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#122499 - 06/28/03 05:14 AM Lupron??  
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Liisa B Offline
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Dr, Mike,
I have read your posts on Depo-Provera, and have also heard good (& not so good) things about this hormone therapy.
What is your opinion regarding Lupron being used with birds?
Thank you,

Liisa

#122500 - 06/28/03 01:18 PM Re: Lupron??  
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Dr. Mike Offline
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Liisa
I'm not surprised that you have heard both good and bad things about Depo-Provera. It is truly a double-edged sword.

This is because it can have some bad side effects in some individuals, depending on a number of physiologic and emotional and hormonal variables. It is sometimes used at too high a dose or too often. I would NEVER use it to stop egg laying, for example, even though it is VERY effective for this. It will reduce (antagonize) the production of both estrogen and testosterone, but is much safer in cases of testosterone blocking in males. In females, there is a higher risk of causing hepatic lipidosis. Keep in mind that both males and females produce both hormones, so there are circumstances where it can backfire in males and where it can be used safely in females. The "trick" is in predicting whether it is likely to be a problem in a given individual. This is not always reliably done.

As a result, the hormones Lupron and Human Chorionic Gonadotropin are often used instead. Neither has shown negative effects. Neither is as potent as Depo, either.

Lupron is a gonadotropin releasing hormone (GnRH) analog. By way of a positive feedback mechanism, it slows or stops the production of this reproductive-tract stimulating hormone from the pituitary. It seems to work relatively well in reducing egg laying, but not as well in affecting behavior changes. It has a very short half-life, so must be given repeatedly to work and is quite expensive.

HCG antagonizes the production of the hormones by causing a very low level of progesterone to be produced by the body. It can work for egg laying as well as for behavior modification. It also needs to be given repeatedly, but is less expensive. Many of us use it a lot. Mainly because it is safe, even though it doesn't work as effectively as Depo.

It is critical that anyone using these hormones understands that their use IS NOT a CURE for anything. The egg laying and the behavior problems they are used for are the result of NATURAL physiologic and behavioral issues that are exaggerated due to the way WE MANAGE THEM. The hormone treatments must be used only as a temporary tool to make it easier (possible) for us to make changes in management that can reduce the MANAGEMENT related problems. Behavior modification - mostly modification of the human in the picture – is the only way to actually RESOLVE the problems.

The problem is that the changes needed to resolve the problems are often the kind of changes that alter the status of our relationship with them as pets in ways we don't want to accept.

Dr. Mike smile

#122501 - 06/29/03 01:17 AM Re: Lupron??  
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Lei Offline
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Dr Mike,

I received Depro-Lupron injections as a treatment for edometrious. Is this the same drug you are referring to? 12 years ago it was $600 a shot and it wrecked havoc on my body, but it did stop the pain. My doctor would only allow me to have monthly injections for 6 months and I had to have surgery in the long run. After knowning what it did to me, I would run the other way before allowing another living soul go through that. Are the effects to the avian body different than the human body, or has the drug improved over the last decade?

Lei

#122502 - 06/29/03 01:58 AM Re: Lupron??  
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Hi Lei
Interesting. I'm sorry you had a bad experience with Lupron. I have actually talked to other women who have had similar experiences. I have also talked to a couple of women who had the opposite experience – all given Lupron for the same problem. There is more than one formulation available – they are the same hormone, but different duration of action. The 4 month injection is currently around 1600.00, but the more commonly used one is a one month injection and costs about 400.00.

I have not seen any negative clinical effects in birds, it just simply doesn't have the desired effect in many cases. Others have had different results. This is probably due to the difference in dosing between people and birds. The published doses are based on limited trials in birds (mostly to stop egg laying). These doses are extrapolated from human doses in an attempt to account for the difference in metabolic rate, so they are probably underestimated. This may represent an underdose, compared to the coresponding human dose.

All this is testimony to the fact that altering the hormone balance in the body will have quite variable effects, depending on many variable factors in each case.

I (and many others) find it to be most useful in ferrets to treat early (but not advanced) adrenal disease. I only use it in cases where surgery is not an option due to the expense. In these animals, Lupron occasionally causes obesity (I have seen this only once out of several dozen that are currently receiving the treatment). Again, no other kinds of side effects have been noticed or reported, other than occasional injection-site reactions.

Thanks for sharing your experience.

