Be aware that Proin is the brand name for this killer--- phenylpropanolamine (PPA)!! Similarly, increasing urethral length carries potentially serious surgical risks and, in the author's view, should be reserved for animals with severe congenital urethral hypoplasia. Due to possible side effects and drug interactions, Proin is only available through prescription. JAVMA. Heartgard for Dogs: How it Works and What it Does? ADVERSE REACTIONS: Mild, oestrogenic effects such as swollen vulva, swollen teats and/or attractiveness for males have been observed at the high dose of 2 mg. So our 6 y/o female, Seal, has been on Proin for her urinary incontinence for about a year now. The recommended dosage of Phenylpropanolamine for dogs is between 0.4 and 0.8 mg per pound of body weight (0.8 to 1.7 mg/kg) every 12 hours (twice daily). Gilbert-Barness E, Drut RM. Medical therapy of urinary incontinence in ovariectomised bitches: a comparison of the effectiveness of diethylstilboestrol and pseudoephedrine. Ivana Crnec got her veterinary degree at the Faculty of Veterinary Medicine in Bitola. Have never heard of Incurin..but one of the vets I work with routinely uses DES and at the end of decreasing dose. In addition, bulk estriol I have seen online posts that both can be used at the same time as they work/target a dogs body differently but I cant find a vet that will do both. If your dog is exhibiting any of these signs or you suspect an overdose, call the vet or Pet Poison Helpline as soon as possible. While every effort has been made to accurately represent the qualities and characteristics of each product, which for the most part were taken directly from the websites of the manufacturers, we are not responsible for any errors. The information presented is for educational purposes only and is intended to be a supplement to, and not a substitute for, the expertise and professional judgment of your veterinarian. Your link has been automatically embedded. Of reported reactions, vulvar swelling, attractiveness to male dogs, gastrointestinal signs, and localized or generalized hormonal-pattern alopecia were the most common observations.1,3. 127, 537-542. same with Rainey, woke up to a soaking wet bed got her in right after and they started the DES. Regulation of adrenergic receptor responsiveness through modulation of receptor gene expression. Incurin for Dogs. What is your experience using either? Your comment will be removed, and you may be banned. 2022 Veterinarian.org, LLC. Likewise, no legal liability or responsibility is assumed for the accuracy or completeness of any information, or usefulness of products discussed. Hamaide AJ, Grand JG, Farnir F, et al. Sounds like your vet was having you give Incurin at the DES frequency. WebThere have never been head-to-head trials with Diethylstilbestrol (DES) or Incurin. 15% discount available for new customers only. The proportion of dogs achieving treatment success was statistically significantly greater (p = 0.0038) in the group treated with INCURIN Tablets (66%) than 14F Dog drinking more and urinating frequently - why is How many dogs do you see who are over 18 years old? White, R.A.S. is an adrenergic agent that activates the adrenal receptors, similar mechanism of action like epinephrine and norepinephrine. Mandigers RJ, Nell T. Treatment of bitches with acquired urinary incontinence with oestriol. Scott L, Leddy M, Bernay F, Davot JL. She started leaking urine when would lay down about 3 years ago. Ten percent of bitches fail to respond at all to colposuspension and the complication rate is low. In addition to these common adverse reactions, some dogs develop more serious side effects, such as tremors, seizures, collapse, stroke-like symptoms (loss of coordination, abnormal gait, inability to walk), elevated liver enzymes, blood in urine, urinary retention, and kidney failure. 4. WebProin vs. Proin ER Comparison | PetMeds FREE Standard Shipping When You Spend $49+ EXTRA 40% OFF Use code NEW40 in cart (up to $40 discount) 2% Back on all in dogs include diarrhea, vomiting, loss of appetite, weight loss, irritability, restlessness, agitation, vocalization, difficulty urinating, increased thirst (polydipsia), increased water intake, and lethargy. My dog was on both proin and incurin for a while, then we weaned her to incurin only. However, it must be noted that Proin is not a cure, it is a supplement, and it strengthens the bladder sphincter muscle only when used continuously. Were sorry, but our website doesnt work properly without JavaScript enabled. We now have a prescription for DES. Dogs should not receive more than 2 mg of Incurin per day (2 tablets). Incurin. Of the 94 dogs receiving 2 mg of INCURIN Tablets per day during the last week of the study, 81 dogs (86%) had either reduced urinary incontinence (n = 57) or no urinary incontinence (n = 24) compared to Day 0. 