# How much SAMe and Milk Thistle?



## Dallas Gold (Dec 22, 2007)

We just put Toby on Denamarin to protect his liver while he is on a long term course of Rimadyl for his eye inflammation issues. His acupuncture vet and the ophthalmologist both recommended it. The acupuncture vet said she recommends it for all her geriatric/senior patients. Denamarin is a veterinary formulation of milk thistle and Sam E and I just saved the product insert to my computer this weekend.
View attachment Denamarin Package Insert.pdf


What I suggest is opening this, and you can see the amounts of each component in each tablet, then going further down the insert, seeing how many tablets they recommend for the dog's weight, and either using the Denamarin or getting the two ingredients at a human pharmacy (OTC). If you supplement with the two separate ingredients, just make sure the formulation doesn't have something else in it. One bottle I picked up had licorice in it as well as dandelion and fennel. Dandelion might be OK, but I couldn't find anything about giving dogs fennel and the licorice increases blood pressure. Since my dog is on hypertension medication that wouldn't work well. I went back and got a pure milk-thistle bottle of about 150 mgs per tablet. His ophthalmologist said that should be fine for a dog weighing about 60 lbs (he's about 55-57 now). I'm using the Denamarin until we run out then will go with separate supplements. The Sam E is also a powerful anti-inflammatory. Toby threw up after starting the full dose and we stepped back and halved the Denamarin until he built up a tolerance for it--his vet said Sam E tends to upset dogs and we should build it into his system slowly. We took a week to do that. 

We did a blood draw two weeks after starting the Rimadyl and Denamarin and his liver enzymes look fabulous! I'm so relieved! 

Good luck--I hope an increased dosage works well for your pup.


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## w00f (Nov 4, 2011)

The nutritionist that put together my dog's diet said that she has had very good luck with Country Life's Liver Support Factors, in case those supplements don't bring those values down.

Some dogs might not do well on the Sam-e, and some dogs might actually be allergic to milk thistle (it's a weed!), so I would start slow and watch for a reaction as you up the dose.


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## Thalie (Jan 20, 2008)

Milk Thistle : from 50 to 250 mg/kg twice a day
For a 39 lb dog, if the lower dosage is used, this translates into 886 mg twice a day. At the highest dosage, it becomes 4431 mg twice a day.

Sam-e : 10 mg/kg/day
For a 39 lb dog, this translates into 335 mg/day

Source : The District of Columbia Academy of Veterinary Medicine (Go toward the end of the article to : "A review of traditional and not so traditional therapies for liver disease" by David C. Twedt DVM, DACVIM)

The same section also mentions giving Vitamin E (preferably water solubilized) at a rate of 50 to 400 IU/ day.

Humans who takes SAM-e are advised to also take a vitamin B complex (B12 & B6) to increase absorption and reduce the possibility of build up of homocysteine which can have a negative impact on the heart. Sources : S-adenosylmethionine ; SAM-e / SAMe (S-Adenosyl Methionine) - On Sale - WholeHealth.com . I do not know if it is the same for dogs but check with your vet. Higher doses of SAM-e are also associated with nausea and vomiting so I would increase Oliver's dose gradually. For the milk thistle, I think you might want to just give him one 450 mg cap with his morning meal and one with his evening meal; that would put you a bit above the lower dosage mentionned in the article cited above.

I hope Oliver's liver levels come down soon.


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## Aunt Betty's Dog (Apr 5, 2011)

Thanks so much guys! I had Ollie on the Denamarin initially, but had trouble finding it, so I decided to go the two seperate supplements route. 

Ollie gets his liver values re-checked in April, so fingers -- and paws -- crossed that they go down. I will keep you posted.

He's such a great little guy. Puts up being the only boy -- not to mention the only Beagle -- in a house full of Golden Girls!


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## Dallas Gold (Dec 22, 2007)

w00f said:


> The nutritionist that put together my dog's diet said that she has had very good luck with Country Life's Liver Support Factors, in case those supplements don't bring those values down.
> 
> Some dogs might not do well on the Sam-e, and some dogs might actually be allergic to milk thistle (it's a weed!), so I would start slow and watch for a reaction as you up the dose.


