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Can i give my siberian huskey Estradiol 1mg. (my script I no…

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Hello, Can i give my...
Hello, Can i give my siberian huskey Estradiol 1mg. (my script I no longer take). Ive tried every med there is for incontience, with NO help.....Shes 7 yrs old. Thanks in advance for your help!!
Submitted: 2 years ago.Category: Dog Veterinary
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Answered in 3 minutes by:
6/26/2015
Dog Veterinarian: Dr. Jo, Dog Veterinarian replied 2 years ago
Dr. Jo
Dr. Jo, Dog Veterinarian
Category: Dog Veterinary
Satisfied Customers: 3,466
Experience: DVM from Iowa State University in 1994; actively engaged in private regular and emergency practice since that time.
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Hello,
I'm Dr. Jo and I'm here to help you with your question about your Siberian husky. I'm so sorry she's having this problem, but glad you're looking for the information you need.

You may join the conversation at any time by typing in what you want to say then clicking REPLY. That way we can chat back and forth until you're satisfied with the information I've provided and are happy to give me a positive rating.

I understand how frustrating this particular situation can be, especially since you've tried so many different things and nothing has worked. I'm also really glad you're asking first, because I would NOT recommend doing this.

More to follow (busy typing)...

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Dog Veterinarian: Dr. Jo, Dog Veterinarian replied 2 years ago

Estradiol *is* an estrogen, but it is not useful for treating estrogen-responsive urinary incontinence in dogs. It - simply put - doesn't work. The only thing it works for in dogs is causing abortions after an unintended mating, and it isn't even used for that any more because there are safer alternatives.

It's a really hazardous drug for use in dogs, as it tends to cause bone marrow toxicity and blood diseases.

Here's the prescribing information on it from a veterinary formulary...

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Dog Veterinarian: Dr. Jo, Dog Veterinarian replied 2 years ago

Estradiol Cypionate

  • (ess-tra-dye-ole)
  • ECP®
  • Hormonal Agent (Estrogen)

Prescriber Highlights

  • Natural estrogen salt used primarily to induce estrus; has been used as an abortifacient (but rarely recommended today).
  • Contraindications: Pregnancy (abortifacient, teratogen); the FDA has stated that the use of ECP in food animals is illegal.
  • Adverse Effects: In cats & dogs: Bone marrow toxicity, cystic endometrial hyperplasia, and pyometra.
  • In male animals, feminization may occur; in females, signs of estrus may occur.
  • Drug Interactions

Uses/Indications

For mares, indications for the use of estradiol include enhancing estrus behavior and receptivity in ovariectomized mares and to treat estrogen-responsive incontinence. Historically, estradiol cypionate has been used as an abortifacient agent in cattle, cats and dogs, but estrogens are no longer recommended by most theriogenologists for use as an abortifacient in small animals and the FDA stated (April 5, 2006): “The use of ECP in food-producing animals is illegal, and manufacturing and compounding of ECP for such use is illegal.”

Pharmacology/Actions

The most active endogenous estrogen, estradiol possesses the pharmacologic profile expected of the estrogen class. Estrogens are necessary for the normal growth and development of the female sex organs and in some species contribute to the development and maintenance of secondary female sex characteristics. Estrogens cause increased cell height and secretions of the cervical mucosa, thickening of the vaginal mucosa, endometrial proliferation, and increased uterine tone.

Estrogens have effects on the skeletal system. They increase calcium deposition, accelerate epiphyseal closure, and increase bone formation. Estrogens have a slight anabolic effect and can increase sodium and water retention.

Estrogens affect the release of gonadotropins from the pituitary gland. This can cause inhibition of lactation, ovulation, and androgen secretion.