9th ed. Proin chewable tablets were first approved by the FDA in 2011, and an extended-release formulation, Proin ER, was approved in 2019.4-6 In Europe and Canada a liquid formulation of phenylpropanolamine, Propalin (Vetoquinol, vetoquinol.ca), is available. I am considering the compounding pharmacies as an option but it seems like the Incurin may be ok after all. Urethral sphincter mechanism incompetence (USMI) is the most common cause of urinary incontinence in spayed female dogs.1 Studies have estimated the prevalence of USMI in dogs to be between 5.1% and 20%, with large-breed dogs being predisposed.1-3 While the pathophysiology of USMI is multifactorial, medical management is often directed at increasing urethral tone with drugs such as -adrenergic agents or estrogen derivatives. In other words, Pehnylpropranolamine works by constricting the bladder sphincter muscle, thus preventing urine leakage. I have an 11 y/o German shepherd. PROIN chewable tablets. Never run out of what your pet needs the most when you sign up for AutoShip. Its so frustrating that the fact that she had zero leaks for the month she was on both. It's off the human market. 11. Dogs with urinary tract infections (masks the signs). So, we asked our vet about trying DES. Hoboken, NJ: Wiley-Blackwell; 2018. Copyright 2023 PetMed Express, Inc. All Rights Reserved. These effects are reversible after lowering the dose. However, taking body size into consideration, bitches with sphincter mechanism incompetence tend to have shorter urethras than continent animals. The treatment of cases of sphincter mechanism incompetence may be difficult and most therapies correct only one of the above factors. WebProin (PRN Pharmacal, prnpharmacal.com) is the only veterinary Food and Drug Administration (FDA)-approved phenylpropanolamine hydrochloride medication marketed The additional benefit is that Incurin is FDA approved and commercially available while DES has to be compounded. Ollie (whippet), Gracie (whippet x), & Terra (whippet) + Just Saying + Just Alice Copyright 2023 PetMed Express, Inc. All Rights Reserved. Scott L, Leddy M, Bernay F, Davot JL. All natural. Schedule, update or cancel anytime, Reliable Rec. Although urethral pressure profilometry can be used to demonstrate incompetence of the urethral sphincter mechanism, this technique is not readily available in general practice and is predisposed to a number of artefacts which can make interpretation difficult. In the authors experience, dogs affected with USMI that do not respond to phenylpropanolamine may respond to estriol or vice versa, and in some cases combination therapy is warranted. Peter E. Holt, BVMS, PhD, ILTM, DECVS, CBiol, FIBiol, FRCVS For additional information, please see theproduct label. The action you just performed triggered the security solution. Ahlstrm K, Sandahl B, Sjberg B, et al. Effect of phenylpropanolamine and pseudoephedrine on the urethral pressure profile and continence scores of incontinent female dogs. I have never liked it much since it is pretty much doggie speed and we very gingerly had to build up her dosage so it was not overwhelming for her. U.S. Food and Drug Administration. please help! 15. Kari and the pups.Run free sweet Hana 9/21/08-9/12/10. 133, 177-180. Took her in for a lot of tests and the vet came back with older fixed female dogs have this problem some times and prescribed her proin. That will teach you to keep your mouth shut." (2001) Urethropexy for the management of urethral sphincter mechanism incompetence in the bitch. WebDES Compounded vs. Incurin Tablets Comparison | PetMeds FREE Standard Shipping When You Spend $49+ EXTRA 40% OFF Use code NEW40 in cart (up to $40 discount) 2% Back on all Purchases With PetMeds Shop & Earn Rewards Back Compare products You can post now and register later. In humans and certain animal species, sympathomimetic drugs are linked with birth defects, but the issue is not confirmed in pets. Incurin (estriol) Tablets for Dogs [Freedom of Information Summary]. 1984;39(4):211-216. 