Dr. Mike smile

#122503 - 06/29/03 02:45 AM Re: Lupron??  
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Dr. Mike,

Would it be correct to assume that Lei's poor reaction was just that and not a common reaction ? Because I know I had poor reaction to birth control pills but I'm one out of TONS who don't. The reason I ask this is because I would hate for people to run scared of a drug just because of an isolated reaction. That would be like pulling birth control pills off the shelves because I couldn't take it. IMO, anytime ANY kind of "medicine" is given to human or animal there is a chance of reaction, just watch the commercials for prescription drugs, most CAN cause a reaction in someone out there so it just comes to weighing the benefit to the "possible" reaction. Correct ?

#122504 - 06/29/03 04:36 AM Re: Lupron??  
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M2Mom
Well said.
I agree totally.

I think that when deciding on the appropriate use of a given drug, several things must be taken into account:

1) The risk vs benefit - does the potential risk outweight the potential benefit? Or the opposite?

2) The incidence of problems reported with the drug

3) A careful analysis (as well as it can be done) of the possible variables that lead to conflicting reports. An example is with progesterone. I believe that it is safer in males, in general, than females, due to the differences in the jobs the estrogen and testosterone are doing in the two sexes at the physiological level

4) A careful look at the possible alternatives to the use of the drug. For example, progesterone (or any other hormone) should NOT take the place of working to understand the problem on a natural behavior level and behavioral modification that should be considered. The "shot" is sometimes very inviting, compared to the very difficult behavior analysis and resulting hard, long work and commitment to behavior modification. I think there are select cases where low doses (many "published" doses are way off and need revision, IMO) are helpful in making the behavior modification process easier on the patient and the client, but it is NOT a substitute. Ever.

Thanks for the great comment - I also am concerned that fear should not be the only reason to condem a drug that, under the correct conditions, may be very beneficial to some.

I am also grateful for the input of others who have shared their experiences, either favorable OR unfavorable, regarding the results from a drug. that is, after all, how we accumulate the information we have to take into consideration when deciding whether we use the drug. It also often leads to insight on what conditions cause the drug to be more or less successful and more or less harmful.

Dr. Mike smile

#122505 - 06/29/03 03:46 PM Re: Lupron??  
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Lei Offline
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M2Mom and Dr Mike,

Both of your points on reviewing the drug's overall benefit to the "general" population is why I asked about Lupron in the first place. If I was to have had my vet recommend the use of a Lupron (or any drug I had had a bad experience with) before seeing posts regarding its use in aviculture with positive results, I would be afraid to use the same drug on my avian companion. That is why I asked if the human body and avian body handled Lupron differently. Dr Mike's explaintion made me feel at ease enough that if my vet ever recommends Lupron for my Daisy Baby, I won't prevent her from receiving medication that could save her.

As I see more and more of human drugs being used in aviculture, I often wonder if the side effects of these drug are the same for our avian companions as it is for humans.

Thank you Dr Mike for taking the time to not only answer the questions of those in need, but to also educate us with your indepth responses. If you ever decide you want to move to Oklahoma (cost of living beats Jeresy and we do have Oklahoma State Vet School), I'll sign up to be your first client with all nine of my parrots in tow.

Thanks again,

Lei

#122506 - 07/11/03 08:34 AM Re: Lupron??  
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Just wanted to add my 2 cents here...
I have used Lurpon on a few birds in my flock for plucking and egg laying. It worked wonderfully on 2 macaws who plucked due to hormones and on an eclectus who plucked a little and layed eggs.
However, it does not have the same effect on every bird and the dosage needs to be played with. In order for Lupron to work on pluckers, the birds must be plucking due to hormones. I have tried it out on other pluckers who we were not sure if they were plucking because of hormones and it just did not have any effect. The dosage that we used was 100-700 micrograms per kilogram of weight. This a a big area to experiment within. My 1400g greenwing needed 150 micrograms every 4 weeks. However, my 1000g B&G needed 350 micrograms every 4 weeks. It took us a while to get the doses corrected. The 2 macaws get the injection every 4 weeks for about 8-9 months out of the year. The eclectus only needed one injection (175 micrograms)and was fine for 7 months after.
I noticed no ill side effects in the birds who took this medication. Once the doses were stabilized, I noticed improvement in them within a few days. Both completely stopped plucking and the GW who was territorial and agressive to some of my staff, was back to his pre-pubescent sweet self.
As in humans, not every bird will have the same reaction. However, I have had very good experiences in treating birds with Lupron.

#122507 - 07/12/03 01:40 AM Re: Lupron??  
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Hi BirdCurator

Thanks for sharing this data! Your 2 cents worth is worth much more than that.....

