# Any Used Denamarin Advanced?



## mudpuppymama (Mar 24, 2012)

Last month both of my dogs were found to have mildly elevated ALT levels at their yearly exam. All other values including thyroid were normal. Neither of them had any symptoms of anything being wrong. The vet suggested giving them Denamarin Advanced to support the liver for 4 to 6 weeks and then retesting them. After 4 weeks of giving them Denamarin Advanced, I wound up with two dogs that were so gassy you could hear their stomachs gurgling across an entire room. Their gurgling stomachs were keeping me up at night! Then they both started vomiting bile in the early morning which neither of them had ever done in their entire 12 year lives. Supposedly this drug rarely has side effects but when I researched it, I see that it can cause gas and digestive upset. So I went from having two dogs with absolutely no digestive issues to having two gassy uncomfortable looking dogs vomiting up bile every morning and crazily eating grass. I feared they must have some horrid thing going on. Then I decided to I stop the Denamarin Advanced. After only one day they were almost back to normal. The next day they were completely normal and they have been completely normal for a week now. I have to question what this drug was doing to my dogs. Just wondering if anyone else has experience with it. Since this is happening to BOTH dogs who have no history of digestive issues and it only occurred after giving them Denamarin Advanced and the symptoms stopped for both of them right after stopping the Denamarin Advanced, the only conclusion I can come to is this drug is the culprit. This also goes to show that even if a drug rarely has side effects, it does cause side effects in some dogs. Anyway just wondering if anyone else has used this drug and what they experienced. Thanks.


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## Tere (Oct 17, 2018)

I did not use the Advanced and wonder what the difference is.


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## mudpuppymama (Mar 24, 2012)

Tere said:


> I did not use the Advanced and wonder what the difference is.


I am not sure of the difference. It sounds like the advanced version is more potent and they absorb more of it which could be the problem. I believe both contain what is in milk thistle which has the following side effects in some people. I assume dogs can have these same side effects. Since it is a chew, there are inactive ingredients as well which is why I hate chews. Sometimes the inactive ingredients are the problem.

indigestion, bloating, gas, stomach pain;
diarrhea; or
nausea, loss of appetite.


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## BoosDad (Mar 8, 2020)

How are your dosing? As I recall, I was advised to administer one hour before a meal or two hours after a meal for best absorption. I'm not sure if that would make any difference with the gas issues or vomiting. I think the Advanced has a greater amount of SAMe (S-adenosylmethionine) in the formula than the regular Denamarin. Don't know if that would cause your problem. If you decide to administer and do not see any changes in blood work after a month or two, you might want to consider other possible explanations for the elevated ALT. As I said in a previous post, I recently learned that these elevations were related to episodes of IBD as opposed to liver dysfunction (so at times they would completely normalize, when IBD controlled). Dosing with Denamarin should help, if actual liver dysfunction is causing the elevated ALT. I think vets will prescribe it, when they see elevations in ALT, as an initial conservative means to address a potential liver problem (which may not be present, as in Boo's case). Some vets also have told me that they did not consider ALT values of up to 199 U/L to be indicative of anything significant unless they appear on more than one occasion.


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## EvaE1izabeth (Nov 14, 2017)

Is it unusual for two dogs of different breeds and ages to begin having mildly elevated liver enzymes at the same time? If it is mild, I wonder why she prescribed the advanced instead of the regular. Mudpuppymama, you’re always on top of the environmental factors, I’m curious what else you are thinking about the situation.


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## mudpuppymama (Mar 24, 2012)

BoosDad said:


> How are your dosing? As I recall, I was advised to administer one hour before a meal or two hours after a meal for best absorption. I'm not sure if that would make any difference with the gas issues or vomiting. I think the Advanced has a greater amount of SAMe (S-adenosylmethionine) in the formula than the regular Denamarin. Don't know if that would cause your problem. If you decide to administer and do not see any changes in blood work after a month or two, you might want to consider other possible explanations for the elevated ALT. As I said in a previous post, I recently learned that these elevations were related to episodes of IBD as opposed to liver dysfunction (so at times they would completely normalize, when IBD controlled). Dosing with Denamarin should help, if actual liver dysfunction is causing the elevated ALT. I think vets will prescribe it, when they see elevations in ALT, as an initial conservative means to address a potential liver problem (which may not be present, as in Boo's case). Some vets also have told me that they did not consider ALT values of up to 199 U/L to be indicative of anything significant unless they appear on more than one occasion.


My instructions were to give on an empty stomach at least one hour before eating. So I have been giving mid afternoon several hours after their morning meal and a few hours before the evening meal. My yorkie was only about 30 points above normal which is not much. Mia was in the low 200s. As you say it may not be the liver at all. I would like to have them recover from this drug for a few more weeks and then retest. I sent an email to the vet about my experience to see if she has seen this before. My dogs are raw fed and their digestion system may be different than a dog who eats kibble. So this may make a difference too. It seems to stimulate bile production which I don't think my dogs need.