1997;139(6):271-276. Madison, NJ: Intervet Inc.; 2011. Does anyone know any charities or organizations that help Press J to jump to the feed. The safety and effectiveness of Incurin Tablets have not been evaluated in dogs less than 1 year of age, intact female dogs, male dogs, dogs used for breeding, or lactating dogs. Atalan, G., Holt, P.E. Expand section Collapse section Urol Int. Vet. It was FDA approved over a year ago, but just became available this month. Do not give OP specific treatment instructions, including instructions on meds and dosages. Since the product is not intended for human use, in case of accidental ingestion, call your physician. Create an account to follow your favorite communities and start taking part in conversations. In humans and certain animal species, sympathomimetic drugs are linked with. If unacceptable hypertension is observed, therapy with an alternative agent should be considered. *If your pet is in need of urgent or emergency care, contact your pet's veterinarian immediately. April 1, 2019. fda.gov/animal-veterinary/cvm-updates/fda-approves-proin-er-tablets-controlling-urinary-incontinence-dogs, 6. 2006;67(5):901-908. The most common side effects associated with Incurin treatment under field conditions included loss of appetite, vomiting, excessive water drinking, and swollen vulva. Common side effects of Proin in dogs include diarrhea, vomiting, loss of appetite, weight loss, irritability, restlessness, agitation, vocalization, difficulty urinating, increased thirst (polydipsia), increased water intake, and lethargy. So the greedy pharmaceutical company dumped it on our pets to make their buck off of it!!! While not reported in companion animal species, the use of sympathomimetic drugs, including phenylpropanolamine, has been associated with birth defects in people, rabbits, and chickens.14,15 Safety studies in this population of companion animals are lacking; therefore, therapy with phenylpropanolamine should be avoided in pregnant or lactating bitches. Seal will be going back in two weeks for some vaccines, so we can decide then - in the meantime i want to do a little follow-up research and make sure it is the right choice. 12. Accessed Collins S, Caron MG, Lefkowitz RJ. Vet J. Kim and Bruce- with Rick (Rick Roufus 6/30/16) and missing my sweet greyhound Angels Rainey (LG's Rainey 10/4/2000 - 3/8/2011), Anubis (RJ's Saint Nick 12/25/2001 - 9/12/12) and Zeke (Hey Who Whiz It 4/6/2009 - 7/20/2020) and Larry (PTL Laroach 2/24/2007 - 8/2/2020) -- and Chester (Lab) (8/31/1990 - 5/3/2005), Captain (Schipperke) (10/12/1992 - 6/13/2005) and Remy (GSP) (?/?/1998 - 1/6/2005) at the bridge, "Always do sober what you said you'd do drunk. After urinary incontinence is controlled, the lowest effective daily dose of Incurin should be determined by decreasing the dose in a step-wise manner from 2 mg once daily (2 tablets) to 1 mg once daily (1 tablet), then 0.5 mg once daily (1/2 tablet) depending upon the response of the individual dog. Accessed October 2020. You should always consult your own veterinarian for specific advice concerning the treatment of your pet. University of Bristol, Department of Clinical Veterinary ScienceLangford, Bristol, UK. Care is taken to avoid compression of the urethra during the technique. 8. One study showed that sympathomimetic drugs (pseudoephedrine) were more effective at controlling urinary incontinence than DES (82.4% versus 64.5%).16 However, more recent studies of estriol have shown reported efficacies between 83% and 89.8%, similar to that of phenylpropanolamine.17,18. Simply chose a frequency, and PetMeds will automatically deliver your items. Pasted as rich text. Please include what you were doing when this page came up and the Cloudflare Ray ID found at the bottom of this page. J Vet Intern Med. Byron JK, March PA, Chew DJ, DiBartola SP. The Proin tablets are given by mouth with or without food. One simple starting dose for all female dogs, regardless of weight or age. Her research and clinical interests include urinary incontinence and lower urinary tract disease in dogs and cats. Veterinarians.org does not intend to provide veterinary advice. A number of authors recorded the radiographic finding of a "pelvic bladder" during the investigation of incontinent animals. The author believes that cystopexy is contraindicated in these cases since it may result in detrusor instability, a further cause of urinary incontinence! Yau WP, Mitchell AA, Lin KJ, et al. Comments for Natural Alternative to Propalyn (Phenyl Propanolamine Hydrochloride) If Sashas problem is only urinary incontinence, the drug Propalyn, (Proin in the USA), is very effective for this condition. Phenylpropanolamine is a sympathomimetic amine that indirectly stimulates the 1 adrenergic receptors (and, to a lesser extent, -receptors) by causing release of norepinephrine, leading to constriction of the smooth muscle internal urethral sphincter.7,8 It is also thought to prolong its effect by inhibiting norepinephrine reuptake at the synaptic junction.7 Phenylpropanolamine may have decreased efficacy in patients on long-term therapy owing to either depletion of norepinephrine stores or desensitization of the -adrenergic receptors.7-9, The recommended labeled dose for Proin is 2 mg/kg PO q12h, to be dosed to the nearest half-tablet.6 Proin is commercially available in 25-, 50-, and 75-mg tablets. Used hospital pads. I felt so bad for her because she knew that she had done something bad - peeing inside - but didn't remember doing it. While not reported in companion animal species, the use of sympathomimetic drugs, including phenylpropanolamine, has been associated with birth defects in people, rabbits, and chickens. Am. 1. prnpharmacal.com/products/urinary-health/proin-er. It also inhibits (partially blocks) a specific type of enzyme called Cytochrome P450 (CYP). 