Diethylstilbestrol (DES) Capsules (Compounded) Rx
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Diethylstilbesterol (DES) Capsules (Compounded) for Pets
Why has my veterinarian prescribed DES Capsules?
Diethylstilbestrol is a synthetic non-steroidal estrogen agent. This medication has been used in estrogen responsive urinary incontinence and to prevent pregnancy after mismating in female dogs and cats. Diethylstilbestrol may be prescribed for other conditions.
How do I give DES Capsules?
First, READ THE LABEL CAREFULLY.
Give Diethylstilbesterol to your pet as directed by your veterinarian.
If you are pregnant or are trying to become pregnant, be sure to handle this medication with caution.
Give this medication one hour before or two hours after meals.
If Diethylstilbesterol is prescribed as a liquid, measure the dose carefully.
Depending on your pet’s response to treatment, this medication may be given once a day, once every 3-5 days, or as a weekly maintenance dose.
DO NOT give your pet more medicine than directed.
DO NOT give your pet medicine more often than prescribed.
Try not to miss giving any doses.
If I miss a dose, what do I do?
If you miss a dose, give it to your pet as soon as possible. If it is almost time for the next dose, skip the missed dose, then continue with the regular dosing schedule. Do not give your pet two doses at once.
How do I store DES Capsules?
Keep this medicine out of reach of children.
Store this medicine at room temperature in a dry, cool place. Keep this medicine away from heat and direct sunlight.
Do not store this medicine in damp places, in the bathroom, or near the kitchen sink. This medication can break down when exposed to moisture or heat.
What are the potential side effects of DES Capsules?
This medicine may cause some blood abnormalities. Contact your veterinarian if you notice any unusual behavior in your pet.
Other side effects may occur. If you notice anything unusual, contact your veterinarian.
What about possible drug interactions?
Be sure to tell your veterinarian about any other medications you are giving to your pet.
It’s not uncommon for your veterinarian to prescribe two different medications, which may cause a drug interaction to occur. If this happens, your veterinarian may change the dose and/or monitor your pet more closely.
The following drugs may interact with Diethylstilbestrol: rifampin, phenobarbital, phenylbutazone, corticosteroid agents, and oral anticoagulants.
Contact your veterinarian if your pet experiences any unusual reactions when different medications are given together.
*SIX MONTH SHELF LIFE ON DES FROM DATE PREPARED.*
Diethylstilbestrol (DES) (Vet)
Medication Fact Sheet
Description of Medicine:
This medication is typically used to treat estrogen responsive incontinence in spayed female dogs and benign prostatic hypertrophy in male dogs. It works by acting on estrogen hormone receptors, although the compound itself is not a steroid.
Cautions and Warnings:
This medication should be used cautiously in older animals as they will be more susceptible to adverse effects. This medication is normally contraindicated in pregnancy, unless specifically prescribed by a veterinarian during pregnancy.
How to Use this Medication:
This medication is usually prescribed as 0.1-1.0 mg daily for five days. After this, the dose is usually reduced to 1-3 times per week. Dosing regimens may vary with weight and disease state.
Possible Side Effects:
Side effects are typically limited to those that are caused by excess estrogen. This includes bone marrow depression, feminization of male dogs, increased risk of pyometra (an infection of the uterus), and increased risk of estrogen-sensitive tumors. Side effects tend to be more prevalent with higher dosages and in older animals. Contact veterinarian if signs and symptoms of lethargy, diarrhea, vomiting, abnormal discharge from vulva, excessive water consumption and urination, or abnormal bleeding occur.
Beyond Use Date:
· Capsules: It is recommended that this product be used within 180 days.
Storage Requirement:
· Capsules: Store at room temperature, protected from light.
· Keep out of reach from children to avoid accidental ingestion.
References:
1. Plumb DC. Diethylstilbestrol. Plumb’s veterinary drug handbook. 5th ed. 2005.
2. Papich MG. Diethylstilbestrol. Saunders Handbook of Veterinary Drugs. 2nd 2007.
What is urethral incontinence?