Pharmacokinetics

No specific information was located regarding the pharmacokinetics of estradiol in veterinary species. In humans, estrogen in oil solutions after IM administration are absorbed promptly and absorption continues over several days. Esterified estrogens (e.g., estradiol cypionate) have delayed absorption after IM administration. Estrogens are distributed throughout the body and accumulate in adipose tissue. Elimination of the steroidal estrogens occurs principally by hepatic metabolism. Estrogens and their metabolites are primarily excreted in the urine, but are also excreted into the bile where most are reabsorbed from the GI.

Contraindications/Precautions/Warnings

Estradiol is contraindicated during pregnancy as it can cause fetal malformations of the genitourinary system and induce bone marrow depression in the fetus.

Estradiol cypionate should not be used to treat estrogen–responsive incontinence in small animals; other estrogens (DES, conjugated estrogens) are less toxic.

In cases of prolonged corpus luteum in cows, a thorough uterine exam should be completed to determine if endometritis or a fetus is present.

In ferrets, estradiol is reportedly very toxic to bone marrow.

Adverse Effects

Estrogens have been associated with severe adverse reactions in small animals. In cats and dogs, estrogens are considered toxic to the bone marrow and can cause blood dyscrasias. Blood dyscrasias are more prevalent in older animals and if higher dosages are used. Initially, a thrombocytosis and/or leukocytosis may be noted but thrombocytopenia and leukopenia will gradually develop. Changes in a peripheral blood smear may be apparent within two weeks after estrogen administration. Chronic estrogen toxicity may be characterized by a normochromic, normocytic anemia, thrombocytopenia, and neutropenia. Bone marrow depression may be transient and begin to resolve within 30-40 days or may persist or progress to a fatal aplastic anemia.

Estrogens may cause cystic endometrial hyperplasia and pyometra. After therapy is initiated, an open-cervix pyometra may be noted 1-6 weeks after therapy.

Estrogens may induce mammary neoplasia.

When used chronically in male animals, feminization may occur. In females, signs of estrus may occur and persist for 7-10 days.

In cattle, prolonged estrus, genital irritation, decreased milk-flow, precocious development, and follicular cysts may develop after estrogen therapy. These effects may be secondary to overdosage and dosage adjustment may reduce or eliminate them.

Reproductive/Nursing Safety

Estradiol is contraindicated during pregnancy. In humans, the FDA categorizes this drug as category X for use during pregnancy (Studies in animals or humans demonstrate fetal abnormalities or adverse reaction; reports indicate evidence of fetal risk. The risk of use in pregnant women clearly outweighs any possible benefit.) In a separate system evaluating the safety of drugs in canine and feline pregnancy (Papich 1989), this drug is categorized as class: D (Contraindicated. These drugs have been shown to cause congenital malformations or embryotoxicity.)

Estrogens have been shown to decrease the quantity and quality of maternal milk.

Overdosage/Acute Toxicity

No reports of inadvertent acute overdosage in veterinary patients were located; see Adverse Effects above.

Drug Interactions

The following drug interactions have either been reported or are theoretical in humans or animals receiving estradiol and may be of significance in veterinary patients. Unless otherwise noted, use together is not necessarily contraindicated, but weigh the potential risks and perform additional monitoring when appropriate.

  • Azole Antifungals (fluconazole, itraconazole, ketoconazole, etc.): May increase estrogen levels.
  • Corticosteroids: Enhanced glucocorticoid effects may result if estrogens are used concomitantly with corticosteroid agents. It has been postulated that estrogens may either alter the protein binding of corticosteroids and/or decrease their metabolism; corticosteroid dosage adjustment may be necessary when estrogen therapy is either started or discontinued.
  • Macrolide Antibiotics (erythromycin, clarithromycin, etc.): May increase estrogen levels.
  • Phenobarbital: May decrease estrogen activity if administered concomitantly.
  • Rifampin: May decrease estrogen activity if administered concomitantly.
  • ST. John’s Wort: May decrease estrogen activity if administered concomitantly.
  • Warfarin: Oral anticoagulant activity may be decreased if estrogens are administered concurrently; increases in anticoagulant dosage may be necessary if adding estrogens.