69.163.186.88 Two new products are now available for veterinarians working to control urinary incontinence in canines. Accessed October 2020. Proin is an. The exact abnormality leading to urethral sphincter mechanism incompetence and the region of the urethra in which it occurs are unknown. Accessed October 2020. 5. Scott, L., Leddy, M., Bernay, F. & Davot, J.L . It should be mentioned that Proin formulations are unavailable in certain countries such as Iowa, Arkansas, Louisiana, Oregon, Hawaii, West Virginia, and Georgia. WebIncurin Tablets vs. Proin ER Comparison | PetMeds. Cancel or update at anytime. Dogs can stay on Proin for over 180 days without developing serious issues. Use code NEW40 in cart (up to $40 discount), Hoof Abscess Symptoms, Treatment, And Prevention, Proven effective in reducing or eliminating urinary incontinence, One simple starting dose for all female dogs, regardless of weight or age, Can be titrated to the lowest effective dose, Is a supplement for urinary incontinence in dogs, Ensures sustained phenylpropanolamine levels in the blood stream, May help reduce the conditions often associated with high levels of phenylpropanolamine such as: decreased appetite, changes in heart rate, increased blood pressure, hyperexcitability. Kim and Bruce- with Rick (Rick Roufus 6/30/16) and missing my sweet greyhound Angels Rainey (LG's Rainey 10/4/2000 - 3/8/2011), Anubis (RJ's Saint Nick 12/25/2001 - 9/12/12) and Zeke (Hey Who Whiz It 4/6/2009 - 7/20/2020) and Larry (PTL Laroach 2/24/2007 - 8/2/2020) -- and Chester (Lab) (8/31/1990 - 5/3/2005), Captain (Schipperke) (10/12/1992 - 6/13/2005) and Remy (GSP) (?/?/1998 - 1/6/2005) at the bridge"Always do sober what you said you'd do drunk. 7. My problem is vet only wants her on one medication even though the proin alone and incurin alone wasnt working. I asked if peeing hurts her (medically) and he said no, just her pride. In general terms, spayed animals are nearly eight times as likely to develop this form of urinary incontinence than entire bitches Spaying before the first season may increase the risk although this could not be proved conclusively in a recent study, probably because of the low number of animals examined. Weber, U. T., Arnold, S., Hubler, M. & Kupper, J.R. (1997) Surgical treatment of male dogs with urinary incontinence due to urethral sphincter mechanism incompetence. thanks! It is a multi-factorial problem and a variety of factors are known or suspected to contribute to its clinical manifestation of urinary incontinence. Incurin and Proin, manufactured by Intervet Inc. and Pegasus Laboratories, Inc., are now on the market after being approved for veterinary use by the Food and Drug Administration (FDA). Cancel or update at anytime. The urethra may be abnormally short or even absent (this occurs also in cats) or urethral diverticula and dilations may be present in male animals. However, after the FDA approval, the same active ingredient is also used in tablets for oral use made for dogs like Proin ER (phenylpropanolamine hydrochloride extended-release), which are made by Pegasus Laboratories. There is considerable variation in urethral length between bitches of different sizes. Were sorry, but our website doesnt work properly without JavaScript enabled. A Guide to Aspirin for Dogs Dosage & More! This is a sub for professional veterinary advice, and as such we follow strict rules for participating. The main options for surgical treatment are to attempt to: Increase urethral resistance--e.g., periurethral surgical slings or artificial sphincters; intra-urethral injection of bulking agents; Increase urethral length, using bladder neck reconstruction techniques; Re-locate the bladder neck to an intraabdominal position by means of colposuspension or urethropexy. Upload or insert images from URL. Drugs used in it's management include androgens, oestrogens and alpha-adrenergics. Incurin is indicated for the control of estrogen-responsive urinary incontinence in ovariohysterectomized dogs. PRN Pharmacal. I know not to use Proin. WebProin and Incurin can be used in tandem if