Friday, December 25, 2009

Side effects of denamarin

I have been getting many hits on this site on possible side effects to denamarin. Denamarin is a combination of Sylimarin (milk thistle) and SAMe. Denamarin is considered extremely safe if administered in the recommended dosage. One important point to make is it should be administered on an empty stomach. It has been known to cause diarrhea in some cases. SAMe can cause some dogs to vomit. But you can switch, with the advice of your vet, to standard milk thistle, liquid vitamin E and a B complex with C. The E and C enhance the effects of the milk thistle. I have taken Macy off Denamarin. Not that she was having problems with the medication, but she was doing beautifully on the milk thistle plus vitamins. She had come completely out of jaundice, was eating well and had regained all her weight. I must add it is cheaper to make your own denamarin. Here is what she gets. One 500 milligram milk thistle 2x a day, One 200 IU vitamin E soft gel (you can also find this in liquid form at a good health food store) 1x a day, Vitamin B complex with C (make sure this includes at least 50 milligrams of B12) 1x a day. You can pick the dosage you want. I tend to get the highest, 1000 milligrams. Vitamin K, 100 milligrams, 1x a day before bedtime. The vet had prescribed 50 milligrams, but the pills are tiny and impossible to cut in half. I upped the ante and watched her carefully. She has done just fine on the higher dosage. Again, I must emphasize that SAMe and vitamin E are not the same. SAMe is a biochemical produced by amino acids and used specifically for liver disease. Vitamin E is a supplement that enhances the effects of milk thistle. Partner with your vet before you make the switch and closely monitor the results. If you are noticing side effects to denamarin, vomiting and diarrhea are most common, make sure you are administering the medication on an empty stomach first. If that does not help, then ask your vet if you might try the above substitute I have found milk thistle to be tremendously effective in Macy's improved health. But the addition of vitamin B, C and E were important too. For more on that read here. I must encourage bookmarking this site for any questions on pet health or medications. They have a wealth of information in their library that is very user friendly. The other thing I like about their site is it is very balanced in it's opinion. Whenever I have a question, they are my first source of reference. Bookmark it, flag it or make me really happy and make it your home page. Merry Christmas to you all! Got lots coming up in the next few weeks, so stay tuned. We are addressing traditional heartworm and flea medications, the study just published in New Zealand on the global impact of pets and discussing more of the searches that land you on my page...successfully or unsuccessfully. This all takes a bit of work, but stay tuned. I really enjoy your feedback, so please don't be shy! Happy Holidays and all the best for the new year! Margot Hackett

37 comments:

donald said...

I just started denamarin for my 16 yo jack russell and did not give it on an empty stomach and have noticed some diarrhea. I'll hold it until the diarrhea resolves then restart with care to give it on an empty stomach. Thanks!

Margot said...

Your welcome!

Vivian said...

One would think that taking it on an empty stomach would actually increase gastric irritation and hence diarrhea. Seems weird that taking it with food would lead to diarrhea and not on an empty stomach. I thought that the advice to take on an empty stomach was in the literature, which was to enhance absorption because taking it with food greatly reduces its effect, and not because of bad side effects. I wonder if Donald's jack russell did any better or worse on an empty stomach.

Rasta Joy said...

My Aussie recently went to the ER with a case of high fever due to suspected hepatitis. He was sent home with a 2-week course of Denamarin. He's done beautifully on it (he is also on antibiotics). He was always dosed on an empty stomach and had no problems. My vet suggested buying ingredients over the counter, but we haven't yet discussed the components and their amounts, so thank you for the assist with that.

Margot said...

Rasta, How is your Aussie doing?
A high fever and high biliruben could indeed indicate either hepatitis or leptospirosis. If you have not done so already, you will want to run a lepto test and, if that is negative, proceed with an ultrasound and a biopsy.
Not cheap! I think my bill was over 6 grand.

I was able to save a lot on the expenses by going over the counter where possible. Vitamins E,C, B and K are all available at your supermarket or pharmacy.

Vitamin K, used to prevent internal bleeding in liver disease, is available at any good natural health store and the savings are significant. The chewable vitamin K the vet was giving me was $50 for a months supply. I was able to buy a three month plus supply at my natural health center for around $12 dollars. (K must also be administered on an empty stomach.)

If your vet prescribes ampicillan, ask him/her for a written prescription. Publix supermarkets will fill them for free and Walmart will fill for something like three dollars.

Denamarin can be purchased at 1-800-Pet Meds at roughly a $20 dollar savings over purchasing at your vets.

Su said...

