What are the contraindications for Incurin regarding polyuria and polydipsia?
Incurin is indicated for the treatment of incontinence due to urinary sphincter mechanism incompetence.
Urinary incontinence can also be caused by several disorders that do not involve USMI including neurological disorders. It is important to ensure that we are dealing with incontinence due to USMI and not any other disorder prior to starting Incurin treatment.
Polyuria-polydipsia conditions can lead to some owners perceiving ‘incontinence’ because they are seeing the animal having ‘accidents’ in the house because of the production of large volumes of urine, or because their animal is pollakiuric (and so has an increased urge to urinate rather than a loss of voluntary control of urination). Careful clinical history-taking can prove critical in these cases.
Evaluation for the presence of underlying disorders should be of paramount importance in the animal presenting with PUPD and perceived ‘incontinence’. In particular, in the case of PUPD due to diabetes mellitus, failure to diagnose and treat appropriately the PUPD-causing disorder could have severe consequences for the animal e.g. ketoacidosis. Other disorders resulting in PUPD of consideration include renal disease, Cushing’s, UTIs, hypothyroidism. For these, oestriol treatment would not be indicated or effective.
What is the onset of action for Incurin?
Some dogs will have a slower onset of action to Incurin, once treatment has started. Thus, although dose changes can be made safely prior to this, if improvement of incontinence due to USMI is slow, full effect to the drug may only be noted after 4-6 weeks1.
This is therefore the minimum trial period recommended to assess initial response in dogs slow to show signs of USMI improvement.
How long does Incurin take to leave the system?
From trial work, there was no demonstration of accumulation of oestriol over time and therefore once the medication is stopped, the therapeutic effect of Incurin may cease within 24 hours2.
Further information is available from the SPC, Datasheet or package leaflet.
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Incurin® contains estriol. POM-V.
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1. Chapter VIII PHARMACOKINETICS OF ESTRIOL AND EFFECTS ON URETHRAL CLOSURE AND BLADDER STORAGE FUNCTION IN NEUTERED FEMALE DOGS, PhD thesis for R.F. Nickel, University of Utrecht. Based upon: R.F. Nickel, A.M.T.C. van Wees, W.E. van den Brom, S.J. Dieleman, J. Fink-Gremmels. 1997 The pharmacokinetics and urodynamic effects of orally administered estriol in neutered female dogs.
2. M. Hoeijmakers, B. Janszen , A. Coert, L. Horspool 2003. Pharmacokinetics of oestriol after repeated oral administration to dogs. Research in Veterinary Science. 75 (2003) 55–59