Urinary Incontinence in dogs

Urinary incontinence is a common problem in older females dogs at Oasis Animal HospitalQuestion:
One of our loyal clients recently asked… “Hey Dr. Tenney:
I just picked up some medication for my Rat Terrier, Bailey. It is Proin for some urinary incontinence. I have not yet started her on it, but I was doing some reading up on it, as I hate to put my pets on any medications. Can you please tell me the difference between Proin and Incurin? Is Incurin safer since it is a natural estrogen? Bailey is only a year old, and her occasional bouts of incontinence did not start until after she was spayed. She can be sleeping, or sitting on your lap and she suddenly piddles. I just want to make sure I am doing the best thing for my baby. Thanks in advance. – Donna R

Urinary incontinence (involuntary urine leakage) can be caused by different medical conditions. Hormone-based urinary incontinence is a common problem in middle-aged and elderly spayed female dogs. The pet can urinate normally, but they leak urine while resting. Frequently the dogs are not aware that they are leaking urine. Physical examination and blood and urine tests are usually normal in these pets. Hormone-responsive incontinence can occur months to years after a dog is spayed.

There are two generally accepted treatments for hormonal urinary incontinence. We generally begin treatment with Proin after ruling out other causes of urine leakage such as urinary tract infections, diabetes, etc.

Proin – a chewable formulation with the active compound of phenylpropanolamine hydrochloride (PPA). This has proven to be both safe (if given at the prescribed doses) and effective (In an FDA approved 28 day clinical trial PROIN reduced mean urinary accidents per week in female dogs by 82%. In the second part of the clinical field study (180 days), PROIN achieved 98.1% owner satisfaction for the control of urinary incontinence.) In a margin of safety study, phenylpropanolamine hydrochloride (PPA) was administered to dogs twice daily at 1X, 3X or 5X the recommended dose (2 mg/kg) for 182 days. This study demonstrated the safety of phenylpropanolamine administered to dogs at 2, 6 and 10 mg/kg twice daily for 6 months. The most pronounced effects of treatment were a dose-dependent increase in blood pressure, and a dose dependent decrease in heart rate.

Incurin – The second prescription we use is Incurin. Incurin (estriol) is a natural estrogen hormone. Estrogens increase the resting muscle tone of the urethra in females and can be used to treat female dogs with urinary incontinence due to estrogen depletion. The most common side effects associated with Incurin treatment included a loss of appetite, vomiting, excessive water drinking and swollen vulva.

Here are links to additional information about Proin and Incurin.


  1. Chris says

    Pro in is so expensive I have decided to let my dog live out her days peeing herself daily. I can’t afford it anymore and nothing else is working

    • superDoc says

      Chris – there are alternatives to Proin.

    • Bill says

      No offense, but proin is one of the cheaper meds. I just paid out the nose for it at my vet : 90 for 180 50mg tabs. That is 50 cents a day. I found the same thing online for $60.
      How much you spending on laundering the soiled bedding and washing your dog?

      • superDoc says

        No offence taken. We have never claimed to be the cheapest source of medicines or Over-the-counter nutriceuticals (however often we are the cheapest after all).
        If you can get Proin online or at one of the Big Box stores and it is the identical product, not short dated (where the expiration date is nearly due or past due) go for it.
        But if you buy your prescriptions from us, you have us to advise you and stand behind our products.

  2. Kim Saari says

    Chris please don’t let her live out her days peeing herself. Urine is strong and can irritate her skin and cause her pain. And she has increased chance for UTIs which are very painful. Not to mention the discomfort and humility dogs feel who lose control.

  3. Michelle says

    What are the alternatives to Pround and incurin ?. Very expensive. I believe there is an injection available

    • superDoc says

      I am not aware of any injectable medicine that will help a pet control urinary incontinence.

      • superDoc says

        My suggestion would be to speak with your veterinarian and see about have the active ingredient, phenylpropanolamine, formulated at a compounding pharmacy. Good Luck.
        Dr Tenney

  4. Barbara says

    My dog is doing great on Proin. However she HATES it. It’s a large enough pill that it’s hard to force it down. Pill pockets and peanut butter have limited success. She acts like she’s being punished after I get one down and we’re doing this twice a day. Can I get it in another form; capsule, liquid or powder?

    • Bill says

      My first dog loved it. This dog hates it. I pulverized the tablet ( stick it in a sand which bag an roll the lid over it with the bottle attached). Pour the powder into the dog food, add a little water and away it goes

    • Ashlee says

      My dog doesn’t do well with pills either. I use a pill crusher or just crush it with a spoon when I can’t locate my crusher. Sprinkle it with a tablespoon of wet food at breakfast and mixed into her meal at dinner. She only eats once a day. We tried to give her breakfast and dinner, but she rarely ever ate breakfast until dinner time. So, she has only had dinner for over 10 years.

    • Elizabeth says

      You can break up Proin into quarters and give her a small bit 3-4X daily. Easier for the dog to take and digest.

