I Could Really Use Your Advice, I Don't Know What To Do

[Batmom]

the head vet said it was DIC.

 

Amicar won't help (and would hurt) in a case of DIC. DIC is awful -- I'm sorry for your loss.

[Charlies_Dad]

Kerry, we also have used Amicar twice. Once when Charlie had his amp and then the second time for Shelby when she had a growth removed from her gums which turned out to be a nightmare of a bleeding issue. Her face filled with blood and no matter what the vet did, they could not get it under control. We remembered Amicar too late and our local vet had never heard of it either but luckily Derek, aka Trihounds, had some via his vet and was so kind to get us some which after given to Shelby helped stop the bleeding.

 

I'm sorry you're going through all this. I also agree with others that getting to the bottom of the low platelets is more important than the dental right now.

[MP_the4pack]

I would also ask for a repeat blood test. The platelets could have started forming a clot in the tube if the draw was done not quite right. If they started forming clots, then they don't show up in counts.

[philospher77]

Just going to mention that the form of the drug can factor into the price at pharmacies, so make sure that they are quoting for tablets and not the injection. I have Katie on generic Prozac, which I had been dosing at 20 mg (capsules). We decided to up the dose to 30 mgs, which isn't an off-the-shelf dose in capsules, so I was given a prescription for 20 mg tablets, so I could give 1 and a half. The price for the capsules is around $15. The price for the same medicine, same dose, same quantity, in tablet form? $161! So now I have a prescription for 10 mg and 20 g capsules. It's crazy. So, check around on the price and the drug format.

 

Also, if Amicar only prevents clots from breaking up, it won't help if your greyhound is low on platelets, since that means that the clots are less likely to form in the first place. Just something to consider.

[MerlinsMum]

Thank you for all your continuing input, it's all really helpful.

Just wanted to clarify that they retested his platelets three times after the first lab results. This did include a manual count, which showed just 4-7 platelets per field, and 'giant' platelets (young platelets that have just been released) running low.

 

Amicar is far, far more expensive in tablet form than it is in liquid form. But, as I mentioned in a previous comment, sadly the liquid form is not currently available due to manufacturing problems (although it's supposed to be available any day now).

[GeorgeofNE]

Dr. Couto recommends all greyhounds be given Amicar pre surgically. I thought it was am amino acid?

[MerlinsMum]

Dr. Couto recommends all greyhounds be given Amicar pre surgically. I thought it was am amino acid?

 

Wow, really? Even when no bleeding episode has been experienced in previous surgeries? Merlin and Sagan have had several dentals between the two of them, and they have never been given it. In fact, I'd never even heard of it. There again they've never had bleeding issues.

 

I found this paper by Dr. Couto's team: http://issuu.com/oncologiavet/docs/aminocaproic_acid_greyhounds_amputation_osa_jvecc_ and I haven't had the time to read it all yet. Unfortunately it looks as though you have to have a subscription to the Journal of Veterinary Emergency and Critical Care in order to download it as a PDF.

 

If bleeding is a particularly greyhound-related issue, and vet offices don't have it on the shelf as a matter of course, I doubt that many greys are being given it pre-surgery... most vet clinics aren't tailored specifically to greys, after all..

Edited July 3, 2013 by MerlinsMum

[LuvEarsies]

LuvEarsies, where did you get it so cheap? I have been looking online and even if you buy it more cheaply from a Canadian store, it seems you have to buy it in large quantities. I don't need 100 tablets.

 

The vet tech I spoke to this afternoon spent ages calling pharmacies around here and no one carried it. They could special order it but the cheapest price quoted to her for the amount I would need was $186 at Rite Aid.

We purchased it at our local Walgreens pharmacy. I am sorry you are having such a hard time finding it at a reasonable cost. However, I agree with what the others have said, the dental can wait until you sort out the platelet issue.

Edited July 3, 2013 by LuvEarsies

[Jackandgrey]

Just as a matter of interest which doesn't likely help you, Amicar has been given pre dental to children with VonWillebrands ( a clotting disorder) for years. Still I would want to know why his platelets are low too. Doing the tick panel may be the way to start anyway Kerry. I'm sorry this all so complicated for you right now.

[Batmom]

Did an outside lab do the platelet count? There's a big difference between finding giant platelets (which are NOT young forms) and platelet precursors (the young forms) in a blood smear.

[tbhounds]

Dr. Couto recommends all greyhounds be given Amicar pre surgically. I thought it was am amino acid?

 

It's Amicar aka Aminocarproic acid.

http://cvm.osu.edu/assets/pdf/hospital/bloodBank/wellness/newsletters/2009/ghwpNewsletterSummer2009.pdf

I just picked up 30 tablets at Walgreens--$76

[MerlinsMum]

So I decided to postpone the dental and get his platelets back to normal first.

 

He is on doxy starting tonight. We will re-test in 7 days, although of course it's likely he'll have to be on doxy longer than that.

 

All of your answers helped me so much. I was able to really read up on aminocaproic acid, for starters, and I feel so much more educated now. I have been reading Dr. Couto's team' studies on the subject, and I also found that I was able to order Amicar from Walgreens (tablet form) for $74 - which is way better than $186!! And they can get it for me in 1 business day. After reading your comments and experiences and reading more information online, I have decided that I will be putting the hounds on Amicar for any future surgery they require.

 

Thanks again so much!

