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 shit! 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 first choice.
PS I am an RVT and have worked in the field for 8 years in both day practice and the past two years in emergency medicine