My 12-year old toy poodle was diagnosed with liver failure at the end of December 2011. Her liver enzyme count was way over the top. I expected the worst. The vet prescribed Denamarin and Dibley's been on it ever since. Together with a complete change in diet - everything prepared by me and no dog foods - she seems to be doing okay (I've even got her eating cottage cheese!). She definitely has quality of life. She's had a loose tum just once, but I wouldn't say it was the fault of Denamarin. The very first thing we do in the mornings is feed her the Denamarin. I'm hoping the next blood test results will show some improvement.

Tami said...

I was wondering since the vitamin E and SAMe weren't the same - did you give SAMe also? They just put our 11y/o dog on Denamarin for elevated liver enzymes and would prefer a less expensive route of improving her health

Margot said...

I didn't because it wasn't available here Tami. And trust me I looked. I used regular, old vitamin E. But that is recommended as well for dogs with this condition. About 250 IU daily for a dog 25lbs. I would suggest you take a look at my post regarding diet and meds for a dog with liver disease. It will lay it out for you

Margot said...

Su, I am so glad to hear your poodle is not having an issue with Denamarin. Macy didn't either. But it was made clear to me on the day it was prescribed, it must be on an empty stomach. So I would pill her in the morning an hour before mealtime.

Margot said...

For you guys wondering, I strongly suggest you take a look at at Cyndi Smasal's book on diet and meds. It's called "Hope for healing liver disease." She really did the footwork on this issue. I emailed her and told her what a revelation she was to me.

Margot said...

You can find it on Amazon.

Wyldwood said...

Regarding Vitamin C: be aware that dogs- unlike humans- actually make their own C, so if you supplement with C, their system will eventually cease to produce it (depending on amounts supplemented). The only downside to this is that you then MUST provide ALL the C they require.

There is some good quantitative research out there on the 'net for further reading.

Caroline said...

You can purchase Denamarin for dogs online, for half the cost of the supplement from the vet. As I have a smaller 18.4lb dog, I will stick with the vet's idea for supplementation and not overdose the dog on vitamins. That is not a good thing either. Would not be cheaper for me to buy the other ingredients and have to put them together myself that I can see.

No prescription needed online.

Anonymous said...

My dog has had two SERIOUS nose bleeds while taking Denamarin. She was also taking tramadol for spine pain. I mean serious like 25 percent of her blood. When not taking the tramadol she was fine with the Denamarin . Any one else have an issue With nose bleeds while on this?

Margot said...
This comment has been removed by the author.
Margot said...

Tramadol can do that. Not saying that is what is happening with your dog but Nsaids, Non steroidal, anti inflammatory drugs, are notorious. Admittedly this is the first I've heard of bleeding through the nose. But it doesn't surprise me. Get your dog to a vet. Have a complete blood work up done, especially liver panels. If those strike suspect, get her off the meds permanent and retest in a month. I know that sounds expensive but you can just test the liver. But get her of the Tramadol!!

marigold said...

it appears the SAMe question was still not answered! gievelsEn17ving vitamins are not the same as SAMe...by any stretch...Administering SAMe (S-Adenosylmethionine), which is found in Denamarin, has been shown to markedly increase liver levels of glutathione,an important compound for liver health formed when SAMe is metabolized. The SAMe in Denamarin has also been shown to help protect liver cells from cell death and may help cell repair and regeneration.has anyone out there successively made theri own denamrin using SAMe and if yes,what is the formula...kindness,
mary beth

Margot said...

So what should I have said in relation to SamE? Your absolutely right as to the benefits. But some dogs get very sick, digestive issues generally.

Anonymous said...

I have a 12 yr old Schipperke who recently, out of the blue started having balance and sight issues. If she leans her head down she has this forward momentum that she cannot control. She Is on phenobarbital And has been for 5 years. Tests were conducted on her liver and it was found her bile acids were elevated. Seeing as they can't figure out as to why she's having these balance issues, they are assuming its from the liver or it's dementia. They started her on Denamarin three days ago and I am hoping for the best. Can anyone offer any information as to how long it takes for this drug to start working? Or has anyone ever experience balance issues in their pets that are having liver trouble?

Anonymous said...

My 8 year old Golden has just been put on Denamarin because of high liver enzymes. I must say that administering the very large pill without food to hide it in is proving stressful. My girl coughs and gags every time. I put the pill far back in the mouth then squirt some water from a syringe to help it go down. She and I both dread it every day. I wish there was a better way!

Anne E said...

I have given my dog Denamarin for 2 years now. At first she had a pill every morning but after a month she got it every second day. That worked well for a year and half, but then I had to start giving it to her every day again.
I give her a pill covered with a thin coat of liverpastry + a tiny bit afterwards - on a empty stomach. It works well - she has no diarrhea or vomits. I make her sit on her hindlegs to take the tablet, that way she has to raise her head so the throat is straight. I use the tiny bit to tempt her so she keeps this postion while she swallows the pill. It works well!

Anonymous said...