Laboratory Considerations

  • Estrogens in combination with progestins (e.g., oral contraceptives) have been demonstrated in humans to increase thyroxine-binding globulin (TBG) with resultant increases in total circulating thyroid hormone. Decreased T3 resin uptake also occurs, but free T4 levels are unaltered. It is unclear if estradiol affects these laboratory tests in veterinary patients.

Doses

Dogs:

  • For pregnancy avoidance after mismating (extra-label): Note: This drug is rarely used or recommended for this indication today as there are safer, more effective treatments. 44 micrograms/kg (0.044 mg/kg) IM once; during day 4 estrus to day 2 of diestrus, toxic at ≥100 micrograms/kg. (Wiebe et al. 2009)

Cats:

  • For pregnancy avoidance after mismating (extra-label): Note: This drug is rarely used or recommended for this indication today as there are safer, more effective treatments. 250 micrograms/kg (0.25 mg/kg) IM once 6 days after coitus; or 0.25 mg/cat IM at 40 hours after coitus. (Wiebe et al. 2009)

Cattle:

  • The FDA has stated that the use of ECP in food-producing animals is illegal.

Horses:

  • To enhance estrus behavior and receptivity in ovariectomized mares (extra-label): 5 – 10 mg (total dose) IM once. (Dascanio 2009)
  • For treatment of mares with estrogen-responsive incontinence (extra-label): 4 – 10 micrograms/kg estradiol cypionate IM daily for three days and then every other day. Some mares will improve, but does not “cure.” (Schott II et al. 2003)

Monitoring

When therapy is either at high dosages or chronic, see adverse effects for more information. Done at least monthly:

  • Packed Cell Volumes (PCV).
  • White blood cell counts (CBC).
  • Platelet counts; Baseline, one month after therapy, and repeated two months after cessation of therapy if abnormal.
  • Liver function tests.

Client Information

Injectable estrogen that should only be given by veterinarians.

Chemistry/Synonyms

Estradiol is a naturally occurring steroidal estrogen. Estradiol cypionate is produced by esterifying estradiol with cyclopentanepropionic acid, and occurs as a white to practically white, crystalline powder. It is either odorless or may have a slight odor and has a melting range of 149-153°C. Less than 0.1 mg/mL is soluble in water and 25 mg/mL is soluble in alcohol. Estradiol cypionate is sparingly soluble in vegetable oils.

Estradiol may also be known as: beta-oestradiol, dihydrofolliculin, dihydrotheelin, dihydroxyoestrin, estradiolum, NSC-9895, NSC-20293 (alpha-estradiol), and oestradiol; many trade names are available.

Estradiol Cypionate may also be known as: oestradiol cyclopentylpropionate, oestradiol cypionate, Delestrogen®, Depo-Estradiol®, Depogen®, Dura-Estrin®, ECP®, E-Cypionate®, Estra-D®, Estrace®, Estro-Cyp®, Estroject®, depGynogen®, Femtrace®, or Gynodiol®.

Storage/Stability

Estradiol cypionate should be stored in light-resistant containers at temperatures of less than 40°C, preferably at room temperature (15-30°C); avoid freezing.

Commercially available injectable solutions of estradiol cypionate are sterile solutions in a vegetable oil (usually cottonseed oil); they may contain chlorobutanol as a preservative.

Compatibility/Compounding Considerations

It is not recommended to mix estradiol cypionate with other medications.

In the USA it is illegal to compound estradiol for use in food producing animals.

Dosage Forms/Regulatory Status

Veterinary-Labeled Products:

There are several estradiol-containing implants for use in beef cattle.

Human-Labeled Products:

Estradiol Cypionate in Oil for Injection: 5 mg/mL in 5 mL vials; Depo-Estradiol®; (Rx)

Estradiol Valerate in Oil for Injection: 10 mg/mL, 20 mg/mL & 40 mg/mL in 5 mL multi-dose vials; Delestrogen®, generic; (Rx)

Estradiol Tablets: 0.5 mg, 1 mg, 1.5 mg, & 2 mg micronized estradiol; Estrace®, generic; (Rx)

Revisions/References

Monograph revised/updated January 2014.

