My Toy Fox Terrier Charlie has come up with elevated liver enzymes - clinically appears very healthy. After a course of antibiotics (in case there was an infection, although no signs of such) and several diagnostic tests (I do not want to go to ultrasound and liver biopsy now), a genetic liver shunt has been ruled out. That leaves several other possibilities. The vet and I have decided on "watchful waiting" for 6 months and check again. The vet wants him to take Denamarin once a day. It apparently is a nutritional supplement supposed to support a healthy liver and to assist the liver in regeneration (I have no idea if this would really happen as so many drug companies promise so much - at least it promotes a healthy bottom line for their company!). Anyway it is supposed to be given on an empty stomach. It can be given supposedly in a tiny bit of food if necessary. Absorption is better on an empty stomach. My dilemma is that he will not chew up the chewable and I really don't want at this point to be pilling him every day with a "nutritional supplement". My direct question - do you suppose it would do any good to simply crush it up and put it in his regular breakfast (it is very difficult to give him a tiny bit of food first thing in the morning and then wait an hour to give him breakfast - he and I both have other lives to live)? I thought maybe he would get some benefit from it if not all that the drug company claims. What do you think? If absolutely necessary (as if we were treating a definite illness with a proven treatment) I will go the harder route, but at this point I am not convinced that this nutritional supplement will actually do much for him. I am trying to feed him quality food and providing good exercise, hoping his body will take care of itself (foolish thinking according to the drug companies).
Two of my cats took Denamarin for liver function - it is based on milk thistle which is a natural remedy for the liver. (They also got antibiotics.) I gave the pill in a coating of Flavor Doh and then waited a bit to feed. When just one boy was taking it, I am so crazy that I actually got up in the middle of the night to give him his pill. (Not recommened for sane people!) My Vet did offer that giving them with food was OK if that was the best I could do. I know that for cats, it is highly recommened by the groups who help people with cats with liver disease.
Yankee - thanks for the input of your experience. This morning I tried again to do it right - took a tiny bit of cottage cheese (which Charlie likes) and added a crushed up dose of the Denamarin. I planned to let him eat that and then wait an hour for his breakfast. He looked at it, smelled it,and walked away. An hour later it was still sitting there. I then mixed it up into his regular breakfast and he ate it all. Maybe the Denamarin will do not as good given in a complete meal, but it certainly will not do any good sitting in the dish because he will not touch it. If I give it to him in a bit of chicken, he eats the chicken, spits out the tiny lump of Denamarin, and looks at me. I suppose I could get the pills and force one down his throat every morning. But I am quite reluctant to do that. I wish I only knew of this stuff is really effective or only part of hype that drug companies pass out - think how they push everyone to take their vitamin pills although studies say eating correctly is the way to go - not wasting money on pills which the body does not use as effectively as good food.
Have you tried a dab of cheeze whiz or sticking it inside a marshmallow? For the cats I gave a little ball of just flaver doh, then the loaded ball then another ball of plain. For a dog I would think that tossing miniature marshmallows might work - toss one or two plain, then the loaded and immediately show another plain to distract from the taste of the loaded one. When does he go for his next blood test?
He will not be tested again until June or so. Last test his levels were coming down a bit - he has not clinical signs of illness. I have tried cream cheese - no luck. I don't have any marshmallows as I detest them myself - but, of course, I could get some. But I fear any good from the Denamarin would be offset by the bad effects of concentrated sugar like a marshmallow - he weighs on 5 1/2 pounds and weight gain would be detrimental. I wish he would just chew it up like apparently most dogs do!
Small dogs seem to be more finicky than big dogs when it comes to eating. I'm not sure my dog even tastes stuff that is small enough to swallow. He can just about swallow a hamburger whole and it takes him less that 10min to make the knuckle that comes out of a ham to disappear and be back looking at you and going "do you have more. "I'd try wrapping it up in some turkey. It's relatively lo-cal. To try it you can buy a slice from the deli.
This message was edited Feb 22, 2013 11:32 PM
OMG! The smallest of my cats is twice the size of your dog! LOL!
The SAME portion of this product (it's a combination of SAME and Milk Thistle) is activated when released in the small bowel, but is neutralized when eaten crushed or chewed up, so it is much less likely to work if you crush it up. It is a pretty effective product and very safe when administered properly... but if you want it to work well, it has to be swallowed whole, sorry. Still, if you crush it up, the Milk thistle portion (Sybilin) will likely still be somewhat active and may still help a bit.. But it is the SAME product that has shown the most promise in clinical trials.
