Evaluation of once daily dose of phenylpropanolamine in the treatment of urethral sphincter mechanism incompetence in spayed bitches
Abstract
The aim of this study was to evaluate the efficacy and long term safety of once daily administration of phenylpropanolamine (PPA) in the treatment of urethral sphincter mechanism incompetence (USMI) in spayed bitches in comparison to three times daily administrations. For this purpose, 22 spayed bitches suffering from USMI received either PPA at the dose rate of 1.5 mg/kg, body weight (BW) once daily (group I, n=11) or 1.5 mg/kg three times daily (group II, n=11) by oral administration. Clinical efficacy was determined by using a scoring system based on analysing the frequency and the amount of unconscious urination on d 7, 14 and 28. There was no significant difference (p>0.05) between the clinical response observed on d 7, 14 and 28 of treatment in group I and II. Eight dogs (72.7%) in each group were continent on d 28. The side effects observed were mild and transient. Phenylpropanolamine therapy was continued in 13 dogs that became continent after 28 d and the dogs were followed up for 12 months. None of the dogs showed symptoms of urinary incontinence except for 2 bitches that became refractory to PPA treatment in group II. Phenylpropanolamine was combined with estriol for 14 d (1 mg/dog PO) in dogs in which PPA therapy was inefficient or unsatisfactory on d 28 and in dogs that became refractory to PPA treatment. A total of 8 dogs were treated with estriol PPA combination. Five (62.5%) bitches were continent on 14th d of estriol PPA combination treatment. In one bitch (12.5%) urinary incontinence improved. In conclusion, once daily administration of PPA at a dose of 1.5 mg/kg, BW is effective in treatment of USMI in spayed bitches and it offers a cheap and convenient treatment option. In addition, recurrence of incontinence can be observed during long term administration of PPA and combination of PPA with estriol is effective in dogs in which PPA therapy alone is unsatisfactory and in dogs that become refractory to PPA treatment
References
- Angioletti A, De Francesco I, Vergottini M, Battocchio ML (2004): Urinary incontinence after spaying in the bitch: incidence and oestrogen therapy. Vet Res Commun, 28, 153-155.
- Arnold S (1997): Urinary incontinence in castrated bitches. 2. Diagnosis and treatment. Schw Arch Tierheilkunde, 139, 319-324.
- Arnold S, Arnold P, Hubler M, Casal M, Rusch P (1989): Urinary incontinence in spayed female dogs: frequency and breed disposition. Schw Arch Tierheilkunde, 131, 259-263.
- Awad SA, Downie JE (1976): The effect of adrenergic drugs and hypogastric nerve stimulation on the canine urethra. A radiologic and urethral pressure study. Invest Urol, 13, 298-301.
- Beceriklisoy B, Kanca H, Aksoy OA, Erunal-Maral N, Fındık M, Kaymaz M, Aslan S (2005): Effectiveness of different pharmacological approaches on post- ovariectomy urinary incontinence in the bitch. Ankara Üniv. Vet Fak Derg, 52, 157-160.
- Blendinger C, Blendinger K, Bostedt H (1995): Urinary incontinence in castrated female dogs. 2. Therapy. Tierarztl Prax, 23, 402-406.
- Callahan SM, Creed KE (1985): The effects of oestrogens on spontaneous activity and responses to phenylephrine of the mammalian urethra. J Physiol, 358, 35-46.
- Carofiglio F, Hamaide AJ, Farnir F, Balligand MH, Verstegen JP (2006): Evaluation of the urodynamic and hemodynamic effects of orally administered phenylpropanolamine and ephedrine in female dogs. Am J Vet Res, 67, 723-730.
- Claeys S, Rustichelli F, Noel S, Hamaide A (2011): Clinical evaluation of a single daily dose of phenylpropanolamine in the treatment of urethral sphincter mechanism incompetence in the bitch. Can Vet J, 52, 501-505.
- Creed KE (1983): Effect of hormones on urethral sensitivity to phenylephrine in normal and incontinent dogs. Res Vet Sci, 34, 177-181.
- Dowling PM (1996): Antimicrobial therapy of urinary tract infections. Can Vet J, 37, 438-441.
- Gregory SP (1994): Developments in the understanding of the pathophysiology of urethral sphincter mechanism incompetence in the bitch. Brit Vet J, 150, 135-150.
- Hamaide AJ, Grand JG, Farnir F, Le Couls G, Snaps FR, Balligand MH, Verstegen JP (2006): Urodynamic and morphologic changes in the lower portion of the urogenital tract after administration of estriol alone and in combination with phenylpropanolamine in sexually intact and spayed female dogs. Am J Vet Res, 67, 901-908.
- Hensel P, Binder H, Arnold S (2000): Influence of phenylpropanolamine and ephedrine on the urethral closure pressure and the arterial blood pressure of spayed bitches. Kleintierpraxis, 45, 617-628.
- Holt PE (1985): Urinary incontinence in the bitch due to sphincter mechanism incompetence: prevalence in referred dogs and retrospective analysis of sixty cases. J Small Anim Pract, 26, 181-190.
