Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - SAMe

My vet recommends that Sunny take SAMe. Anyone have any experience with this supplement? Sunny takes so many pills that I do not want to add any more unless they are necessary or helpful. Do you give them with food? Two pills at once? Thanks for any advice you can give me. Leslie and Sunny

Leslie Oceanside

i did a quick search and this is what i found... S-Adenosyl (SAMe) was formulated to improve liver metabolic activity and restore proper liver function. Its unique, enteric-coated delivery system allows it to stand up formidably to stomach acid and effectively deliver the S-Adenosylmethionine 1,4 butanedisulfonate (SAMe) to the small intestine for proper absorption. Both strengths contain SAMe and other important ingredients for proper liver support such as milk thistle to help protect liver cells from toxins and reduce damage to those cells caused by some prescription drug use. It also contains antioxidants to help neutralize oxygen free radicals, amino acids to stimulate glutathione synthesis and reduce oxidative damage, B-vitamins to provide nutritional support ensuring proper protein and energy metabolism, and vitamin B-6 for synthesis of cysteine in the liver detoxification pathway.

josh california

Leslie, I just had a very bad experience with the vetinary form of sam e, called Denosyl. I posted about it earlier this week will and repeat here for you. Wylie had a splenectomy on May 9. came thru great was and looking great. A few weeks later the vet prescribed Denosyl. He didnt want me using the over the counter brand I think Natures variety for people that most people use on this board because he thought it had too many ingredients. A few weeks alter I notice Wylie is shedding a lot. It continues to get much worse and she is losing weight. Mid July the vet ran a pancreatitis test and a vitamin b absorption test. Both came back negative. I am feeding her more but she continues to go downhill with weight and hairloss, She also has not grown back the the hair when she was shaved from the splenectomy. She went in Aug 5 for thyroid, cushings and addisons test and an ultrasound of her stomach. The vet cant believe how afwul she looks, like the moisture was sucked out of her body and hair falling out and skinny. By now I have spent close to $1000 on these tests, thats okay but poor Wylie going to the vet constantly, we know how much our dogs are terrified of going now. In the back of my mind I keep saying I am going to take her off the denosyl but dont. The lastest tests come back negative this was 2 1/2 weeks ago. the vet is grasping at straws and said stop other meds since end of June. Within 3 days I noticed she is not losing her hair as much and 6 days later her coat was improving. The vet says yes this is suppose to have no side effects like this but with elderly dogs and diseases you just dont know. SHe has been off now for 2 1/2 weeks and she has gained 3 #, barely shedding and the fur from the May surgery is growing back fast. Laurie Laurie

Laurie CA

Leslie, Dr. Dodds recommended Sam-e to me the first time we talked. I put Chance on Denamarin (Sam-e and milk thistle) a veterinary product immediately. To give you an idea of how severe his liver was being impacted by the prednisone, at one point his alkaline phosphatase was over 8,600 with a high normal of about 212. Other liver values were very high too. Those numbers came down very quickly once we added the Denamarin. Later, when he had less serious numbers I switched to otc Sam-e and Country Life Liver Support Factors. I attribute his quick recovery to these supplements. As with every product that is made from a supplement or herb or vitamin, there is very little regulation or testing of them by the FDA. This came about because of the Dietary Supplement Health and Education Act of 1994. Any studies that are done are usually limited. The government declines to become deeply involved in this otc supplement industry unless there are serious illnesses or deaths associated with the use of them. In 2008 they passed an act that required companies selling otc supplements to at least provide the values of the product that they advertise. So if they claim there is 20mg of silymarin available in a milk thistle product, it should measure that much in a lab. Laurie's experience is likely infrequent and is certainly not the norm for Sam-e. In general it is considered safe. There are, however, a few side effects that are not harmless. If there is a serious deficiency of certain B vitamins in the body while taking Sam-e, the body levels of homocysteine can become too high and this can lead to problems of the arteries. Is this the same for dogs? I don't know. I have experienced some dizziness and nervousness when I have taken Sam-e. I was taking too high of a dosage. What happens if we don't supplement with anything to protect the liver from the prednisone? Well, the liver chemically processes many of the medications we take into the body. During high prednisone usage, liver cells can die in large numbers in their effort to process this steroid. The liver is very regenerative and will keep trying to grow new liver cells to recover. This rapid growth is what triggers some of the enzymes we see on our dog's chemical screen test. Giving the liver support, or providing it with stuff that helps it process the steroids easier is what we are trying to do when we give Sam-e and milk thistle. Sam-e comes as over the counter or as a veterinary product that is dosed according to weight. In a large dog like Chance, the human dose was fine. When you get into smaller dogs, it becomes difficult to find very small doses of Sam-e otc. Sam-e (or Denosyl or Denamarin) should be given on an overnight fast with small amounts of food or water. This allows the liver to process it alone. There should be a minimum of 1-2 hours before any other food or drug is given. What are Sunny's liver values on the chem screen? I assume since your vet recommended this to you, they must be over the normal range. Your vet most likely recommended the otc Sam-e to save you some money. The veterinary products are very expensive but considered very high quality. Patrice

Patrice NYS

I am sorry I didnt want to panic anyone about possible side effects. I just wanted tell what happened to me. I researched the heck for potential side effects and came up zip. So I do think Wylie is RARE and had a reaction. Like my vet said, he has treated AIHA many times but with everything that pops up with Wylie she is abi-normal. I want to let people know if they have similar symptoms to look at the denosyl as a possible cause. A Question about sam e, was it first a liver drug that they noticed it helped with depression, or vice versa. since the over counter doesnt go into the liver benefits but mainly the depression/ mood elevating part. I was always joking with WYlie and say "are you a happier dog now". Laurie

Laurie CA

Patrice, The vet sold me the Sam e. It was expensive, about $65 for 60 pills. I am supposed to give 2 tablets each day. I was not told to give it on an empty stomach. The instructions on the bottle are covered by the prescription label and I can't remove it. Currently, I get up at 6 AM and immediately give Sunny carafate to coat his stomach. I wait until 7:30, give him his prednisone and doxycycline. Then I feed him. So, should I give him the Sam e instead of the carafate? Or maybe give him the sam e in the afternoon without food? Can I give him both tablets at once? Perhaps I need to call the vet.