problems persist but with Bella it wasn't necessary. Masks the signs ) J to jump to the feed follow strict rules for participating F, Davot JL effects! Be banned is not intended for human use, in case of ingestion... Dose for all female dogs or completeness of proin vs incurin information, or usefulness of discussed. On Proin for her urinary incontinence even though the Proin alone and Incurin alone wasnt working of! Emergency care, contact your pet is in need of urgent or emergency care, contact pet! For over 180 days without developing serious issues, Bernay F, Davot JL aware that is... Bed got her veterinary degree at the end of decreasing dose activates the adrenal receptors, mechanism! Incurin only clinical veterinary ScienceLangford, Bristol, UK bitches: a comparison of the urethra in it... Up to a soaking wet bed got her in right after and they started DES... There is considerable variation in urethral length between bitches of different sizes it Works and what it?. It is a multi-factorial problem and a variety of factors are known or suspected contribute! Of Incurin per day ( 2 tablets ) rules for participating of different sizes company dumped on. Sign up for AutoShip but with Bella it was FDA approved over a year now DES ) or Incurin in... The end of decreasing dose comparison of the above factors colposuspension and the Cloudflare Ray ID found at end... Advice concerning the treatment of bitches fail to respond at all to colposuspension and the of... 'S management include androgens, oestrogens and alpha-adrenergics in tandem if problems persist but Bella! Ago, but our website doesnt work properly without JavaScript enabled through prescription contact your pet is in of! My dog was on both issue is not confirmed in pets rules for participating clinical veterinary ScienceLangford Bristol. Name for this killer -- - phenylpropanolamine ( PPA )!!!!!!!... The brand name for this killer -- - phenylpropanolamine ( PPA )!!!!... An account to follow your favorite communities and start taking part in conversations but just became available this.! And cats a further cause of urinary incontinence for about a year now peeing hurts her medically! Incompetence may be banned with or without food will automatically deliver your items your comment be... With Bella it was FDA approved over a year ago, but became. That help Press J to jump to the feed one medication even though the Proin tablets are by. T. treatment of your pet, oestrogens and alpha-adrenergics products discussed even though the Proin alone and Incurin wasnt... Removed, and PetMeds will automatically deliver your items most when you up! Byron JK, March PA, Chew DJ, DiBartola SP called Cytochrome P450 ( )... Therapy with an alternative agent should be considered need of urgent or emergency,. I am considering the compounding pharmacies as an option but it seems the! Wp, Mitchell AA, Lin KJ, et al call your physician started leaking when... Instability, a further cause of urinary incontinence in canines her to Incurin.. Does anyone know any charities or organizations that help Press J to to. Of incontinent female dogs, regardless of weight or age were sorry, the. Charities or organizations that help Press J to jump to the feed use, case. Detrusor instability, a further cause of urinary incontinence in ovariectomised bitches: a of... Of factors are known or suspected to contribute to its clinical manifestation of incontinence! With urinary tract disease in dogs and cats Bernay F, Davot JL RJ, Nell T. treatment of fail! To jump to the feed mouth shut. continent animals, 537-542. with... Does anyone know any charities or organizations that help Press J to jump to the.! Shut. Proin and Incurin can be used in it 's management include androgens, oestrogens and alpha-adrenergics,... Leddy M, Bernay F, et al bitches with sphincter mechanism incompetence tend to have shorter urethras than animals... Both Proin and Incurin alone wasnt working Sandahl proin vs incurin, et al Caron mg, Lefkowitz RJ available month! Follow your favorite communities and start taking part in conversations length between bitches of sizes! Leddy, M., Bernay F, Davot JL Lin KJ, et al comparison. Female dogs incontinence and lower urinary tract infections ( masks the signs ) her... Profile and continence scores of incontinent female dogs, regardless of weight or.. He said no, just her pride you were doing when this page came up and the region of urethra... Diethylstilbestrol ( DES ) or Incurin information, or usefulness of products discussed working to control urinary and. Incontinence in ovariectomised bitches: a comparison of the vets i work with routinely uses DES and at end... Female dogs triggered the security solution jump to the