I dip the pill in water before putting it in my dogs mouth. I then use more water and holding the muzzle with my hand I rub the underside of her jaw/throat and she swallows just fine. I think the key is the wet pill

Anonymous said...

Regarding your 12yr old Shirperke. Your dogs problem could be the phebobarbital. Even though he has taken it in the past, he may no longer be able tolerate it. I assume he is it for seizures? I work with a rescue and recently one of our dogs was put on phenobarbital for his seizures. He satarted getting symptoms similar to uour dog. Only they got so bad he was staggering and not responding neurologically when taken to the vet. The young vet hinted that the best thing was to euthanize the dog. Our people took the dog to a neurologist we work with. In just a short time, she said it was the pheno. The dog was taken off it and is now his usual happy self. He is being given a different anti seizure drug.

Margot said...

Thank you from one anonymous to another. I hope that has you sorted! I think the mingling of minds never hurts! But if not i will ask. Not my specialty but I will look into it

Margot said...

Anonymous with the Golden. I get that. I so do because I am going through that very thing. So you have a dog with a heightened gag reflex. OK.. most every pharmacy has a pill grinder. You can chew that massive pill into powder and mix it with a bit of water and give it to her that way. Or cut the pill into tiny bits, which is what I have had to do with many of my meds. Royal pain, I grant you, but might work.

Margot said...

In regards to my post, Sam E wasn't available here while Macy was alive. It is now. Consult with your vet as to dosage for weight.

Margot said...

I have the same issue with pills. I have a triple threat when it comes to digestive issues and my gag reflex has become so heightened, it's hard for me to swallow a pill. I grind my pills or chew them if the taste isn't too bad. Like denamarin, they need to be taken on an empty stomach. It's a royal pain in the ass, but it is what it is. But I understand how hard it is to get a dog with a heightened gag reflex to take the pill. Macy was the bomb! I didn't have to pill her unless she was really sick. I would just hold it my palm and she would take it. But I am going through it now with her best friend Bailey who has been diagnosed with dysplasia. She won't eat anything so pilling has become a nightmare.

Anonymous said...

Tramadol isn't a NSAID. In humans, it's trade name is Ultram.

Bing said...

My 10 year old Shih Tzu was just given Denamarin. Now he has NEVER allowed me to put a pill in his throat.
Now after reading your blogs I'm seeing he may develop loose stools..?
I had no choice but to wrap it in a piece of cheese... My question is , Why did the Vet give me a pill form instead of the chewable type??? I just seen the chewable online
I can't believe too the price I was charged at 55.00 a box when their 35.00 online? This makes me angry at these money hungry Vets.. 20.00 ? Is a bit Too much don't you think when we're trying to save our little fur children.
I just gave my little guy his pill less than an hour ago.. Wait and see ...the next box will be ordered online in chewable form..

Anonymous said...

2 years ago, our dog developed Auto Immune Hemolytic Anemia. He was very very sick, but our wonderful vet pulled him through. It did damage to his liver. He was on Denamarin for over a year. We took him off of it due to adverse symptoms. It makes excessive hunger, thirst, panting, and shedding. After we took him off it, these symptoms demished. Last month he had a bad back spasm, which increased his liver enzeymes again. He went back on Denamarin. These symptoms have returned. He just had another blood test in which the enzymes were still elevated. Our vet wants him to continue the Denamarin. We do not want to continue, but I am wondering if we are doing the right thing. He seem's to have increased stomach issue's, but no diarrhea. Has anyone else experienced these symptoms??

Anonymous said...

My dog started to take the denemarin, but he urinates a lot. Everywhere in the house, he urinates. He never done that but I dont know why he's urinating a lot. Ever since he starting to take denamarin, he's doing that. Does anyone know why? Perhaps its like a side effect? Thanks you

Mary said...

Can you please give me some information about Vitamin K? You have posted 100 mg, but all I look at are in mcgs. Is it a typo on your part? Also I see there is K1, K2 and K3. Which is it? Very confusing! THank you!

Anonymous said...

the urinating a lot is part of the liver issues that denamarin is for. My cocker had the same issue but it stopped once the denamarin kicked in.

Anonymous said...