Urethral or urinary incontinence is the loss of voluntary control of urination. It is usually observed as involuntary urine leakage.
What are the clinical signs of urethral incontinence?
The most common clinical sign is pooling or spotting of urine underneath the dog when it is sleeping or relaxed. Many dog owners report finding wet spots on the bedding or floor where the pet has recently been laying down or sleeping. Occasionally owners will report dribbling of urine while the dog is walking or after she urinates. In many instances the dog seems unaware of what is happening. It is estimated that urethral incontinence may affect over twenty percent of all spayed female dogs, especially large-breed dogs. Urethral incontinence is most common in middle-aged to senior, medium to large-breed female dogs although any dog may be affected.
What causes urethral incontinence?
There are several potential causes of urinary incontinence. These include:
- Neurological Causes including spinal injuries, disruption of the nerves controlling the bladder and brain diseases or lesions.
- Bladder Storage Dysfunction including bladder hypercontractility in which the bladder contracts frequently resulting in small amounts of urine leakage.
- Urinary tract infections or bladder tumors, or any condition that compresses the bladder from the outside
- Urethral disorders in which the muscles that close the urethra fail to tightly contract and urine leakage occurs. This is one of the more common causes and is often associated with hormone responsive urinary incontinence, urinary tract infection or inflammation, prostatic disease in male dogs and vestibulovaginal anomaly in females.
- Anatomic Abnormalities such as a congenital defect, an injury or surgery that has caused damage or altered the normal bladder function. Ectopic ureters (ureters that are not in the correct anatomical location due to a birth defect), urethral hypoplasia, and vulvar or perivulvar conformation abnormalities are some of the anatomic abnormalities that can cause urinary incontinence.
- Urine Retention results when a dog will not urinate due to stress, fear or behavioral abnormality and ultimately urine leakage occurs when the pressure inside the bladder exceeds urethral outlet resistance.
- Mixed Urinary Incontinence occurs in both dogs and humans and is the combination of multiple factors affecting normal urination. Combinations of urethral and bladder storage dysfunction and anatomic and functional disorders are most likely to occur.
How is urethral incontinence diagnosed?
Urethral incontinence is diagnosed based on clinical signs, medical history and blood and urine tests. Bladder radiographs and ultrasonography are often performed to search for bladder stones or other abnormalities affecting urine storage and outflow. Neurological tests such as examination of the anal and tail tone, perineal sensation and various spinal reflexes will be performed if a neurological disorder is suspected. Urethral catheterization may be required if urine retention is observed, to determine if there is an obstruction or other urethral abnormality present. Cystoscopy may allow the veterinarian to see an abnormality within the bladder or urethra. In certain cases, specialized testing such as measuring the pressure within the bladder is performed.
How is urethral incontinence treated?
"Treatment will be based on your pet's specific diagnosis."
Treatment will be based on your pet's specific diagnosis. Medications that increase urethral sphincter tone such as phenylpropanolamine (PPA) or imipramine, or hormone replacements such as estrogen or diethylstilbestrol (DES) are commonly used alone and in combination. Many dogs that respond poorly to PPA alone will benefit from a combination of PPA and DES. Approximately 70% of all cases respond well to medical therapy alone. GnRH analogs may be considered in severe or refractory (failure to respond) cases. With long-term usage, the patient's blood and urine should be periodically tested to ensure that there are no untoward side effects. Your veterinarian will prescribe the best treatment for your pet's individual needs.
"Many dogs that respond poorly to PPA alone will benefit from a combination of PPA and DES."
New research has focused on collagen injections and a novel substance called Tegress. These surgical solutions hold promise and should be discussed with your veterinarian to determine if any of the surgical specialists in your area are performing these procedures.
What is the prognosis for urethral incontinence?
While the prognosis is determined by the specific cause, in general the prognosis is good. Control of urine leakage will vary from dog to dog but most dogs can be managed successfully with medications, lifestyle changes such as more frequent trips outside to urinate, and close monitoring.