Leslie Oceanside

Dear Laurie, I would never suggest that you had panicked anyone! Your observations are real and you did some good investigative work figuring out what was wrong! When you read the possible side effects on the back of a package and you see "Rare, less than .5% of population", there is SOMEONE out there that experienced that side effect, even if it is rare. I wonder if this experience that Wylie had was somehow related to this rare side effect of the Sam-e with a severe B vitamin deficiency? I know Chance has been very low in his B12 for a long time and I have to supplement this with routine shots. B12 (and several others such as folic acid) are the deficiencies that cause the serious side effects with the metabolism of Sam-e. I have done some reading about the effects of a deficiency of B vitamins on red blood cell production and there seems to be a relationship. B12, for instance, is essential to the production of RBC. It's a vitamin that can't always be supplemented orally. The history of supplements often tend to have multiple stories. Chemists, who understand the chemical nature of supplements, often deduce that it might have applications in the human body. Opportunistic chemists might see an chance to make some money by marketing something. I am reading a good book right now called "The Queen of Fats: Why Omega-3s Were Removed from the Western Diet and What We Can Do to Replace Them" The blurb says "A nutritional whodunit" and is about the history of discovery of fatty acids known as omega-3s. Believe it or not, the beginning of this story started in the late 40', early 50's with a couple of researchers who wanted to test the blood of a population (that would be quite isolated) to see how cholesterol affected their heart and circulatory system. They ended up testing Danes and Eskimos. It was a very convoluted sequence of events after this that finally led to the discovery of Omega 3 fatty acids. Now-a-days everything has that listed on the front of the box as a selling point. But the important thing is that Americans still don't understand fats very well. The government has to intervene and outlaw something like hydrogenated fats to protect the public! In any case, it is always a good idea to be suspicious of supplements! Research them carefully before you use them. You might have an allergy to a particular herb in a supplement or it might be contraindicated with a prescription medication you are taking. A lot of people neglect to tell their doctor about the supplements they are taking and then end up in trouble. Patrice

Patrice NYS

Leslie, It sounds like your vet prescribed Denosyl for you. This is a veterinary formulation of Sam-e and is dosed by weight. Here is a link to the instruction page for dosing this med by weight: http://www.nutramaxlabs.com/products/animal/liver/liver.asp Click on the small print on the bottom of the page that says "Download Denosyl Brochure." It will open a nice flier for you to read: "Absorption of Denosyl is decreased when it is given with a meal. For optimal absorption, administer Denosyl at least one hour before feeding your pet. For owners who find it difficult to administer tablets to their pets, Denosyl® tablet(s) may be disguised in a small bite of moist food. It is not necessary to withhold water from your pet when giving Denosyl." And here is a dosing instruction I found for NatureMade Sam-e, a popular brand: "SAM-e should be taken on an empty stomach to help it absorb. Lower doses should be taken once a day, about half an hour before breakfast. Higher doses should be split, with the remainder taken one-half to one hour before lunch." The brand I bought was from Vitacost (their NSI brand) and it recommended an overnight fast. I know how hard it is to give these meds. We started with Mark giving the Sam-e at 5 am. Then he gave Chance his sucralfate at 7 am. I got up early and gave Chance his cyclosporine at 9:30 am. At 11 or so he got his pepcid and an hour later he got his meal with prednisone and antibiotics. I had to give him his vitamins and probiotics at 2:30 before I left for work with a small snack. Then Mark would start all over again with meds when he got home at 6pm. I would continue when I got home at 1 am. It was like this for at least 5 months. It was very exhausting. It's a good idea to call your vet. It might only take less than a minute for them to explain to you what they want you to do and you will feel better that you know! Patrice

Patrice NYS

Laurie, I hope you are able to work out the issue with the SAM-e. Another thought would be try the ingredients separately (if you can get them). I know for people you can get milk thistle as a stand alone supplement (I take it myself), but I also know someone who breaks out in a rash from milk thistle, so maybe there is an allergic reaction taking place. Just a thought, I don't really know. Patrice, as always, you are a wealth of information. I'm big on the Omega-3 thing and have read a couple of books: Erasmus - "Fats that heal, Fats that Kill..." and Enid - "Know your Fats, A Primer...". I must say quite the eye openers. Now, I think I have to go order "Queen of Fats".

Ronda So Cal

Patrice, Wylie had the colibrium test done which measures vitamin B absorption (is this the same test that shows vitamin B deficiency) which came back negative and she is on a vitmain b supplement. "In any case, it is always a good idea to be suspicious of supplements! Research them carefully before you use them." YOu got that right, the anal person I am, Funny I dont if I would have done this for myself before going under the knife. I researched eveything Wylie was on before her splenectomy and couldnt believe things like glucosomine causes clotting issues and I think fish oil was one too. And that milk thistle was actually good for surgery, cleansing the liver of the anesthetic. Ronda. Wylie is on milk thistle seperately. Laurie

Laurie CA

This thread was discussed between 21/08/2008 and 22/08/2008

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