Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Milk Thistle question

I received a response from Dr Dodds office. I'm being told Winston may be on Too Much Cyclosporin for his weight...50mg/day for a 7.5lb Maltese. Which as you all have mentioned, may cause liver issues. Which may be causing his hemocrit to drop. I'm going to ask for a Serum Chemistry Profile but in the meantime... What is the recommended dose for the milk thistle? The local pharmacy has 175mg caplets. There have also been many who are giving pepcid for stomach upset. How do you know what amount to give? Pepcid is over the counter at 10mg. Do you cut this in half? Is the whole pill too much? I am so concerned because neither of these have ever been suggested by Winston's doctor..

Lisa TX

Lisa, i can't really comment on the pepcid. We had all the stomach protectants through the vet. I gave Kahlu a 250mg capsule of Milkthistle. Make sure it has silymarin in it. After Kahlu developed extremely high liver enzymes, we switched to a product in tincture form. as far as I know you can not over dose on Milkthistle, so as long as you get a quality product you are fine. Brigitte & Kahlu

Brigitte BC Canada

Lisa, I am glad you contacted Dr Dodds. As for Milk thistle and stomach protectorant, because of his weight I have have the vet prescribe both. Take care Laurie

Laurie CA

Yeah that does sound like a high dose of cyclosporine. Cyclo is known to cause pretty terrible renal problems as well as liver problems so adding milk thistle is VERY important...when taking any drugs really. I say this because at higher doses milk thistle will protect the kidneys to a degree. The liver will regenerate but the kidneys won't. If I were you I'ld start at the normal human dose add more every couple/few days. This is for the regular milk thistle caps (silymarin's the latin name so same thing). Keep a good eye on Winston for side effects. I have yet to hear of any but you never know right. You could also look into Marin/Denosyl/or samE. Some are protectants and others are detoxifyers. Dosages of course would be different for these. I'm not sure of the dosages for pepsid. I use omeprazole as a protectant...it's a prescription med. Just call the doctor and ask them. All my best, Johnny & Tessy

Johnny

Lisa, With Holly we purchased the raw seed milk thistle from a health food store, put in a coffee grinder to a powder and then give her about 1/2 to small full teaspoon once a day mixed in with her kibble and a little water. With the pepcid we would break 1/2 of 10mg of that once a day before her prednisone about 1 hour. Are you also giving sulfacrate to him? Also stomach protectant. Johnny, omeprazole is the generic term for the pepcid. Linda

Linda Sapphire

Linda - How do you know the "dosage" of the milk thistle if you grind up yourself? Was this an amount that was recommended to you or was it trial and error? As to the pepcid - there was never any conversation about meds for preventing stomach problems with Winston's doctor at all - I was so surprised to find all the visitors to this site discussing medication related complications. I don't know what sulfacrate is so I assume Winston is not getting any...The discussions here have given me so much information to go back to Winston's doctor to discuss but I also know not all medical providers believe in herbal remedies.

Lisa TX

Hi Lisa Golly, Riley is on this dosage of cyclosporine, and similar in weight, probably lighter! This wasincreased in the last few weeks in the hope to try to reduce the pred and azathioprine - Im intrigued by this response from Dr Dodds. I get so frustrated by all of the medications, and what I am supposed to do, and what I should ask etc. I know Im not the only one. Sucralfate is under the brand name of Carafate here - stomach protectant - easily dissolvable with a litle water and syringed into the dog's mouth, much to their disgust. It should be given separately to any food - few hours in between. Hope that helps. I would be interested to hear what your vet has to say about the cyclosporine - it is expensive for sure! Cheers Silka

Silka Melbourne Australia

Linda, omeprazole IS NOT the same thing as pepcid. Close yes but the same no. The key ingredient in pepcid is famotidine and the key ingrediant in Prilocek is omeprazole magnesium. Unlike Pepcid, prilosek is released slowly into the body to target acid production. Prilosec's proton pump inhibitor's actually work to close the acid pumps that move acid into the stomach. Pepcid works differently. It only "helps" to reduce the amount of acid that the stomach produces and helps to stop the backup of acid from the stomach into the esophagus area. Pepcid doen't work as effectively as prilosek....so I've been told. I give Tessy her omeprazole once a day but I'm assuming the pepcid has to be given several times a day. I've heard that the over the counter form of prilosek has a potential of causing Gasto intestinal cancers (in rats) but not the under the counter kind. Not trying to knock pepcid but I just think omeprazole is a better choice...at least for me. Johnny & Tessy

Johnny

Hi Lisa I found this on the internet but you might want to double check the dosage with Dr Dodds or your vet. Here is a link to where I found it at http://www.canine-epilepsy-guardian-angels.com/milk_thistle.htm Milk Thistle Dosage (from the newsletter "Healthy Pets - Naturally"): Dog's size Dose as % of adult human dose 5 lbs 10% 5-10 lbs 15% 11-20 lbs 20% 21-40 lbs 30% 41-70 lbs 50% 71-100 lbs 75% 100 lbs 100% I would have the trough test done before I change the dosage, just because the absorption level might be different for each dog. Hope this helps, Cheryl & Ginger

Cheryl & Ginger Pineville PA

At the Novartis website, the treatment dosage (FOR ATOPHY or inhaled canine allergies) of Atopica, as listed on their website for veterinarians, for a dog weighing between 4-6.5 lbs should be 10 mg. daily. Side effects (reversible over a 12 week reduction period) were shown at *extremely high doses* (upwards of 3 to 9 times the recommended dose) in a large study of dogs. They included vomiting, diarrhea, weight loss, skin lesions, swollen gums, lower serum albumin, higher: cholesterol, triglycerides, IgA and IgG. Anemia and decreased leukocyte counts were seen in some dogs as well as some changes to the kidneys. Again, these seemed to reverse as the dose was reduced. There seemed to be less persistent side effects if the doses were carefully tapered. As for milk thistle: "Traditional milk thistle extract is made from the seeds, which contain approximately 4-6% silymarin." The extract consists of about 65-80% silymarin (a flavonolignan complex) and 20-35% fatty acids, including linoleic acid." So the important element in milk thistle is silymarin. Extracting it carefully to increase it's effectiveness and packaging it carefully to maintain it's purity is the big difference between buying a bottle of milk thistle for $3 at the drug store (probably just crushed seeds) and paying $30 for a package of Marin from your vet. Nutramax's webpage for Marin states: "The silybin in Marin which is in a phosphatidylcholine complex has increased bioavailability, reaching levels up to 4 times more than that seen with 80% standardized milk thistle extracts(silymarin). Silybin (derived from milk thistle) supports oxidative balance and helps the flow of bile through the liver. Bile is important in aiding digestion and nutrient absorption. Silybin may also support levels of glutathione which is an important compound for liver health." This is a fancy way to say that they extract the essence of milk thistle and put it into a "special package" of lipids that is more readily absorbed in the body. These "packages" are similar to cellular membranes in their structure. Think of it as body friendly. So it can be very worth while to utilize the Nutramax version of Marin (Silybin) or Denamarin (Sam-e and Silybin) when the liver enzyme values are extremely high. At one point Chance's alk phos was over 8600 (with a high normal of 212). I paid over $50 a month for Denamarin for him because I knew how important it was. my best patrice

Patrice NYS

This thread was discussed between 03/01/2010 and 04/01/2010

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