Diethylstilbestrol DES Capsules (Compounded) for Pets (Rx)
Trade Names:
Stilbesterol
General Description:
This drug is a synthetic hormone that is used primarily in dogs and cats to help increase muscle tone of the bladder. Diethylstilbestrol is available in many forms from a compounding pharmacy.
What is this drug?
- A type of estrogen
- Given by mouth
Reasons for prescribing:
- To treat hormone responsive urinary incontinence in spayed dogs and cats
What dogs/cats should not take this medication?
- Animals that are not spayed
- Animals that are breeding males
- Animals with mammary cancer
- Animals with bone marrow disease
- Animals that may be pregnant or nursing
- Animals with a known hypersensitivity or allergy to this drug should not take this medication
Directions:
Read and follow the prescription label carefully.
Give the exact amount prescribed and only as often as directed.
Discuss with your veterinarian if this medication is to be given with food.
Give this medication for as long as your veterinarian directs. Do not skip doses or stop giving the medication without consulting your veterinarian.
Baseline blood work and urinalysis may be recommended to assess your pet's general health before starting this drug.
Periodic blood work and urinalysis to monitor diethylstilbestrol's effect on the body is also advised as long-term therapy is often necessary.
Dose adjustments may be made based upon these results and an assessment of how your dog or cat is responding clinically.
Call ahead for refills.
Ideally, give this medication at the same time(s) daily.
What if a dose is missed?
If a dose is missed, give it as soon as you can. If it is time already for the next dose, skip the missed dose and go back to the normal schedule. Do not give two doses at the same time.
What to tell/ask a veterinarian before giving medication?
Talk to your veterinarian about:
- When your pet will need to be rechecked
- What tests may need to be performed prior to and during treatment with this drug
- What are the risks and benefits of using this drug
Tell your veterinarian about:
- If your pet has experienced side-effects on other drugs/products
- If your pet has experienced digestive upset now or ever
- If your pet has experienced liver or kidney disease now or ever
- If your pet has experienced any other medical problems or allergies now or ever
- All medicines and supplements that you are giving your pet or plan to give your pet, including those you can get without a prescription. Your veterinarian may want to check that all of your pet's medications can be given together.
- If your pet is pregnant, nursing or if you plan to breed your pet
Storage and Warnings:
Diethylstilbestrol should be stored in a childproof container in a cool, dry place at room temperature away from heat and direct sunlight.
Keep this and all medication out of reach of children and pets.
Diethylstilbestrol can cause abortions and should not be handled by pregnant women or women trying to become pregnant.
Call your physician immediately if you accidentally take this product.
Potential side effects:
- This medication can affect the gastrointestinal system causing lack of appetite, vomiting and diarrhea
- This medication can affect the reproductive system in unspayed females causing uterine infections
- This medication can cause lethargy, an increase in thirst and urination
- This medication can affect the bone marrow resulting in abnormal bruising, bleeding, and an increase risk for infections
- If these symptoms persist or you notice anything else unusual, contact your veterinarian
Can this drug be given with other drugs?
- Yes, but possible interactions may occur when giving diethylstilbestrol in conjunction with: corticosteroids, phenobarbital, rifampin, warfarin
- Drugs other than those listed may also interact with diethylstilbestrol
- Do not give new food or medications without first talking to your veterinarian
- If your pet experiences any unusual reactions when taking multiple medications, contact your veterinarian
Overdosing?
Contact your veterinarian immediately if your pet receives more than the prescribed amount.
What else should I know?
Notify your veterinarian if your animal's condition does not improve or worsens despite this treatment.
As with all prescribed medicines, diethylstilbestrol should only be given to the pet for which it was prescribed.
It should be given only for the condition for which it was prescribed.
This is just a summary of information about diethylstilbestrol. If you have any questions or concerns about diethylstilbestrol or the condition it was prescribed for, please contact your veterinarian.