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Phenylpropanolamine HCL (PPA) is a sympathomimetic amine which causes the release of norepinephrine by indirectly stimulating both the alpha and beta-adrenergic receptors. Its primary use in veterinary medicine is to increase smooth muscle tone of the urethra and the bladder neck. Other pharmacologic effects of PPA include vasoconstriction, increased heart rate, and coronary blood flow, increased blood pressure, and mild CNS stimulation.
In humans PPA was used as a nasal decongestant, and for appetite suppression but it has been withdrawn from the human market. There are some restrictions to the purchase of large quantities of PPA because it may be used illegally in the manufacturing of methamphetamine.
Urinary incontinence is a common clinical problem in both dogs and cats. It is seen more commonly in dogs than in cats and certain populations or breeds of dogs are more frequently affected. It is most common in older, female, spayed, dogs. Large and giant breeds are more at risk as are dogs with docked tails and dogs that are overweight. Urinary leakage is most likely to occur when the animal is tired, relaxed or sleeping.
Although PPA is an effective nasal decongestant and appetite suppressant in humans, it is less effective for this purpose in companion animals.
PPA needs to be given for several days before the full effects are seen. Client compliance with regular dosing is also important for this drug to work fully. Diethylstilbestrol is also used to treat urinary incontinence (see DES).
Rare: restlessness, excitability, hypertension, anorexia or decreased appetite.
PPA should be used with caution in animals with glaucoma, prostatic hypertrophy, hypertension, hyperthyroidism, diabetes mellitus, and cardiovascular disorders.
It is not known if PPA crosses the placenta or is excreted in milk. There is some clinical evidence that PPA may decrease ovum implantation. It should only be used during pregnancy or lactation when the benefits out weigh the risks.
PPA should not be administered with other sympathomimetic drugs such as ephedrine or epinephrine.
PPA should not be used within 2 weeks of treatment with monamine oxidase inhibitors.
The risk of hypertension is increased if PPA is given with NSAIDs (including aspirin), reserpine, tricyclic antidepressants, or ganglionic blocking agents.
There is an increased risk of cardiac arrhythmia if PPA is given with cyclopropane or halogenated hydrocarbon anesthetic agents.
Signs of overdoses with PPA resemble more severe side effects. Central nervous system signs can range from stimulation to coma. Cardiovascular signs can include both hypertension and rebound hypotension, bradycardia to tachycardia and finally cardiovascular collapse. Supportive treatment including gastric emptying, cathartics, and activated charcoal may be used if the overdose was recent.
Dr.
Barbara Forney is a veterinary practitioner in Chester County, Pennsylvania.
She has a master's degree in animal science from the University of Delaware
and graduated from the University of Pennsylvania School of Veterinary Medicine
in 1982.
She began to develop her interest in client education and medical writing 1997. Recent publications include portions of The Pill Book Guide to Medication for Your Dog and Cat, and most recently Understanding Equine Medications published by the Bloodhorse.
Dr. Forney is an FEI veterinarian and an active member of the AAEP, AVMA, and AMWA.
You can purchase books by Dr. Forney at www.exclusivelyequine.com
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