to have 12 months in comfort rather than 13 months in misery?

Going back to the OP. I want a urine sample at least. Bloods depend on the presence or absence of symptoms.

Blood tests in hyperthyroid cats can be reduced with good clinical monitoring and a sensible owner.

The key thing is to communicate with owners and offering options is in order. Dictating routine testing is not our job as clinicians.

RE: Phenylpropanolamine, is a pretreatment blood sample advisable?

David Mills — Sun, 20 Oct 2019 19:42:13 GMT

[quote user="janine redman"]In an older dog both urine sample and basic blood check would be advisable.[/quote]

They wouldn't, though.

The case described is abnormal. According to clinical exam the dog was healthy.

Thousands or millions of dogs have been started on this medication without pre testing, safely and without issue. The number needed to test - assuming anything would come up on bloods - is huge for very little benefit. Just like pre ga blood testing.

The case described is correlation, not necessarily causation. Anecdote has no place here. What are your figures for picking up these abnormalities you describe?

Witholding nsaids for dogs with arthritic pain whose owners say no to a blood test is unethical. Vets propagating this nonsense need to have a long hard look at themselves.

Likewise routine biochem for those on long term nsaids fundamentally misunderstand the pharmacology of these drugs and renal effects.

RE: Phenylpropanolamine, is a pretreatment blood sample advisable?

janine redman — Sun, 20 Oct 2019 19:12:40 GMT

In an older dog both urine sample and basic blood check would be advisable. Perhaps not in a young fit bitch though I would offer it routinely. Not all owners are good at noticing increases in thirst

RE: Phenylpropanolamine, is a pretreatment blood sample advisable?

Beats — Sun, 20 Oct 2019 17:59:40 GMT

Would a pre-treatment ultrasound scan not make more sense than a pre-treatment blood sample (what parameters do you have in mind)?

Or perhaps a regular abdominal ultrasound every year/month/week/day* in every German Shepherd after its 13th birthday?

*delete as appropriate

Other than not treating it's incontinence, what do you think you would have done differently in this case if you had known that would die of hemoabdomen so soon afterwards?

RE: Phenylpropanolamine, is a pretreatment blood sample advisable?

Julie Turner — Sun, 20 Oct 2019 15:38:55 GMT

Hi Neil

in my locum travels I’ve seen many a dog on the above which actually had another clinical reason for its incontinence - usually polyuria related to renal insufficiency or DM. I don’t know if some of these disorders had developed after the meds but certainly some had only recently been on the drug. I would wholeheartedly support at least initial bloods and urine and then regular biochem for these pets.