Companion Animal Product & Promotions Guide

25 March 2023 | Product and Promotions Guide Diagnosing with a once-daily treatment When diagnosing UI by response to therapy, start at the highest dose of PROIN ER (4 mg per kg) and adjust down if necessary. Phenylpropanolamine acts on alpha receptors in the urinary lower tract and, depending on the number and robustness of these receptors, a dog will respond more or less robustly. Because phenylpropanolamine has a short half-life, reducing the dose can quickly minimize any potential side effects, such as minor changes in appetite, sleeping patterns or agitation levels. PROIN ER is highly effective, so if UI isn't managed after three to four days, veterinarians may question whether the patient is suffering from an issue other than UI. At this point, consider re-examining the diagnosis. About the author Julie Byron, DVM, MS, DACVIM, is an Assistant Professor at The Ohio State University on the Small Animal Internal Medicine Service. Her clinical interests include nearly all aspects of internal medicine with special interest in urinary tract diseases, including diagnostics such as cystoscopy and urodynamic testing to evaluate urinary bladder and urethral function, particularly in dogs and cats with urinary incontinence. IMPORTANT SAFET Y INFORMATION: For oral use in dogs only. Not for human use. Keep out of reach of children. If accidentally ingested by humans, contact a physician immediately. The most commonly reported side effects were vomiting, loss of appetite, diarrhea, excessive salivation, agitation, tiredness, vocalization, confusion, increased water consumption, weight loss, weakness, fever, panting, and reversible changes in skin color (flushing or bright pink). Abnormal gait, seizures or tremors, as well as liver enzyme elevations, kidney failure, blood in urine and urine retention have been reported. In some cases death, including euthanasia has been reported. Sudden death was sometimes preceded by vocalization or collapse. Instances of dogs chewing through closed vials of PROIN ® and eating the vial contents have been reported, in some cases resulting in overdose. Keep the product in a secured storage area out of the reach of pets in order to prevent accidental ingestion or overdose, as dogs may willingly consume more than the recommended dosage of PROIN ® Chewable Tablets or PROIN ER ™ tablets. Contact your veterinarian immediately if the dog ingests more tablets than prescribed or if other pets ingest PROIN Chewable tablets or PROIN ER tablets. PROIN and PROIN ER may cause elevated blood pressure and should be used with caution in dogs with pre-existing heart disease, high blood pressure, liver disease, kidney insufficiency, diabetes, glaucoma, and other conditions associated with high blood pressure. Dogs may transition from PROIN Chewable Tablets to PROIN ER without a break in administration. However, do not alternate PROIN ER with PROIN Chewable Tablets because the effectiveness and safety of interchangeable use have not been evaluated. The safe use of PROIN and PROIN ER in dogs used for breeding purposes, during pregnancy or in lactating bitches, has not been evaluated. Contact your veterinarian if you notice restlessness or irritability, loss of appetite, the incontinence persists or worsens, or any other unusual signs. See prescribing information for complete details regarding adverse events, warning and precautions or visit prnpharmacal.com. © 2023 PRN Pharmacal, Inc. All rights reserved. All trademarks are registered trademarks or trademarks of Pegasus Laboratories, Inc. Keep the Water Flowing Well-meaning clients may be tempted to restrict their dog's water intake in an effort to decrease incontinence. This isn't ideal, even for a dog with healthy kidneys. Make a point to tell clients that dogs with UI may be at an age when renal function is decreased and that concentrated urine may but them at risk for developing other issues. Managing client expectations Let clients know that their dog's dose of PROIN ER may need to be adjusted. While the treatment goal may be no incontinence, dogs likely will experience breakthrough urination. Work with clients to establish an acceptable outcome for the management of the dog's UI. This conversation should include the message that PROIN ER may be a lifelong medication. Because it's both convenient and effective, once-daily PROIN ER can positively impact your patients and their entire family. To learn more about PROIN ER, contact your Covetrus ® representative or visit proin-er.com. I have found that the extended release of PROIN ER provides a smoother response for dogs that may experience appetite changes or excitability after taking traditional PROIN. JULIE BYRON, DVM, MS, DACVIM

• Cover