Palmbob - if it should not be chewed up, why is it manufactured in such a large disk that is scored in the middle? For a 5 lb dog it has to be cut in half and then cut again. Even a large dog getting the whole product would probably chew it. I guess nothing is perfect. Thanks for explaining about where the SAME portion is activated. I understand why you are saying don't put it in his food. But - the question may be moot anyway. For the last several days I put it crushed in his breakfast food which he had been eating well (after several months of trying to find a quality food that he would eat well). His reaction to this was to smell the food and walk away. If I gave him nothing else all day, he finally ate it in the late afternoon. This was not good for several obvious reasons. This morning after that performance I put a bit of the regular food on a plate without the denamarin and he smelled it, looked at me, and then ate it up. So apparently he simply does not like the denamarin. I don't want to put him off of eating again - that can't be healthy for him. Do you know of a SAME product (perhaps a liquid) that is separate form the milk thistle? At this point I am ready to stop this whole thing, get him to eating well again, and use only the Canine Hepatic Support (which contains a little milk thistle, but no SAME and therefore less than ideal), and try again in a month or so. This is getting to be a big issue for a product that you say has only "shown promise in clinical trials". I know I am being unrealistic wanting a medication that is 100% effective at "growing a healthy liver" that is yummy for the dogs. Not going to to happen, I guess. Charlie seems very healthy and I am trying very hard to trust the results of a couple of blood tests that say he is not or may potentially have a problem. The vet we are consulting seems very competent and is working with me to find the best course for Charlie - I could not ask more as she cannot product a miracle drug that does not exist.
When SAME first came out, it was all by itself in a product called Denosyl... then, later, they same manufacturers had the idea of putting Milk Thistle in with it and changed the name a bit... You can still get Denosyl... a bit cheaper. I am pretty sure the pills are not scored. I cannot explain the scoring, unless they have changed the formulation that allows it to be freed of its coating (most drugs with a coating have it for a reason-either it is because the product tastes like crap, or because it's supposed to be swallowed, protected from the stomach, and activated deeper in the intestinal tract).
What I have is by Nutramax called Denamarin Chewable Tablets (not the earlier pills). Each one is the size of very thick nickel and is scored across the middle. The vet's office cut several of them on the score and again in half, producing 1/4 of each for giving a small dog. Supposedly they have a pork flavoring (must be pretty nasty). So these chewables must be meant to be chewed and it apparently is okay to cut them up at least 3 or 4 days ahead (one gets cut into 4 little ones). The directions by Nutramax on the bottle give the dose size of 1/4 tablet for a dog up to 6 lbs (Charlie is 5 lbs). But obviously these chewable tablets are going to be acted upon in the stomach. Maybe having the stomach empty means it would be moved out faster. Big dogs probably gulp them or do minimal chewing. Unfortunately, Charlie does not seem to recognize them as edible. I suppose I could get the regular pills and shove one down his throat first thing every morning - great way to start the day. (I know - I need to change my attitude about this).
So if there is a chewable, obviously the problem of intestinal release has been resolved... hope they really work.
Just to add final update - the Vet called me yesterday and we talked all this over. Final agreement was to back off - don't want to start an eating problem where he rejects all healthy food. She suggested trying one last time using a glob of peanut butter (strong taste) with denamarin crushed up first thing in the morning when he is at his most hungry. Otherwise, just stop with this and wait and see. She said her dog gobbles it up, but then went on to say he is a Lab and gobbles up everything in sight without tasting anything! She said these small dogs are a bit more dainty and it is hard to get anything by them. So - this morning I tried the peanut butter. I first gave him just a lick of plain PB to be sure he would not reject it out of hand (he has never had it before). He licked it fine - just a smear. Then I put down a small glob with the crushed med. He looked at it, smelled it, and walked away. A few minutes later I put down his regular Merrick Terducken breakfast and he quickly ate it (showing he was hungry). So - that is that for now. I will try again periodically with different foods, but don't expect much. She agreed that pilling him over this is not good - we might have to do that at some time with definite medication and don't want to get him paranoid over this. When I brought Charlie into our home back in August, I had no idea he was such an opinionated little fellow - he seems quite sensible about everything we have asked of him except this denamarin. Well - I guess we are all allowed to be stubborn about a few things in life, even when it is not good for us!