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## EvaE1izabeth (Nov 14, 2017)

BoosDad said:


> Dosing with Denamarin should help, if actual liver dysfunction is causing the elevated ALT. I think vets will prescribe it, when they see elevations in ALT, as an initial conservative means to address a potential liver problem (which may not be present, as in Boo's case). Some vets also have told me that they did not consider ALT values of up to 199 U/L to be indicative of anything significant unless they appear on more than one occasion.


Does this mean that treating with the medication can also be diagnostic? Or not really, since elevations can be related to something else and go down on their own?

There was another thread related to liver elevations, maybe a year or more ago, where it also came up i think in reference to dental issues, and someone mentioned other reasons for minor fluctuations.


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## mudpuppymama (Mar 24, 2012)

EvaE1izabeth said:


> Is it unusual for two dogs of different breeds and ages to begin having mildly elevated liver enzymes at the same time? If it is mild, I wonder why she prescribed the advanced instead of the regular. Mudpuppymama, you're always on top of the environmental factors, I'm curious what else you are thinking about the situation.


The problem with liver enzymes is that so many things can impact them, many of which have nothing to do with the liver. Since both dogs showed mild ALT increase simultaneously, I was suspecting exposure to toxins. However, we are careful here and use no chemicals, and the dogs are not on any flea tick preventatives or other drugs. Mia just had her teeth cleaned so doubt it is that. However, anesthesia drugs could tax the liver and Mia did have some issues under anesthesia and who knows what that may have caused. My yorkie has a bit of tartar but the vet says he does not need a cleaning. One thing that happened in November is that I found a puffed up tick on each dog roughly around the same time which escaped me. It could be that their immune systems were fighting a tick borne disease. Ehrlichia is epidemic here and Mia actually tests positive for the Ehrlichia antibody. Although she does not actually have the disease. Fighting a disease can definitely stress the liver. One other thing that could be a problem is the green tripe I was feeding. It is from a good source, however there is a chance that contained some toxins. I have eliminated that from their diet. I do think it is very strange they would both present mildly elevated ALT simultaneously if it is because of some health issue, however they are getting older and I guess this is a possibility. Anyway, lots of unknowns! I just hope the retest goes well.


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## BoosDad (Mar 8, 2020)

Denamarin is a drug to detox the liver, and help it function better. So, if liver dysfunction is not causing the elevation in ALT, from my understanding, Denamarin will not lower the values. It's confusing because ALT often is referred to as the liver function test. However, inflammation in the intestine or a dental infection, which are unrelated to inflammation in the liver, also can cause a rise in ALT. Frequently, dogs with IBD have elevated ALT and AST values. As in Boo's case, at times, both AST and ALT normalized on their own, when he was not having problems with intestinal inflammation. If his problem had been a chronic liver issue, the values likely would not have decreased without some type of liver support. Mudpuppy mama - do you think that your dogs ate something that could have been toxic to the liver, causing an acute (single) instead of a chronic (long term) problem? If so, some initial dosages of Denamarin might get the liver functioning again, and you could discontinue after 6 weeks. Based on my experience, ALT values in the low 200s or 30 points above normal are not considered to be particularly elevated. However, I always would follow the advise of a trusted vet.


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## mudpuppymama (Mar 24, 2012)

BoosDad said:


> Denamarin is a drug to detox the liver, and help it function better. So, if liver dysfunction is not causing the elevation in ALT, from my understanding, Denamarin will not lower the values. It's confusing because ALT often is referred to as the liver function test. However, inflammation in the intestine or a dental infection, which are unrelated to inflammation in the liver, also can cause a rise in ALT. Frequently, dogs with IBD have elevated ALT and AST values. As in Boo's case, at times, both AST and ALT normalized on their own, when he was not having problems with intestinal inflammation. If his problem had been a chronic liver issue, the values likely would not have decreased without some type of liver support. Mudpuppy mama - do you think that your dogs ate something that could have been toxic to the liver, causing an acute (single) instead of a chronic (long term) problem? If so, some initial dosages of Denamarin might get the liver functioning again, and you could discontinue after 6 weeks. Based on my experience, ALT values in the low 200s or 30 points above normal are not considered to be particularly elevated. However, I always would follow the advise of a trusted vet.


The only thing I am thinking they could have both eaten that contained toxins is the green tripe I was feeding. That is something lots of raw feeders feed but it does come from places that make pet food so there is always a chance of contamination. Everything else they eat is human grade and mostly organic. They do occasionally eat deer or rabbit poop which I assume could contain something bad but I would think the main problem with those is parasites and their stool samples were good. I made it through four weeks of the Denamarin Advanced. Maybe they have gotten some benefit out of it, but I cannot continue to give something that I feel is causing more problems than it is fixing! The vet actually said give it for 4 to 6 so I did make it to 4. Since raw fed dogs have very strong acidic stomachs to digest meat and bone I am wondering if they could be more sensitive to this drug. Also as you said their values are not that high so maybe the dosage is just too much for them. I will be speaking with the vet. Thanks for all your feedback. I really appreciate it.


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