    • Dee says

      We wrap our proin in a small meat ball made of turkey and put it in the freezer until needed. We take it out by 4 (2 day supply) and let it thaw overnight in the fridge. The pills softens and our dog will eat it right down – only way we have found to get a hard pill down her. Hope this helps.

    • dana says

      I roll it in cream cheese, you don’t need a lot, and my dog swallows it in one second.

  5. DV says

    My dog will not take the tablet. It’s a traumatic event for all involved when I do give it to her. She won’t take any snack or food if she smells the slightest hint of it. Her teeth are big. I’m not sticking my fingers in there even though she is docile. I crush half a pill, mix with enough water and beef bullion to draw into a 5cc syringe and push it into her mouth. She usually gets about half in her mouth cuz she shakes her head. Half on the floor, the walls, me. Fun times! I’m with letting her live her days dribbling. We give her a special towel and treats. For as much as she loves us unconditionally we should spoil her, not torture.

    • superDoc says

      Proin is a beef flavored treat that most dogs accept readily.

      • Ronnie Breitstein says

        Yes I don’t understand all these reactions unless the side affects are so bad the dogs associated to the pill and are smarter than you think. I gave it once to my Lab and she almost stroked out – panting, and snarling, pacing for hours.

        • superDoc says

          Below are the most common side effects of Proin (or Phenylpropanolamine)
          Caution: Glaucoma, prostatic hypertrophy, hyperthyroidism, diabetes mellitus, cardiovascular disorders, or hypertension.
          Adverse Effects: Restlessness, irritability, hypertension, & anorexia.

  6. Jennifer says

    My dog is on proin,and she’s lost her appetite!! Has anyone else experienced this?

  7. charlie says

    We had our black lab taking Proin and she started panting ALOT and she got so hyper especially when playing we were afraid she would have a heart attack. Her heart was pounding even while sleeping….not going to use it any longer. We are asking to put her on Incurin to see if that helps..She was fine until she was spayed (at 9 months per vet instructions because of being a larger dog) We have had numerous females and never had any issues with incontinence in any of them. I feel so bad for her because she was house broken at 9 weeks and never went in the house..she is so humiliated when it happens.

    • superDoc says

      Below are the most common side effects of Proin (or Phenylpropanolamine)
      Caution: Glaucoma, prostatic hypertrophy, hyperthyroidism, diabetes mellitus, cardiovascular disorders, or hypertension.
      Adverse Effects: Restlessness, irritability, hypertension, & anorexia.

  8. Tom says

    The only offense here is the cost of blood testing every 6 months to maintain a prescription for pro in. It ought to include a six month supply of proin for the price. Maybe pets need Obama care. It certainly would take care of the Vetting. Vet’s need to be regulated. Give them Proin.

  9. Ronnie says

    Ok I have my 4-year old, 66 lb Labrador the first 50mg dose of Proin. About 2-3 hours later she turned into a meth freak. Panting madly, jumping on and off the bed, onto her bed, back onto ours, etc etc. Took her outside to “walk it off” after mistakenly thinking some food would “dilute” the affects. She threw up immediately (stupid – like giving dog food immediately after playing) and re-ate before I could get to it. Took overnight to mellow her out and she is still puffing. I’m afraid to give her even half the dose.

    • superDoc says

      Below are the most common side effects of Proin (or Phenylpropanolamine)
      Caution: Glaucoma, prostatic hypertrophy, hyperthyroidism, diabetes mellitus, cardiovascular disorders, or hypertension.
      Adverse Effects: Restlessness, irritability, hypertension, & anorexia.

  10. Lee Ann says

    My dog is 9, been on Proin since 10 weeks old. She was in rescue and spayed at 10 weeks, before we got her. Proin worked “OK’ for years, and then suddenly, less and less, until now, even at higher levels, not at all. We have tried incurin. We did DES at a holistic vet and acupuncture, nothing has helped. She is now not just leaking, but full on, full bladder like in a fast drip, until she is soaking EVERYTHING. I am out of my mind. We do extensive bloodwork, every year. This year they deemed her thyroid “perfectly normal”, although last year, it was “questionable”, and I wonder if a thyroid medication would help her, and believe she may have a problem with her thyroid after all. She has TERRIBLE skin problems, almost unbearable during the summer (in FL it’s always summer). I am going to buy her some diapers today. I feel like this may make her more comfortable, to not have to constantly lay in urine, and smell like it. We throw away blankets and dog beds daily, and we buy huge remnants of carpet from home depot and throw them away and replace them every 6 months. I know she is miserable, and I can hardly take it anymore. She is a doberman, btw. I am just going to get the diapers now and hope that it can make her more comfortable, and maybe she can lay in a bed for more than a day before it is destroyed. Nothing. Has. Worked. I have a great relationship with my vet and am going to talk to him about trying a thyroid medication, as I ahve heard some with the identical situation, skin issues and all, and it has worked.

    • superDoc says

      Sounds pretty hard. Have your vet look for other causes including urinary tract infections.
      Remember that there are a few alternatives to Proin. Good luck.