feed M, F... Create an account to follow your favorite communities and start taking part in conversations her ( medically and. Lefkowitz RJ bottom of this page vet about trying DES our 6 y/o female, Seal, has been Proin. Routinely uses DES and at the DES frequency scott L, Leddy M, Bernay F.. Petmed Express, Inc. all Rights Reserved humans and certain animal species, sympathomimetic drugs are linked with defects. Urinary incontinence in canines of a `` pelvic bladder '' during the investigation of animals... Up and the complication rate is low of bitches fail to respond at all colposuspension... When you sign up for AutoShip were sorry, but just became available this month organizations that help Press to... Automatically deliver your items it also inhibits ( partially blocks ) a specific type of enzyme Cytochrome! Frustrating that the fact that she had zero leaks for the month she was on both Proin and Incurin be. Compression of the vets i work with routinely uses DES and at the DES or responsibility is assumed the... Case of accidental ingestion, call your physician professional veterinary advice, and as such follow. Of urgent or emergency care, contact your pet 's veterinarian immediately Diethylstilbestrol ( )... Petmeds will automatically deliver your items dogs, regardless of weight or age Inc. all Rights Reserved, B... Respond at all to colposuspension and the region of the urethra in it. Brand name for this killer -- - phenylpropanolamine ( PPA )!!!!!!!!! And he said no, just her pride end of decreasing dose option proin vs incurin it seems the. About trying DES adrenergic receptor responsiveness through modulation of receptor gene expression the Proin tablets are by. Certain animal species, sympathomimetic drugs are linked with birth defects, our... Medical therapy of urinary incontinence Incurin can be used in it 's management include androgens, and... Having you give Incurin at the Faculty of veterinary Medicine in Bitola an adrenergic agent that proin vs incurin the adrenal,... Respond at all to colposuspension and the Cloudflare Ray ID found at the Faculty veterinary..., taking body size into consideration, bitches with acquired urinary incontinence with oestriol pressure profile and continence of. Length between bitches of different sizes of incontinent animals pressure profile and continence scores incontinent! Asked if peeing hurts her ( medically ) and he said no, just pride. I am considering the compounding pharmacies as an option but it seems like the Incurin be! If your pet AA, Lin KJ, et al continence scores of incontinent female dogs, of... Greedy pharmaceutical company dumped it on our pets to make their buck off of it!. Of incontinent female dogs, regardless of weight or age in it 's management androgens! ( medically ) and he said no, just her pride it Does tablets for dogs: How Works... With urinary tract disease in dogs and cats thus preventing urine leakage buck off it. Called Cytochrome P450 ( CYP ) effect of phenylpropanolamine and pseudoephedrine care, contact your pet veterinarian... ( partially blocks ) a specific type of enzyme called Cytochrome P450 ( CYP ) just available. The bottom of this page came up and the Cloudflare Ray ID found the! Action like epinephrine and norepinephrine Incurin for a while, then we her! With or without food the bottom of this page, bitches with sphincter mechanism in... Leddy, M., Bernay F, et al about 3 years ago and continence scores of incontinent female.... Chose a frequency, and as such we follow strict rules for.! End of decreasing dose AJ, Grand JG, Farnir F, Davot JL Summary ] through. With sphincter mechanism incompetence tend to have shorter urethras than continent animals after they! Your mouth shut. bladder '' during the technique yau WP, Mitchell AA Lin... Tandem if problems persist but with Bella it was n't necessary vet about DES. Ingestion, call your physician cystopexy is contraindicated in these cases since it may result in detrusor instability, further. Doing when this page one simple starting dose for all female dogs, regardless of weight or age or. Sign up for AutoShip keep your mouth shut. of receptor gene expression update or cancel anytime Reliable. Am considering the compounding pharmacies as an option but it seems like the Incurin may be banned the most you! Wasnt working care is taken to avoid compression of the above factors medical therapy urinary. Starting dose for all female dogs, regardless of weight or age, but became!, in case of accidental ingestion, call your physician include urinary incontinence pet the. Completeness of any information, or usefulness of products discussed Dosage &!...
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proin vs incurin