Adding Sam E and milk thistle?

[Jen]

Hi All! I want to start by thanking everyone for their support and advice. Since Maggie was diagnosed it truly has been an emotional roller coaster ride with so many unanswered questions. This forum is truly amazing and has given me so much information. Maggie had a PVC test Thursday and her RBC is holding at 34 and platelets have climbed. As long as we continue in the right direction, I can get by with just PCV test ($25) instead of the full testing each time so that will help save money.
I took your advice and discussed anti clotting meds w vet- she is now on 1/2 tab of baby aspirin daily. Vet suggested feeding her liver b/c her iron is a little low. Anyone know how much and how often?
Also advised to give her Sam E , melatonin, & milk thistle. One last question, should I be staggering all these meds or is it ok to give them at once (Pepcid with meds?).
Thank you again! I’m stillwaiting on copies of records before contacting Dr Dodds.

[Tamara]

Hi Jen, I’m so happy to hear how well Maggie is doing! And that you’re able to get away with PCV now, $25 is so much better than $125!

I’m a little worried that aspirin dosage may be too high, I’m hoping someone else will see this and comment. If I’m remembering correctly Hope’s Steve was on 1/8th of a baby aspirin (which she finally had compounded into liquid as it was frustrating her to try and cut it into pieces that small lol) and he weighs 50 pounds.

I always gave the pepcid away from the other meds, I think an hour before a meal. Keep a close watch on Maggie’s poo for blood or black as with all these meds she could develop a bleed. Adding sucralfate twice daily may be a good idea. It’s kind of a pain as it needs to be given two hours apart from all food and meds, but it’s a very good drug that protects the GI tract very well — it will prevent and heal any ulcers.

If you go with milk thistle and sam-E separately you can give those with meals. I’m not sure about the melatonin. There is also veterinary product called denamarin which is a formulation of the active ingredient in milk thistle plus sam-E, but that must be given on an empty stomach because of the enteric coating.

Do you normally give the atopica with food or without? I was advised to give it 2 hours after meals so I give pred with meals and then 2 hours later the atopica. But I do know others have been advised to give atopica with food. I think what’s important is consistency there. I was also told to keep the atopica in the freezer to help reduce GI problems.

I give Ashki about 1/8 cup of an organ meat mix daily for vitamins. You can also purchase Pet-tinic (Amazon sells it), Dr. Dodds recommends this as it is a hematinic which will help with red blood cell production. It has iron and B-vitamins in it, and I think also copper.

Sending you and sweet Maggie hugs and love —
tamara and ashki xoxox

[Patrice]

Manufacturer: Novartis
ATOPICA (cyclosporine capsules USP) MODIFIED is an oral form of cyclosporine that immediately forms a microemulsion in an aqueous environment.

ATOPICA should be given at least one hour before or two hours after a meal. If a dose is missed, the next dose should be administered (without doubling) as soon as possible, but dosing should be no more frequent than once daily.

ATOPICA should be stored and dispensed in the original unit-dose container at controlled room temperature between 59 and 77°F (15-25°C).

Vomiting and diarrhea were the most common adverse reactions occurring during the study. In most cases, signs spontaneously resolved with continued dosing. In other cases, temporary dose modifications (brief interruption in dosing, divided dosing, or administration with a small amount of food) were employed to resolve signs.

[hope]

Hey Jen!

AWESOME to hear Maggie is holding her own (and then some!) — wonderful news! I’m also super glad your vet is starting her on something to prevent clotting. Tamara is very correct — Steve was and still is on 1/8 81mg baby aspirin once a day. When he was first diagnosed, it was 1/8 BID (so 1/4 baby aspirin every day) but he was also 50 lbs and is (ahem) 61 now. . he’s gained a few recovery lbs. She’s also correct in that my *new level of sanity* does not allow for me to cut baby aspirins into 1/8s lol – for literally over a month after he was diagnosed I ran off of like 3 hours of sleep a day – I would pass out after hubby got up and take cat naps between all of Steve’s meds. Trying to cut little aspirins into little pieces wasn’t happening bc of course I would freak out if they were just a little too big or too small. Finally I talked my vet into calling it into a compounding pharmacy – expensive though ($35/bottle) but worth it for me lol. Just as important as the aspirin is, it’s important you don’t give too much bc aspirin is another one hard on the tummy. I think the recommended dose is 0.5mg/kg.. I don’t remember how much Maggie weighs but you may want to have a word with your vet about it?

Hang in there!
xoxo hope and steve

[Jen]

Anyone know the correct dose of milk thistle for 26 lb dog? I keep reading conflicting things.

[Tamara]

Hi Jen, I can send you a document on milk thistle that someone else made up. My email addy is (deleted). Once you have my email address let me know and I’ll ask the moderators to delete my address since this is a public forum.

Patrice — it’s interesting, I wondered about storing the Cyclosporine in the freezer and whether it would affect Ashki’s levels. But when Ashki wasn’t responding to treatment we tested his levels to make sure they were therapeutic and they were, so apparently storing the cyclo in the freezer is something clinicians have figured out helps with the GI side effects and doesn’t interfere with efficacy.

tamara

• This reply was modified 10 years, 2 months ago by Vally.
• This reply was modified 10 years, 2 months ago by Vally.

[Patrice]

Jen,
Dosage depends on the quality. The dollar store has bottles of milk thistle for a dollar. It probably has very little, if any, of the active ingredient, silybin, and most likely contains contaminants such as lead.

Chance’s liver enzymes were very high, for instance his ALKP was 40x normal. It was an emergency that he get those values down immediately. He was in pain and the liver was being damaged. I wanted, and the vet agreed, the highest quality supplement that I could use immediately. It was right on my vet’s shelf, Denamarin. Within a month his levels were much closer to normal and he was feeling more comfortable.

I have noted on a number of occasions here that supplements are very loosely regulated. Even after strengthening their language, the FDA could only make recommendations that manufacturers must comply by having records available, if asked, to show that the products they sell are safe,contain no contaminants, contain enough of the active ingredient, and have shown that enough is absorbed to be effective. This applies only to US manufacturers. There are not enough inspectors to ever cover the number of manufacturers adequately. Some companies have decided to do their own quality inspections with independent inspectors and market them with this seal of approval. Nature Made is one vendor that does this.

The same regulations don’t apply to dog products. You can still buy dog food and dog supplements made outside the country, such as China. There are very few regulations, if any, on those products.

You can never be sure exactly how much of the active ingredient you are getting in the product unless you purchase a product that has conducted independent studies on the efficacy. Thus the dose can be widely variable.

This document contains a chart of all the possible contaminants that can be in these products.
http://apps.who.int/medicinedocs/documents/s14878e/s14878e.pdf
my best
patrice

[Tamara]

Jen has emailed me; can one of the moderators please delete my email address?
thank you —
tamara