Dascanio, J. (2009). Hormonal Control of Reproduction. Proceedings: ABVP. accessed via Veterinary Information Network; vin.com

Schott II, H. & E. Carr (2003). Urinary incontinence in horses. Proceedings: ACVIM Forum. accessed via Veterinary Information Network; vin.com

Wiebe, V. J. & J. P. Howard (2009). Pharmacologic Advances in Canine and Feline Reproduction. Topics in Companion Animal Medicine 24(2): 71-99.

January 1, 2005 (published) | January 1, 2015 (revised)

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Dog Veterinarian: Dr. Jo, Dog Veterinarian replied 2 years ago

As I said before, I'm really sorry your dog is having this problem, but Estradiol is not the solution. The real solution is to continue working with your vet or a specialist to determine a more suitable treatment plan. I know you've already tried "every" drug, but it may be that there is some underlying problem contributing to your dog's incontinence that needs to be addressed. Even arthritis has been known to contribute to incontinence, as well as unusual diseases like diabetes insipidus.

If your vet has exhausted all his/her resources and capabilities and hasn't been able to help you, then it's time for a referral to someone who can.

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Dog Veterinarian: Dr. Jo, Dog Veterinarian replied 2 years ago
Ask Your Own Dog Veterinary Question
Dog Veterinarian: Dr. Jo, Dog Veterinarian replied 2 years ago

The above articles will reference the most current and successful medications used for managing female urinary incontinence in the dog. While most dogs show improvement with at least one of the drugs discussed above, not every dog will. Most of those dogs, in turn, have some other underlying illness contributing to the problem, and they do better when that underlying illness is addressed.

I do hope this is helpful information to you and a satisfactory answer to your question.

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Dog Veterinarian: Dr. Jo, Dog Veterinarian replied 2 years ago

Please rest assured I am here to help.
You may still reply when you return online. I will be notified of your response via email and will do my best to help.
Please remember I am here for you and am happy to discuss this with you until you are satisfied with the information I've provided.
You may return to this page at any time to review the information and/or post more. I will be notified of your response via email and will do my best to help.
If you are satisfied with the information I've provided so far, I'll kindly ask you to rate my response on your way out of the chat, as this is the only way I am compensated for my time and effort.
If you are not, please let me know how else I may be of assistance.
Thank you for using our website.

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Customer reply replied 2 years ago
Thanks for your help. please discontinue my trial,
Dog Veterinarian: Dr. Jo, Dog Veterinarian replied 2 years ago
I apologize, but I am here to answer veterinary questions. I am unable to process any customer service issues with the website. If I am understanding your request to discontinue your trial as a request for the Just Answer website, please click on their customer service link for assistance with that, and they will be glad to help you.
My job as a veterinarian is to provide you with the answer to your question and it is important for me to be as complete, accurate, and honest in doing so, even if it isn't the answer you wanted to hear.
Again, sorry for the redirect to customer service, and before we wrap it up here, can you please let me know if I've answered your question to your satisfaction?
Thank you.
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Dog Veterinarian: Dr. Jo, Dog Veterinarian replied 2 years ago
To clarify, I am a working veterinarian sitting at my laptop, picking up questions on this website between patient visits. With what I see of the website on my end, I can read your questions and provide answers, but I cannot handle any website business. If you are needing to cancel a subscription or some other customer service issue, I *can* report the question to customer service, but you need to pursue it with them on your end.
In an effort to help you, if you are seeking customer service assistance I can go ahead and report your question, but I need to be sure that's what you're looking for before I do that. I am not sure what you meant when you said "discontinue my trial" because I don't know what a trail is or what services you applied for.
Do you want me to report your question to customer service?
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