Just a word of warning--if a dog is hypertensive, the Country Life Liver Support Factors may not be the best option due to the addition of licorice to the formulation. Licorice raises blood pressures.


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## Tahnee GR (Aug 26, 2006)

w00f said:


> The nutritionist that put together my dog's diet said that she has had very good luck with Country Life's Liver Support Factors, in case those supplements don't bring those values down.
> 
> Some dogs might not do well on the Sam-e, and some dogs might actually be allergic to milk thistle (it's a weed!), so I would start slow and watch for a reaction as you up the dose.


I second the Country Life's Liver Support Factors-I have had excellent results and so have a lot of people on the Tick-L list. Of course, these dogs are on it due to being on high dose doxy for a long period of time, to treat Lyme disease or other tick borne disease.


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## AmbikaGR (Dec 31, 2007)

I also give individually to Lucy for the past year for liver issue.
Milk Thistle - 200mg silymarin
400mg - SAMe


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## puppatoos (Jul 23, 2012)

I'm curious. My golden girl has pretty bad arthritis in both her knees, basically cartilage is no longer there or something (she whines badly after walks). While my boy is generally healthy, except for low thyroid, not low enough for medication but just supplements. My holistic vet cum acupuncturist prescribed SAM-e 400mg for both of them once a day, and told me to give milk thistle (never mentioned the dosage).. 
I thought some sites say milk thistle must not be taken long term and they both have no elevated liver enzymes or liver issues, which could lead to health problems later and be counter productive. Is this safe? And must SAM-e and milk thistle be taken together? anyone?


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## cgriffin (Nov 30, 2011)

Vets prescribe Denamarin, which contains SAMe and milk thistle, all the time. Never heard from any of them, that it would be harmful long term.


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## Dallas Gold (Dec 22, 2007)

Our conventional vet, who also does acupuncture, believes all senior dogs should be on Denamarin as it's such a good liver protector and the Sam E has such great anti-inflammatory properties. 

I did a post in some thread a while back with doses of what I was giving my dog of Marin (without additives due to his other health issues) and Sam E. I priced it out and eventually went back to Denamarin because the pricing, with matching at our vets, was about the same and it was much easier to use one pill instead of two. I understand the denamarin dosing for marin is lower than is recommended for dogs.


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## cgriffin (Nov 30, 2011)

I have to use the chewable Denamarin, can't get the regular caplets into Thunder. So, he gets a whopping does of three chewables daily at about 5 AM.
My Toby is on and off of Rimadyl for bad days, can't get either form of Denamarin into that boy. It is hard, because the Denamarin is suppose to be given on an empty stomach, can't hide it in food. 
I found pretty good Denamarin deals at 1-800 petmeds and allvetmed.com.


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## Dallas Gold (Dec 22, 2007)

cgriffin said:


> I have to use the chewable Denamarin, can't get the regular caplets into Thunder. So, he gets a whopping does of three chewables daily at about 5 AM.
> My Toby is on and off of Rimadyl for bad days, can't get either form of Denamarin into that boy. It is hard, because the Denamarin is suppose to be given on an empty stomach, can't hide it in food.
> I found pretty good Denamarin deals at 1-800 petmeds and allvetmed.com.


I didn't even know they had chewables...I've been putting it in a pill pocket and Mr. Eats Anything just gobbles it down . Thanks for the links above--I'll check them out for price matching. It's hard to find good price matches as many of the online stores cannot carry it, probably because of manufacturer restrictions.


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## cgriffin (Nov 30, 2011)

I used to buy the chewables for all dogs at my vet's office, but they switched to the caplets only. I talked to the vet about it and he said, they could special order it for me. I have not done so yet, because I found a better price for the chewables online. 
The good thing with 1-800 petmeds is, that if you order something online that is on sale, you can keep re-ordering it for the on sale price, once you get an online account with them, they also do price matches. Also they will keep sending you 10 percent off next purchase e-mail coupons.
Last two times I ordered the chewables from allvetmed.com because they had the 75 count bottle of chewables for a better price than the 30 count bottles at 1-800 petmeds. 
So, I usually go with whoever has the best deal at the time. They are both ViPPS certified online pet pharmacies.