- Kinn AC, Lindskog M (1988): Estrogens and phenylpropanolamine in combination for stress urinary incontinence in postmenopausal women. Urology, 32, 273- 280.
- Laflamme DP (1997): Development and validation of a body condition score system for dogs. Canine Pract, 22, 10-15.
- Mandigers PJ, Nell T (2001): Treatment of bitches with acquired urinary incontinence with oestriol. Vet Rec, 149, 764-767.
- Noel S, Cambier C, Baert K, Gustin P, Denooz R, Massart L, Hamaide A (2010): Combined pharmacokinetic and urodynamic study of the effects of oral administration of phenylpropanolamine in female Beagle dogs. Vet J, 184, 201-207.
- Noel S, Massart L, Hamaide A (2011): Urodynamic and haemodynamic effects of a single oral administration of ephedrine or phenylpropanolamine in continent female dogs. In press, Vet J, 27. doi:10.1016/j.tvjl.2011.05.003.
- Reichler IM, Hubler M, Arnold S (2008): Urethral sphincter mechanism incompetence in spayed bitches: new insights into the pathophysiology and options for treatment. European Journal of Companion Animal Practice, 18, 187-191.
- Scott FB, Bradley WE, Timm GW (2002): Treatment of urinary incontinence by an implantable prosthetic urinary sphincter. J Urol, 167, 1125-1129.
- White RA, Pomeroy CJ (1989): Phenylpropanolamine: an alpha-adrenergic agent for the management of urinary incontinence in the bitch associated with urethral sphincter mechanism incompetence. Vet Rec, 125, 478- 480. Geliş tarihi: 09.01.2012 / Kabul tarihi: 02.03.2012 Address for correspondence Dr. Halit Kanca Department of Obstetrics and Gynaecology Faculty of Veterinary Medicine University of Ankara, 06110, Diskapi Ankara-Turkey E-mail: hkanca@ankara.edu.tr
Kısırlaştırılmış dişi köpeklerde üretral sfinkter mekanizması yetersizliğinin tedavisinde günlük tekdoz fenilpropanolamin uygulamasının değerlendirilmesi
Abstract
Bu çalışmanın amacı, kısırlaştırılmış dişi köpeklerde üretral sfinkter mekanizması yetersizliğinin (urethral sphincter mechanism incompetence, USMI) tedavisinde günde tek doz fenilpropanolamin (phenylpropanolamine, PPA) uygulamasının uzun dönem etkinlik ve güvenirliğinin günde üç doz uygulama ile karşılaştırılarak araştırılmasıdır. Bu maksatla, USMI teşhisi konan 22 kısırlaştırılmış dişi köpeğe günde tek doz 1,5 mg/kg, vücut ağırlığı, per os (grup I, n=11) veya günde üç doz 1,5 mg/kg, vücut ağırlığı, per os (grup I, n=11) PPA uygulandı. Tedavinin klinik etkinliği 7, 14 ve 28. günlerde istemsiz ürinasyonun frekans ve miktarının ölçülmesine dayalı bir derecelendirme sistemi kullanılarak belirlendi. Tedavinin ilk 28 günü sonunda her iki grupta 8’er köpekte (%72,7) semptomlar tamamen ortadan kalktı. Gruplar arasında tedavinin 7, 14 ve 28. günlerinde klinik yanıt bakımından bir farklılık gözlenmezken (p>0,05), hafif ve geçici yan etkiler gözlendi. Tedavinin ilk 28 günü sonunda idrar kaçırma şikayeti ortadan kalkan 13 köpekte tedaviye devam edildi ve köpekler toplam 12 ay süreyle izlendi. Bu süreçte grup II’de PPA tedavisine dirençli hale gelen 2 köpek dışında idrar kaçırma şikayeti ile karşılaşılmadı. Fenilpropanolamin tedavisinin başarısız olduğu veya istenilen düzeyde etkili olmadığı köpekler ve PPA tedavisine dirençli hale gelen köpeklerde PPA 14 gün süreyle östriol (1 mg/kg, per os) ile kombine edildi. Fenilpropanolamin estriol kombinasyonu tedavisine alınan toplam 8 köpekten 5’inde (%62,5) tedavi sonunda idrar tutamama semptomları ortadan kalkarken, 1 köpekte (%12,5) semptomlar azaldı. Sonuç olarak, kısırlaştırılmış dişi köpeklerde üretral sfinkter mekanizması yetersizliği tedavisinde PPA’nın günde bir 1,5 mg/kg vücut ağırlığı dozunda uygulanması etkili olmakta, ucuz ve pratik bir tedavi seçeneği sunmaktadır. Ayrıca, uzun dönem PPA tedavisi sırasında idrar tutamama tekrarlayabilmekte ve PPA östriol kombinasyonu, PPA tedavisinin tatmin edici yanıt vermediği köpeklerde etkili olmaktadır
Keywords
Fenilpropanolamin kısırlaştırılmış dişi köpek östriol üretral sfinkter mekanizması yetersizliği
References
- Angioletti A, De Francesco I, Vergottini M, Battocchio ML (2004): Urinary incontinence after spaying in the bitch: incidence and oestrogen therapy. Vet Res Commun, 28, 153-155.
