Incurin for Dogs – Spay Incontinence Treatment
Incurin (estriol) is a short-acting estrogen for estrogen-responsive urinary incontinence (USMI) in spayed female dogs.
Dose
Loading (first 7-14 days)
1 mg PO once daily
Maintenance
Taper to LOWEST EFFECTIVE dose – typically 0.5-1 mg every 1-2 days
USMI – Urethral Sphincter Mechanism Incompetence
- Affects ~20% of spayed females (higher in large breeds)
- Estrogen deficit reduces urethral muscle tone
- Incurin restores tone
- ~80% success rate
Alternatives
| Treatment | Dose | Notes |
|---|---|---|
| Incurin (estriol) | 1 mg daily then taper | Short-acting estrogen |
| Phenylpropanolamine (Proin/PPA) | 1-2 mg/kg q8-12h | Alpha-adrenergic |
| Combination | Both at lower doses | Refractory cases |
| Surgical | Colposuspension, hydraulic occluder | Severe refractory |
âš Contraindications
- Intact females – never use
- Pregnancy – teratogenic
- Suspected breeding female
- Bone marrow disease
- Mammary tumors
Side Effects – Rare with Short-Acting Estriol
- Mild vulvar swelling
- Attraction by intact males
- Mammary changes (rare)
- GI upset uncommon
- Bone marrow toxicity rare at low dose
Unlike older estrogens (DES), Incurin has wide safety margin.
Monitoring
- Continence frequency log
- Watch for estrogen excess signs
- Annual CBC
- Long-term/lifelong therapy typical
Frequently Asked Questions
How much Incurin for my spayed dog?
STARTING DOSE: 1 mg (1 tablet) PO once daily for 7-14 days. MAINTENANCE: Once continence achieved, taper to LOWEST EFFECTIVE dose – typically 0.5 mg (1/2 tablet) every 1-2 days. Some dogs need 1 mg daily long-term; others maintain on every-other-day or twice-weekly dosing. Use minimum effective dose. Tablets are splittable. Long-term/lifelong therapy typical. Goal: full continence with smallest dose. If no improvement after 4-6 weeks at 1 mg/day, consider alternative diagnosis or combination with PPA.
Incurin vs Proin (phenylpropanolamine) – which is better?
BOTH effective with ~80% success rate. Different mechanisms. INCURIN (estriol): 1) Short-acting estrogen; 2) Restores urethral muscle tone; 3) Once daily then taper; 4) Spayed females only; 5) NEVER pregnant/intact; 6) Side effects: vulvar swelling, attractiveness to males. PROIN (PPA): 1) Alpha-adrenergic agonist; 2) Increases urethral sphincter tone; 3) Three-times-daily dosing typical; 4) Both sexes; 5) Side effects: restlessness, decreased appetite, elevated BP, GI upset. CHOOSE INCURIN if: prefer once-daily dosing, PPA not tolerated, cardiac/hypertension concerns. CHOOSE PROIN if: needs immediate effect, can give TID, no cardiac issues. COMBINATION: Both at lower doses for refractory cases. Discuss with vet.
Is Incurin safe long-term for my dog?
YES – generally safe long-term at lowest effective dose. Most dogs need lifelong therapy. ESTRIOL is SHORT-ACTING estrogen – safer than older diethylstilbestrol (DES) which had bone marrow toxicity. SAFETY: 1) Wide safety margin; 2) Low risk bone marrow effects; 3) Mild estrogen-like effects possible (vulvar swelling); 4) Annual CBC monitoring recommended; 5) Most dogs tolerate well; 6) Adjust dose as needed. CONTRAINDICATIONS: 1) Intact females (NEVER); 2) Pregnancy (teratogenic); 3) Bone marrow disease; 4) Mammary tumors; 5) Estrogen-dependent tumors. MONITORING: 1) Continence diary; 2) Vulvar size; 3) Mammary changes; 4) Annual CBC; 5) Periodic vet visits; 6) Adjust dose if breakthrough incontinence. WORK WITH VETERINARIAN for personalized protocol.
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References & Further Reading
The dosing ranges and safety information on this page are drawn from the following veterinary references. Always defer to your own veterinarian and the manufacturer’s label for your specific product.
- Plumb DC. Estriol/Incurin.
- Hamaide AJ et al. Pharmacologic management of USMI in dogs.
- Lekcharoensuk C et al. USMI in spayed female dogs.
- Ettinger SJ. Textbook of Veterinary Internal Medicine.
- PuppaDogs. Proin Calculator, Urinary Incontinence Calculator. puppadogs.com.
