# Opinions on Estrogen for Urinary Incontinence



## CharismaticMillie (Jun 16, 2010)

I spoke to two different vets about Millie's incontinence problem. Even though there have only been 2 incidences about 6 weeks apart, I still wanted to get their opinion.

The *Holistic/Integrative* vet wants to run another urine sample (send it away because the traditional vet only did an in-house the first time). They will charge $150 for it. Then, once everything else is ruled out, they would talk about giving her medicine like estrogen and/or supplements.

The *Traditional* vet said she recommends giving Millie a 2-3 week dose of estrogen and she thinks this will help "tighten" things up. The vet does not think Millie will need to take estrogen long term. She thinks that Millie simply has a relaxed sphincter and that is why she leaks when she sleeps sometimes. She said she would be willing to send the urine away for analysis again, but it would be expensive ($170) and based on her previous analysis of urine (under the microscope) there was no blood, white blood cells, etc. or anything to suggest a UTI. Kidney problems and diabetes were also ruled out.

I asked about side effects of estrogen and she said that she will give Millie a VERY low dose and she has never seen any side effects. Mammary tumors can happen at very, very high doses, but Millie will be given a very small dose. Not to mention it will only be for a few weeks.

She said she sees situations like this very frequently and a small course of estrogen fixes things.

What would you do? Would you send away for the urinalysis again? Would you try a 2-3 week treatment with estrogen? Would you just do nothing and wait and see if it continues to happen?

ETA: The traditional vet has a standard poodle and she is on the same page as me as far as not wanting to give medication. That being said, she told me she would do for her dog, if necessary, what she recommended for Millie.


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## Birdie (Jun 28, 2009)

I would do the 2-3 week course of Estrogen, if it were my dog. If the Holistic vet is going to do the exact same thing after another urinalysis (which you've already had done), why spend the extra $150? I would go ahead with the Estrogen, it's only for a few weeks. It should help, and there are very little risks. Now if she wets herself again after/during the course of taking Estrogen, I would go back to the Holistic vet and get a second urinalysis. 
Good luck! Sorry that Millie has this problem ): Poor baby.


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## fjm (Jun 4, 2010)

I agree - time enough for more tests if the estrogen doesn't work.


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## CharismaticMillie (Jun 16, 2010)

Thanks! That is what I am leaning towards as well..


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## Feralpudel (Jun 28, 2010)

I would go with the estrogen. There is no harm in waiting for a few weeks to see if it works, and the estrogen itself is low risk.


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## wishpoo (Sep 12, 2009)

"The lower urinary tract shares a common embryologic origin with the genital tract and the urogenital sinus, and estrogen and progesterone receptors are present in the vaginal epithelium, urethra, and bladder trigone. Reduction of estrogen after menopause leads to significant atrophic changes in the genital tract, which might lead to itching, burning, dryness, and dyspareunia. Coexistent symptoms, including urinary frequency, urgency, UI, and recurrent urinary tract infections, were thought to be related to atrophy of the urinary tract. Because MHT has a beneficial effect on vaginal mucosa, in particular in improving symptoms of atrophic vaginitis, it was suggested that MHT might also improve UI. However, epidemiologic and trial evidence has shown both beneficial and harmful effects of estrogen on UI."

JAMA 2005

This was, of course, human trail, but one can get a "glimpse" of estrogen effect.

IMO, 2-3 weeks, low dose should not do any harm and can possibly help : ). BUT , and my biggest BUT is :

- if her girly-parts did not develop properly due to early spay , than longer estrogen therapy would be needed. Long enough for her to go "through puberty" and develop properly. 

-if she stops taking estrogen, than reversal of the process might happen, as it does obviously occur in the absence of estrogen with menopausal women 

I am so sorry to hear that Millie has a problem with continuance : (, but it is really very mild case, so try to concentrate on that :clover: I know that it is easier said than done : ((. If she was my dog, I would definitely try short term estrogen , but would never keep her long term on it. If your Vet had great success with that (you can ask how many dogs she treated and how many were cured) , than lets keep our fingers crossed that Millie responds splendidly and gets rid of that pesky problem :thumb:: ))))))) !!!!!!! 

Regarding what Vet should you choose - it really does not matter since they will take the same course - except if holistic one would use bio-compatible estrogen compound, or something.

Best of luck with it all !!!!! :rose::rose::rose:


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## CharismaticMillie (Jun 16, 2010)

I am keeping my fingers crossed!


