Is Your Dog on PPA (Phenylpropanolamine)? (chs. 49-51)

Large dogPPA is a medication which many dogs take for urinary incontinence. It tends to work well but it can be a little pricey.

I have a lot of dogs in my practice on an alternative medicine called Stilbestrol. Stilbestrol can be a little controversial. The drug insert for this medication tells us that the drug can cause a serious bone marrow toxicity which can lead to life threatening problems. For this reason many vets shy away from it.

However, in my opinion this is really not necessary.

Bone marrow toxicity is a concern when dogs are on a dose of stilbestrol that exceeds one mg per kg of body weight. The vast majority of dogs who are put on this medication are put on a total of 1 mg no matter what the size of the dog is. Therefore, for any dog who weighs more than 1 kg (2.2 lbs) they will not be receiving any where close to a toxic dose. The vast majority of my patients who have a problem with incontinence that is responsive to stilbestrol are large dogs.

I have never seen a dog have a problem with stilbestrol. A review of hundreds of thousands of cases on Veterinary Information Network does not show any cases of bone marrow toxicity with this drug.

While PPA is given two or three times daily, stilbestrol is usually given once daily for 5 days and then one to two times per week. It is much less expensive than PPA.

It’s worth asking your vet about!



When to Spay or Neuter Your Dog or Cat

This is a controversial subject! Many people believe it is best to wait for a female dog or cat to go through a heat cycle before spaying them. Some believe that it is best to let a female dog or cat have a litter before they are spayed.

Unfortunately this is all folklore. Veterinary research shows that spaying an animal before their first heat
drastically reduces their chances of getting mammary (breast) cancer later on in life.

Unspayed females are also at risk for a number of problems that can be quite costly. These include:

  • Pregnancy related complications (C-Section, etc.)
  • Ovarian cancers
  • Ovarian cysts
  • Uterine cancers
  • Pyometra (a very serious infection in the uterus that requires an emergency surgery)
  • Complications of a false pregnancy
  • Mastitis (infected mammary glands)

And what about male dogs? Neutering a dog before he reaches sexual maturity can cut down on many unwanted behaviors including:

  • Urinary spraying
  • Mounting objects
  • Aggression
  • Prostate problems
  • Testicular cancer

I usually recommend a spay or neuter between 5 and 6 months of age. This will ensure that we remove the reproductive organs before an animal reaches sexual maturity.

If we do wait to spay an animal until they are older the surgery is generally more expensive. The older an animal gets the larger the blood vessels leading to the ovaries/testicles are. This means that the surgery will take longer and the surgeon will need more suture material. This often causes the cost to go up.

What About Rural Practices?

I have found that often a practice located outside of the city can be less expensive than an urban practice. But remember, if you are phoning for prices, don’t ask for vaccine prices (because many higher priced clinics will match vaccine prices but be higher on everything else). As mentioned in a previous tip, here are some prices you can ask for to get an idea of how expensive a clinic is:

  • a dental cleaning for an animal with a mild amount of tartar and no extractions?
  • an injection of anti-inflammatory such as metacam?
  • a general wellness blood profile?
  • expression of my dog’s anal glands?

In most cases, a rural practice is similar in quality of veterinary medicine to an urban practice, but sometimes you may find that the veterinary care is not as top notch as in the city. It’s often hard to know whether a practice has a good standard of care. If you have the time, it would be great to visit the practice and ask for a tour. Generally, if the clinic looks clean and modern it is good.

Another thing you can do is ask whether the vet you will be seeing is a member of Veterinary Information Network. Vets pay a lot of money to belong to VIN which is a service where we can talk to specialists and post information about difficult cases and generally learn a lot of things about new treatments available. In most cases, if a vet belongs to VIN, they are the type of vet who is up to date with current treatments and always wanting to learn about how to treat their cases.

Article by Dr. Marie

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