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## puppatoos (Jul 23, 2012)

My SAM-e is the one from Life Extention brand 400mg. The only one the vets here use. It's a coated tablet and it's a human version supplement and I have to add milk thistle myself. I was searching at iherb and reordered that because I didn't know better, but also ordered a cell life one, which is in liquid form. Does this work the same for joint/arthritis? I can't get denamarin here.


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## cgriffin (Nov 30, 2011)

Denamarin or SAMe and milk thistle are a supplement for the liver, has nothing to do with joints or arthritis. 
For joints/arthritis you should get a supplement with glucosamine and chondroitin. There are many made especially for dogs but if not available you can use the human form, just make sure it does not have any added vitamins and such, that was only ment for humans. There is a sticky about arthritis/joint supplements here in the forum:

http://www.goldenretrieverforum.com...supplements-etc-arthritis-joint-problems.html


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## Dallas Gold (Dec 22, 2007)

cgriffin said:


> Denamarin or SAMe and milk thistle are a supplement for the liver, has nothing to do with joints or arthritis.
> For joints/arthritis you should get a supplement with glucosamine and chondroitin. There are many made especially for dogs but if not available you can use the human form, just make sure it does not have any added vitamins and such, that was only ment for humans. There is a sticky about arthritis/joint supplements here in the forum:
> 
> http://www.goldenretrieverforum.com...supplements-etc-arthritis-joint-problems.html


I agree, but the SAM E does have anti-inflammatory properties, which are good for all sorts of issues, like arthritis... The other supplements mentioned are the gold standard ones to use for joints/arthritis.


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## cgriffin (Nov 30, 2011)

Thanks, Anne! I did not know that about SAMe.


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## Dallas Gold (Dec 22, 2007)

cgriffin said:


> Thanks, Anne! I did not know that about SAMe.


If I can remember tomorrow, I'll find a copy of the handout I got at a seminar that discussed SAM E's benefits. I have it on my other computer, somewhere!

Edit: found the handout and it just mentions Sam E is helpful for osteoarthritis. I'm attaching the PDFs for both Sam E and Milk Thistle to this post for the OP because dosing is on the bottom of the VIN. Soure for these handouts--see top right hand corner for source.

View attachment VIN Same.pdf


View attachment VIN Silymarin Milk Thistle.pdf


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## dborgers (Dec 7, 2011)

Andy's on Denamarin (Large Dog dose) because he's on daily low dose Prednisnoe and every-three-week CeeNU chemo (for as long as that maintenance chemo works ... 4 months so far, so good). 

After paying $213 for the first month's supply at his docs (yikes!), I found a site called IdealPetX.com that sells 15 day supplies (30 pills) for $57, or $114 a month, with a 5% discount every succeeding order for return customers. They and most other places I checked today are out because Nutramax didn't make enough last month. Said they'd have more in September. 

I found a month's supply today (60 pills) through Amazon.com for $140 including shipping:








Amazon.com: 60 Tablets NutraMax Denamarin Tabs for Large Dogs 35 lbs and over: Pet Supplies


Andy's doc also likes Denamarin because it contains antioxidants.


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## cgriffin (Nov 30, 2011)

Thank you for the info, Anne! Thank you, Danny!
I finally got my Toby to eat the Denamarin chewables. Now I am waiting for my order of more Denamarin to come in. It has been 10 days already. If Nutramax had a delay, that would explain the delay of the order.
I would love to give the caplets, but I just cannot bribe both of my large senior dogs into taking them, lol. So, I have to keep buying the chewables of which each of them has to take 3 a day. Not cheap!
Thank you again Anne and Danny!


