I would like to get the word out with this info, so if you guys know of anywhere else to post please tell me or feel free to post yourself.

I have some new information about PROIN (phenylpropanolamine(PPA) or Dexatrim(in humans))

As some people may know, Dexatrim, a diet drug containing PPA was taken off the market because it caused CVA (stroke) in humans. When the veterinary community started using this drug, now called Proin, to help with urinary incontinence there was "no known correlation with CVA in dogs." (I wonder who did a study on a compounded drug that no drug company makes any money from)

So, I was debating whether to put my little dog on Proin, my great dane has been on it for ~2years. My doctor said "here's something I found about Proin you should read before you put wala on it. I had beth [her dog] on it for years and never had any... oh s***t! I bet she stroked out on me." You see beth had been on PROIN for urinary incontinence and had died ~1year ago from a stroke. Within seconds of the onset of symptoms, beth was dead. They were home and going to the car but before they could make it there she was gone. They are both vets and his clinic is literally across the street.

I am so shocked by this. It seems like every older canine female patient seen at clinics these days is on Proin. There are other alternatives like artificial hormones (DES) and the natural hormones in in soy, but I don't think most people are given these options. It's not to say that DES is without side effects, but compare those to CVA and it seems like a better choice. Plus, we have the natural soy isoflavones to try as well (side note, I have read many great things about them and will be trying them with my dogs). Many patients on Proin aren't even having their blood pressure monitored.

The info I saw was on VIN (so I can't link it) and it constituted of anecdotal evidence from board certified neurologists who stated that they have seen many dogs with MRI evidence of CVA with no other cause of CVA other than Proin. This, in combination with the existing info in humans, is enough to convince me. Will there ever be studies? I doubt it, because as I said earlier, this drug is compounded for very little money from several veterinary pharmacies. There is no large drug company standing behind the product in either veterinary or human medicine. I wonder why?

My dogs will not be on this drug ever again. It is the choice a urine in the house or death. I'd rather they sleep in a cage with bedding that I can change daily (or several times a day) or put underpants on them or take them out hourly during the day and deal with it at night than to loose them. The natural estrogens in soy will be my choice.

PS i have posted here a few times but wanted to say FYI, i'm an rvt with 8 years of experience both in day practice and for the last 2 years in emergency medicine.

Well, as always a good idea to ask your vet, because it would, obviously, be tragic for your pet to become heartworm positive, but, here is the study from Novartis(the makers of interceptor/sentinel). which does state the minimum does for heartworm prevention only to be: a "Minimum dose of 0.1 mg/kg"

and here's the link:
                 http://www.fda.gov/cvm/FOI/1365.htm

If you were to call up your veterinarian (which I would suggest), all it would take would be a tech to look up the dose in "Plumb's Veterinary Handbook."

PS if you do live in a year round HW hotspot you might also, if you reduce the dose of interceptor think about getting bi-yearly fecals because your area is bound to be a good area for intestinal worms as well.

ps I'm glad she's feeling better!

Well, I currently work for a cat only hospital and emergency hospital and i just can't help but say, if a DVM is popping a bladder on a "routine OHE" (with the understanding that no surgery is routine BUT this is one of the most common surgeries performed by DVMs) I would be absolutely shocked! I'm an RVT and have been working in hospitals since I was 19. I have NEVER seen this happen! NEVER! And I have even done brief stints in horrible horrible "clinics."  I understand that this COULD happen but I would run the other way if I ever heard/witnessed such an event. I have never even seen an emergency case while i've been working at the emergencey clinic.