PPA safety for dogs.

Dr. Marie replied:

Hi Julie,

I'm glad to hear that Jammy's urine tests were normal!

PPA is a really good medication to help with urinary incontinence. You will read things online though that make it look quite scary.

The reason why it gets a bad name is that a few years ago, human products containing PPA were withdrawn from the market. The concern was that it could cause an increased risk of stroke in women. Strokes are not common in dogs. There has been a very rare report of a possible stroke in dogs on PPA, but the risk is extremely small.

I am cautious in using PPA in dogs that have high blood pressure issues, but this is really not common. It doesn't cause high blood pressure but could make an existing issue worse.

One thing to think of for the future is that the literature shows us that if Jammy was to be put on an NSAID (i.e. an arthritis medication like Metacam, Rimadyl, Deramaxx, or Previcox) then it could increase the risk of high blood pressure. In cases like this where a dog needed both medications I would likely do periodic blood pressure checks.

My main concern with PPA is that I have seen some dogs that, once they are on the drug, get excessively hyperactive and jumpy. It doesn't happen often, but for those dogs I put them on something else. The drug I generally use for incontinence in spayed female dogs is stilbestrol (DES). However, in some areas, DES is not readily available. It comes with its own list of possible but rare side effects as well.

I have a good number of dogs in my practice that have been on PPA for many many years. Jammy should do just fine.

Dr. Marie

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