As you point out, Lupron may or may not benefit an individual and the variables include whether the stress level in the individual is being significantly contributed to by hormonal pressure, and of course, the dose and frequency used.

Hormone treatment is a "tug-of-war" with the hormone levels produced in the individual. It is quite variable and a lot of trial and error is needed to arrive at a dose and frequency that gives the desired result and is not giving adverse effects.

Fortunately, Lupron has been given in very large doses and has not been found to cause adverse effects, so the risk is low. This is also true of Human Chorionic Gonadotropin (HCG), another hormone commonly used.

The hormone that seems to often work the best is progesterone, (Depo-Provera), but there is a HIGH risk in overdosing this one, so that is why it's use is being replaced by Lupron and HCG. There is a large price differnce between HCG and Lupron. The former is relatively inexpensive, compared to the latter. For this reason, many people are not willing to continue with the trial and error process long enough to arrive at a dose and frequency that will be effective, so overall, it does not have a great reputation for effectiveness.

I also like to emphasize that most of the time, these hormone treatments should not be viewed as a "cure", but rather as a "helper", used to aid in behavior modification programs, making them more effective. The goal should always be to resolve the behavior issues with behavior modification, in the long term plan for the individual.

I recognize that, like other facets of keeping these birds in captivity, this goal may, in many cases, be realistically unattainable, due to the circumstances in the individual's life and human/bird flock, so the use of Lupron as a safe long-term solution would be nice, but the expense is a real limiting factor.

May I ask, what you pay for the doses you have mentioned, so others may get an idea of the cost of your success?

Dr. Mike smile

#122508 - 07/12/03 03:50 PM Re: Lupron??  
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May I ask, what you pay for the doses you have mentioned, so others may get an idea of the cost of your success?

I can not remember the exact amount of each because I always took both of the macaws in for treatments at the same time, so they were billed together. I believe that we paid around $200-$225 a month for both of the macaws to be treated. The eclectus dose was right around $70.

Its not a cheap treatment, and I agree that most people give up on playing with the dosage because of the cost. It is also far from a cure, but in all 3 cases, none of the birds had behavioral problems that needed to be corrected. I did, however, eventually change their environment. The macaws were part of an educational program where they were housed (in seperate cages) with many other birds. Because most of the parrots in the program were entering maturity at the same time, I thought it was best to retire these 2 from the program so that they were not influenced by the communal hormone level (it was like being in a Junior High School sometimes). Their new families have been keeping up on the treatments, but have told me that they can hold off longer during non-breeding season.
The eclectus is my personal pet. I am not sure why she only needed one injection, but I suspect it was because we gave it to her at a time where her calcium level had spiked. She is starting to exibit nesting behaviors now, but so far there are no eggs.

#122509 - 07/12/03 07:07 PM Re: Lupron??  
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Hi BirdCurator - thanks for the info - You got a bargain compared to what I have to charge for similar doses.

I am confused. You said, "It is also far from a cure, but in all 3 cases, none of the birds had behavioral problems that needed to be corrected."

Why, then, are you dosing these birds with a hormone?

To prevent behavior problems, or to prevent egg laying?

If it is to prevent egg laying, have they had a history of having any trouble forming and laying eggs?

Please endulge my curiosity smile

Many thanks for your willingness to share - I'm sure others are learning from this information.

Dr. Mike smile

#122510 - 07/12/03 08:06 PM Re: Lupron??  
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You are right Dr. Mike; I'm following this thread w/ MUCH interest !! Having a houseful of female birds (except my RB2; isn't HE the stud w/ his harem wink ) these are the types of things I'm very interested in. So far (TG) none of my girls have had any female problems but I love to be educated BEFORE things arise.

#122511 - 07/12/03 11:31 PM Re: Lupron??  
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I'm sorry for the confusion. The 2 macaws were pluckers. The B&G pulled out all of her back and under wing feathers in 1 night. She then continued to her chest. We put her on the Lupron within a few days of the start of the plucking and saw results in about a week. We took her off of it for a month to see if that was the real problem and she immediatly went back to pulling feathers. The GW was a plucker for a while prior, but only during breeding season. They did not have behavior issues before, so I am sure that it was purely hormonal. Teh male GW was territorial of his cage, but this was not a very big deal as I could still handle him.
The eclectus was put on it for egg laying and a little plucking. She stopped both.

Since there were so many birds in the program, we received a substantial discount on these treatments.


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