- Arnold S (1997): Urinary incontinence in castrated bitches. 2. Diagnosis and treatment. Schw Arch Tierheilkunde, 139, 319-324.
- Arnold S, Arnold P, Hubler M, Casal M, Rusch P (1989): Urinary incontinence in spayed female dogs: frequency and breed disposition. Schw Arch Tierheilkunde, 131, 259-263.
- Awad SA, Downie JE (1976): The effect of adrenergic drugs and hypogastric nerve stimulation on the canine urethra. A radiologic and urethral pressure study. Invest Urol, 13, 298-301.
- Beceriklisoy B, Kanca H, Aksoy OA, Erunal-Maral N, Fındık M, Kaymaz M, Aslan S (2005): Effectiveness of different pharmacological approaches on post- ovariectomy urinary incontinence in the bitch. Ankara Üniv. Vet Fak Derg, 52, 157-160.
- Blendinger C, Blendinger K, Bostedt H (1995): Urinary incontinence in castrated female dogs. 2. Therapy. Tierarztl Prax, 23, 402-406.
- Callahan SM, Creed KE (1985): The effects of oestrogens on spontaneous activity and responses to phenylephrine of the mammalian urethra. J Physiol, 358, 35-46.
- Carofiglio F, Hamaide AJ, Farnir F, Balligand MH, Verstegen JP (2006): Evaluation of the urodynamic and hemodynamic effects of orally administered phenylpropanolamine and ephedrine in female dogs. Am J Vet Res, 67, 723-730.
- Claeys S, Rustichelli F, Noel S, Hamaide A (2011): Clinical evaluation of a single daily dose of phenylpropanolamine in the treatment of urethral sphincter mechanism incompetence in the bitch. Can Vet J, 52, 501-505.
- Creed KE (1983): Effect of hormones on urethral sensitivity to phenylephrine in normal and incontinent dogs. Res Vet Sci, 34, 177-181.
- Dowling PM (1996): Antimicrobial therapy of urinary tract infections. Can Vet J, 37, 438-441.
- Gregory SP (1994): Developments in the understanding of the pathophysiology of urethral sphincter mechanism incompetence in the bitch. Brit Vet J, 150, 135-150.
- Hamaide AJ, Grand JG, Farnir F, Le Couls G, Snaps FR, Balligand MH, Verstegen JP (2006): Urodynamic and morphologic changes in the lower portion of the urogenital tract after administration of estriol alone and in combination with phenylpropanolamine in sexually intact and spayed female dogs. Am J Vet Res, 67, 901-908.
- Hensel P, Binder H, Arnold S (2000): Influence of phenylpropanolamine and ephedrine on the urethral closure pressure and the arterial blood pressure of spayed bitches. Kleintierpraxis, 45, 617-628.
- Holt PE (1985): Urinary incontinence in the bitch due to sphincter mechanism incompetence: prevalence in referred dogs and retrospective analysis of sixty cases. J Small Anim Pract, 26, 181-190.
- Kinn AC, Lindskog M (1988): Estrogens and phenylpropanolamine in combination for stress urinary incontinence in postmenopausal women. Urology, 32, 273- 280.
- Laflamme DP (1997): Development and validation of a body condition score system for dogs. Canine Pract, 22, 10-15.
- Mandigers PJ, Nell T (2001): Treatment of bitches with acquired urinary incontinence with oestriol. Vet Rec, 149, 764-767.
- Noel S, Cambier C, Baert K, Gustin P, Denooz R, Massart L, Hamaide A (2010): Combined pharmacokinetic and urodynamic study of the effects of oral administration of phenylpropanolamine in female Beagle dogs. Vet J, 184, 201-207.
- Noel S, Massart L, Hamaide A (2011): Urodynamic and haemodynamic effects of a single oral administration of ephedrine or phenylpropanolamine in continent female dogs. In press, Vet J, 27. doi:10.1016/j.tvjl.2011.05.003.
- Reichler IM, Hubler M, Arnold S (2008): Urethral sphincter mechanism incompetence in spayed bitches: new insights into the pathophysiology and options for treatment. European Journal of Companion Animal Practice, 18, 187-191.
- Scott FB, Bradley WE, Timm GW (2002): Treatment of urinary incontinence by an implantable prosthetic urinary sphincter. J Urol, 167, 1125-1129.
- White RA, Pomeroy CJ (1989): Phenylpropanolamine: an alpha-adrenergic agent for the management of urinary incontinence in the bitch associated with urethral sphincter mechanism incompetence. Vet Rec, 125, 478- 480. Geliş tarihi: 09.01.2012 / Kabul tarihi: 02.03.2012 Address for correspondence Dr. Halit Kanca Department of Obstetrics and Gynaecology Faculty of Veterinary Medicine University of Ankara, 06110, Diskapi Ankara-Turkey E-mail: hkanca@ankara.edu.tr
Details
| Primary Language | English |
|---|---|
| Subjects | Veterinary Surgery |
| Other ID | JA56FV75CN |
| Journal Section | Research Article |
| Authors | |
| Publication Date | September 1, 2012 |
| Published in Issue | Year 2012 |