What a great site to have found today. My husband and I have dogs and cats and since we have no children, we try not to stress too hard about the vet bills. This is what we signed up for and we try to make their lives as comfy as possible. One of our small dogs is a schnauzer-chow mix. She had her gallbladder removed 2 years ago. When the surgeon was in there she identified Lily as having chronic liver disease. Since then we've had her on Denamarin and Ursidiol. Her liver enzyme levels went down and all has been well until recently. It sounds just like someone else who wrote in about side-effects. She pants constantly and after all the dogs have eaten, Lily spends an hour cleaning the bowls, she seems insatiable in her hunger and it makes me feel she's undernourished or something just isn't working. She's lost some weight as well. We took her to the vet and had an ultra-sound done. Her kidneys and adrenal glands looked abnormal. Blood-work was fine with a bit more of a spike in her liver numbers. The reason we took her was two-fold, she didn't want to eat and that was a huge red-flag since she seems famished all of the time. Here's what my vet is thinking from the symptoms - that she may be becoming a dog with Cushings Disease (forgive if spelling is wrong). So we are looking this up and reading all we can. I would say she might be onto something for sure for anyone who is witnessing this. Something else that evidently also can tag along after that is Diabetes. I'm a bit worn out on which came first - chicken or egg - on these subjects. She's only 7 years old. I want her to be happy and healthy and do the right thing for her. Today, I didn't give her her Denamarin or Ursidiol as yesterday she threw them up anyway. And today she seems to be less stressed, ate and is laying beside me right now as I type. I'd love some input about this situation. Thanks too for info on getting Denamarin online. I do have a couple helpful hints for the people I read having trouble with the pills. I've had very large and very small dogs as well as cats. I've had to learn to give them all pills in a low-stress good vibe way and for me it works if you wanna give it a go. I life Lily's snout/top of nose upward and the lower jaw automatically begins to drop away and their biting reflex is not as strong in this way. I usually take a bit of yogurt and stick the pill in that (not peanut butter, too thick and the pill gets found out too easily), then I stay lifting the snout and gently put the yogurt/pill blob on the roof of her mouth. She want to swallow it immediately. When I can see she has, I then tilt her chin up and gently rub her throat like I'm helping her swallow. I wouldn't squirt anything in her mouth though as it would make her panic. The other way without food that works for Lily and others I've had is to do the same lift of the snout until her biting reflexes seem disengaged and gently place the pill deep in the back of throat. I then tip her chin up to close her mouth and rub her throat again. I try to be all "zen-like" so she doesn't get stressed from my energy as well and it works pretty well. Not many gags at all. But it took me a long time to make her sort of look forward to it as a "treat". That's where the yogurt comes in handy. Anyway, I hope that helps someone and I really appreciate finding this site! I'll check back in for any feedback! peace n happy holidays to everyone! xo Jennie

DEE said...

Denamarin caplets or Denamarin chewables. Denamarin chewables have additives that the caplets dont't plus it has a terrible odor. My Boston had taken the caplet for months with difficulty because of the size & it couldn't be crushed. Asked vet to get the chewables. This was a nightmare! They were huge & smelled terrible. Broke into 8 pieces to try to get down her. Would place in chicken, beef, etc to disguise the size & odor. This was a continual fight to get down her. She had taken 19 of the chewable & I noticed during this time that her appetite decreased, she would not drink any water, she slept all the time-22 out of 24 hours & when she was awake, she staggered. I thought my Boston was dying. My vet was out of town so I stopped giving her the chewables 5 days ago. Her appetite has been increasing. She is alert & has a bounce in her step today. She has had only two 1 hour naps in 8 hours. Finally got to talk with vet. My Boston is not to take anymore Denamarin chewables & questionable if she will ever take any Denamarin again. Spoke with company that makes Denamarin & they told me that there have been some issues with the Denamarin chewable. Was told that the caplet could be crushed & mixed with a little water & given with a syringe immediately. Also was told that the chewables has additives that the caplets don't. The company also told me that my Boston could have had a reaction to the additives in the chewable. Would love to hear from others if their pets got sick on the Denamarin chewables or even worse- passed. Hope this helps someone to decide not to give their pet the chewable Denamarin. Don't chance it- give the caplet if you have to give.

James Lis said...

Started our 8 year old laid back chihuahua on denamarin two weeks ago after he became extremely sick. Liver enzymes went up to 1600. Think he got into something really bad outside during one if his walks. Stuff is amazing. Within two days he was back to normal. Only thing is he now eats like a small horse. Our chubby Chihuahua (Teddy).

Anonymous said...

My 70lb goldendoolde has been on prednisone (starting with a very high dose for 40mg and slowly tapering) for a month now and as a result his liver function started to suffer. He was prescribed Denamarin about 10 days ago and after a week his liver function improved by about 30% (was 600 yesterday, down from 900). I asked my vet about the Denamarin causing vomiting or diarrhea and she said that abnormal liver function would cause that and is more likely the cause than the Denamarin but was fully supportive of me switching to milk thistle as he is almost off the prednisone and his liver function has improved already. He has had occasional loose stools and about every other night for the past week I wake up to watery puke by the door. She recommended some fiber (canned pumpkin, cooked squash or sweet potato with each meal) for the loose stool and a Famotidine (Pepcid) at night to settle his stomach. Still came down to vomit after the first night on Pepcid but nothing this morning so I'm not sure if that is working for him or not.