Susan L. Clubb, DVM, JoAnn Hautamaki, and Mary Jo Meyer
Summary Style Manuscript
Affiliation: From Rainforest Clinic for Birds and Exotics, Inc, 3319 E Road, Loxahatchee, FL 33470, USA.
Feather damaging behavior is one of the most challenging case presentations that avian veterinarians face. The use of paired skin biopsies has been helpful in categorizing clinical cases so an appropriate clinical management plan can be devised.1,2 However due to the nature of psittacine patients, long-term management of either inflammatory or psychogenic patients is challenging for the owner and veterinarian.3,4 Owners often report that long-term oral medication of parrots becomes difficult and addition of medication to favorite foods is often refused. Oral administration of haloperidol tends to make parrots very drowsy initially, altering their personality in a way that is unacceptable to many owners. It also tends to wear off quickly, and for total control of feather damaging behavior may require multiple dosing each day. Such administration can damage the bond between the bird and its owner.
It was in this light that attempts to administer haloperidol transdermally were initiated. The dose could be applied to the owners thumb and discretely applied to the bird’s foot while it perched on the owner’s hand, thereby reducing adverse reaction to the owner’s attempts at medication. We have used transdermal haloperidol administration primarily in cases identified as psychogenic; however, haloperidol has a mild antihistaminic effect and has shown some benefit in calming birds identified as having inflammatory skin disease. In general, when applied transdermally the sedative effect of haloperidol seems less severe and the duration of effect appears longer. Controlled studies would be needed to confirm or refute these observations. Client compliance was generally better than with orally administered haloperidol.
Transdermal holoperidol was compounded in vanishing cream to a concentration of 2 mg/0.1 ml cream (Franks Compounding Lab, Ocala, FL, USA). Initial dosage was 0.01 ml/100 g body weight applied q24h or q12h, and owners were encouraged to increase dosage as needed to arrive at the desired effect. For very small birds, we diluted the product in order to achieve measurable volumes. Finger cots were dispensed for the owners’ use if they desired. Most clients have reported that they did not use them and have had no adverse effects.
Initial findings for transdermal use of haloperidol are mixed. In cases of acute onset of feather damaging behavior, cases of overpreening, and damaging of flight and tail feathers, transdermal haloperidol appeared to provide initial benefit, especially in cases where owners could not easily medicate their birds orally. Use of transdermal haloperidol in chronic cases, especially those diagnosed as being primarily inflammatory skin disease, provided little long-term benefit.
Transdermal application of haloperidol can be a useful tool, especially in initial management of acute causes of psychogenic feather damaging behavior. It is especially useful in birds that are difficult to medicate orally. However, initial data indicates that it may not be beneficial in long-term management of severe or chronic cases.
1. Clubb SL, Garner MM, Cray C. Detection of inflammatory skin disease in psittacines birds using paired skin biopsies. Proc Annu Conf Assoc Avian Vet. 2002;193.
2. Garner MM. Inflammatory skin disease in feather picking birds: histopathology and species predispositions. Proc Annu Conf Assoc Avian Vet. 2006;17–20.
3. Lennox AM, Van Der Heyden N. Long-term use of haloperidol in two parrots. Proc Annu Conf Assoc Avian Vet. 1999;133–137.
4. Clubb, SL. Clinical management of feather damaging behavior associated with inflammatory skin disease in parrots. Proc Annu Conf Assoc Avian Vet. 2006;73–77.