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## Dallas Gold (Dec 22, 2007)

dborgers said:


> Andy's on Denamarin (Large Dog dose) because he's on daily low dose Prednisnoe and every-three-week CeeNU chemo (for as long as that maintenance chemo works ... 4 months so far, so good).
> 
> After paying $213 for the first month's supply at his docs (yikes!), I found a site called IdealPetX.com that sells 15 day supplies (30 pills) for $57, or $114 a month, with a 5% discount every succeeding order for return customers. They and most other places I checked today are out because Nutramax didn't make enough last month. Said they'd have more in September.
> 
> ...


Thanks for the referral to your source! I usually get a price online and do price matching at the veterinary clinic because they are so close and they usually have a supply whenever we need it. It is expensive to use, but so worth it if they need to be on it. 

BTW, just re-reviewed the VIN for Sam-E-- and if anyone is using Tramadol--note this: _Theoretically, concurrent use of SAMe with tramadol, meperidine, dextromethorphan, pentazocine,
monoamine oxidase inhibitors (MAOIs) including selegiline, selective serotonin reuptake inhibitors (SSRIs)
such as fluoxetine, or other antidepressants (e.g., amitryptiline, clomipramine) could cause additive
serotonergic effects_.


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## dborgers (Dec 7, 2011)

DallasGold

Thanks for the postscript. Andy's been taking Tramadol since that ACL tear. I'll have to ask Dr. Wang about that. Thanks.


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## Claudia M (Aug 8, 2012)

Dallas Gold said:


> We just put Toby on Denamarin to protect his liver while he is on a long term course of Rimadyl for his eye inflammation issues. His acupuncture vet and the ophthalmologist both recommended it. The acupuncture vet said she recommends it for all her geriatric/senior patients. Denamarin is a veterinary formulation of milk thistle and Sam E and I just saved the product insert to my computer this weekend.


Double check with your vet on the Rimadyl. Our dog Jack was on it and while it worked Ok at first, it nearly killed him. Hyperactivity and seizures. He was 15 at the time. I would google Rimadyl side effects and also Rimadyl alternatives and take it to the vet.


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## Dallas Gold (Dec 22, 2007)

Claudia M said:


> Double check with your vet on the Rimadyl. Our dog Jack was on it and while it worked Ok at first, it nearly killed him. Hyperactivity and seizures. He was 15 at the time. I would google Rimadyl side effects and also Rimadyl alternatives and take it to the vet.


Thank you for your concern; however, I'm pretty knowledgeable about medications prescribed my dogs over the past 20+ years. We do blood work on Toby every 4 months. This drug was prescribed by his ophthalmologist post cataract surgery and the other options were aspirin or a drug used in cancer treatments. After careful consultation with the ophthalmologist and two veterinarians at the regular veterinary clinic, where the side effects and risks were laid out for me, we opted for the Rimadyl as the least problematic. We will find out next month if we can reduce the dosage or eliminate it. Right now he's on a half-dose, once a day. 

Our other two arthritic dogs both took Rimadyl without any incident--one passed at 13 1/2 and the other at 12 years 11 months.


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## kwhit (Apr 7, 2008)

Dallas Gold said:


> Our other two arthritic dogs both took Rimadyl without any incident--one passed at 13 1/2 and the other at 12 years 11 months.


Yeah...Chance has been on Rimadyl for almost 7 years with no issues. I did switch him to Deramaxx one time to try it and he got so sick for 2 days. I put him back on Rimadyl and haven't looked back. He does, however, get his liver values checked every three months just to be on the safe side.


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## Dallas Gold (Dec 22, 2007)

kwhit said:


> Yeah...Chance has been on Rimadyl for almost 7 years with no issues. I did switch him to Deramaxx one time to try it and he got so sick for 2 days. I put him back on Rimadyl and haven't looked back. He does, however, get his liver values checked every three months just to be on the safe side.


I feel the extra blood test is worth it to keep on track of the effects and it sounds like you are doing the same thing--great minds!  Are you doing the SamE/Milk Thistle or Denamarin as a protector too?


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## kwhit (Apr 7, 2008)

Dallas Gold said:


> Are you doing the SamE/Milk Thistle or Denamarin as a protector too?


I've given Milk Thistle but not the other two. I'll have to do some research on them.


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