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## pudlemom (Apr 16, 2010)

I agree with the others I would try the short term treatment and see if it helps,that would give you a couple of weeks to figure out what your next plan of action would be if it did not work. Prayers for Millie.


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## cbrand (Aug 9, 2009)

You already ruled out JRD, right? So why another urine analysis? I say put her on the estrogen. Also, who spayed this bitch? I would contact the vet who spayed her and let him/her know that Millie most likely has spay induced incontinence. Remind the vet that if he/she had waited a bit longer, the chance of spay induced incontinence would have gone down.


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## CharismaticMillie (Jun 16, 2010)

cbrand said:


> You already ruled out JRD, right? So why another urine analysis? I say put her on the estrogen. Also, who spayed this bitch? I would contact the vet who spayed her and let him/her know that Millie most likely has spay induced incontinence. Remind the vet that if he/she had waited a bit longer, the chance of spay induced incontinence would have gone down.


Yes, they ruled out JRD. 

I am not sure if this is necessarily a direct result of being spayed. Ie., she always had a seemingly immature bladder and it took her longer than my other dogs to develop good control. I discussed this with the vet today and I asked about its correlation to her spay. The vet said that studies haven't been able to prove that spaying earlier or later has an effect on whether or not they develop this. She defended the decision to spay Millie early because of her reduced risk of mammary cancer. She said she has to tell too many clients that their bitch has cancer and it could have been prevented by spaying sooner. Finally, the vet said that the nearly eliminated risk of mammary cancer outweighs the problem of incontinence. 

Regardless, it makes sense to me that the estrogen she WOULD have developed during puberty would have "tightened" things up naturally. The vet explained this. Whether or not she would have still developed spay incontinence after being spayed if I had waited, who knows? 

Given Millie's seemingly immature bladder control, I now believe she in particular would have benefited from a later spay. 

Too late now!


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## CharismaticMillie (Jun 16, 2010)

Millie leaked again.

I was sitting on the couch studying for this big test tomorrow and I noticed wetness under my hand. Millie was laying right next to me and, yep, it turns out she peed in her sleep. Poor baby. I hate that this happens to her. It hasn't happened in _months_.

Does anyone know if this could be exacerbated by taking Prednisone right now? She is on Pred. for the swelling in her ear with this bad infection.

She keeps trying to drink water too. Lots of it. Maybe that's what the Pred. is doing ot her and then she can't hold her bladder since we all know it's not the strongest.


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## Siskojan (Mar 13, 2011)

Sisko was on a medication for his belly skin pimples last year and that made him have bladder accidents - I think there was a steroidal component. On the estrogen topic - our dear departed old border collie peed in her sleep as a youngster and 5 days of estrogen cured her for the rest of her 12.5 years.


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## CharismaticMillie (Jun 16, 2010)

Siskojan said:


> Sisko was on a medication for his belly skin pimples last year and that made him have bladder accidents - I think there was a steroidal component. On the estrogen topic - our dear departed old border collie peed in her sleep as a youngster and 5 days of estrogen cured her for the rest of her 12.5 years.


Yeah - Millie did a single round of estrogen around october or november and hasn't leaked since. This is the first time since then. And, I think it happened last night too - I saw a weird spot on my comforter where she sleeps, and just thought "hmmm" and threw it in the wash earlier today. But now it makes sense....

I am hoping it is just a side effect of the meds. I will call the vet tomorrow. I think they are sick of hearing from me! I'm not giving her any more prednisone I decided. It was just supposed to be a very short dose for her ears - but I think it's unnecessary and I don't like her leaking in her sleep.


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## Siskojan (Mar 13, 2011)

I wish I could remember exactly what he was on, but the vet did warn us about the bladder side effect. We had 2 huge puddles and when we discontinued the med there were no more.


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## DoeValley Poodles (Jun 12, 2010)

ChocolateMillie- Pred does cause PU/PD -increased drinking & increased urinations.


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## bigpoodleperson (Jul 14, 2009)

Absolutely the Pred. could be the cause for the leaking, and it is the cause for increased thirst! I know of lots of dogs that have leaking on pred with no prior history of it. I would wait to see how she is once off the pred. before treating the leaking.
Riley gets horrible increased thirst/urination, and increased appitite on higher doses of the pred. He has finally gotten used to his daily dose for the addisons, and just drinks slightly more in general. When we first put him on it though he ate Everything (got into garbages All the time, his cat poop eating behavior came back after years, etc). Even the other week I have him a very small amout of steroid injection for his ears and he was Bad!!


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