[tbhounds]

:-)!!! Let's hope the doxy does the trick for you :-). Fwiw-I always have Amicar in my drug draw (yes, I have a doggie drug draw)-if you ever need Amicar in a pinch and for whatever reason you can't locate any just give me a call :-)

In the meantime-brush, brush and brush those toofiers!

[4My2Greys]

Keeping my fingers crossed that the Doxy does the trick.

[Batmom]

Ah, glad to see an update! Fingers crossed!

[MerlinsMum]

Thank you! I was alarmed and had a mini freakier tonight when I have him the Doxy, as the vet's instructions on the label said to give 4 (100mg) pills wrapped in food every 24 hours. Presumably, since a typical range for dosing (as I understand it) is between 5mg and 10mg per kg, and Sagan is 85lbs (=40kg), he was given the higher-end dosage. Giving him 4 pills at once in Pill Pockets was super stressful for me since, unlike Merlin, Sagan is unused to being given pills and tends to "clamp down" whenever I ask him to open his mouth. I freaked out because the first time I gave him 2 capsules in one Pill Pocket and although I meant to put it at the back of his throat, somehow he clamped down on it and we heard a crunch! I hope he's going to be alright My vet was very insistent that the capsule be wrapped and swallowed properly so that it reaches the stomach before dissolving... which is why I bought the Pill Pockets (which I'd never used before). As I recall, it has something to do with an increased risk of esophageal cancer in dogs that chewed it or something...? I didn't see any powder "spillage" in his mouth when I opened it after I heard the crunch. Let's hope I didn't do any damage

 

The thought of repeating the process for the next 24 capsules fills me with anxiety. I also find it weird that I have to give him 4 capsules at once. Why not 2 capsules twice a day? Does it target the problem faster if it's given all at once, who knows.

 

This is when I wish I'd gone to vet school. If I call my vet to check they might fire me I feel like I pester them as it is...

[Batmom]

Hey, you pay your vet bills, you get to ask question! I don't know the answer to that one, tho -- I'm more familiar with dosing 2x/day. tbhounds might have some insight. Not likely to risk problems from one incident. If you're concerned, you could give him a couple of treats to make sure a little more swallowing goes on to wash everything down.

 

I hate to admit it , but I have one dog who is not fond of being pilled -- Gidget. Not long ago, I also had to give her Tylan powder. So I got some canned food, scooped out enough for 1 big meatball (to hold the powder) and 1 small meatball. Prepared both meatballs. Offered the big one -- GULP! -- and then the small one -- 2nd GULP! Wouldn't work with a more suspicious dog but maybe worth a try.

[robinw]

This is how they get dogs to take meds at FBM...they put a bit of canned cat food on their hand (yuck) and mix the pills in as good as possible. Then they throw the mixture on the floor. What dog could resist eating stuff from the floor? Work with all of my dogs except Iker, who is afraid of food on the floor.

 

Fingers crossed for Sagan.

[greysmom]

Use distraction and momentum! Mine love to eat pill pockets as treats, so I give them a small bite of one (about a 1/4 of a pocket), then do it again, then give the one with the pill, then RIGHT AWAY offer the next small piece. They usually just swallow the pill one down without chewing so they can get to the next one. If you need to, keep putting in empty bites in between the pill-filled ones.

 

Pilling is no fun at all, but I also have a technique for it. While standing on their right side, grab the top of their mouth/face on the left side, not the bottom, with left hand. Try not to bend their head back too far. If you sort of press their lips into their teeth, they will automatically open their mouth. Pry it open a bit more and stuff the pill down, poking it as far back as you can (hopefully beyond the "bend" in their throat). If you get it far enough, it will just go down the rest of the way. You may need to gently hold his mouth closed, BLOW gently into his face a couple times (this makes them swallow reflexively when they blink), and gently rub their throat. I can pill Cash in about 3 seconds this way. Lilly is harder because she isn't as used to it, but it still works.

 

I'd also call the vet and ask if you can do 2 pills twice a day. That's weird.

[JJNg]

I usually use doxycycline at 5-10 mg/kg twice daily, but it can also be dosed at 10 mg/kg once daily. I'm not sure if there's much difference between the different protocols. I'd ask your vet if it's ok to just give 2 capsules twice daily.

 

The esophageal concerns with doxycycline is mainly just irritation if the pill/contents don't go down and remain in contact with the esophageal lining for an extended period. It's really more of an issue with cats, and as long as he ate/drank after the pill, he should be fine. I always just instruct owners to make sure the doxy is followed with food or water.

[MerlinsMum]

I usually use doxycycline at 5-10 mg/kg twice daily, but it can also be dosed at 10 mg/kg once daily. I'm not sure if there's much difference between the different protocols. I'd ask your vet if it's ok to just give 2 capsules twice daily.

 

The esophageal concerns with doxycycline is mainly just irritation if the pill/contents don't go down and remain in contact with the esophageal lining for an extended period. It's really more of an issue with cats, and as long as he ate/drank after the pill, he should be fine. I always just instruct owners to make sure the doxy is followed with food or water.

Thank you so much. This really helps to assuage my concerns.

 

Thanks to everyone who has offered tips to better administer pills to an unwilling patient A lot of great suggestions here - I appreciate it! I feel as though I have lots of ideas and options now.

[o_rooly]

Just following along, and wanted to chime in and say that Sagan is such a lucky (and gorgeous) hound! I hope the pilling gets easier and less stressful (especially for you!) with each time

[philospher77]

Just some more tips: when I did pill pockets, I would get the capsule size, and that would hold generally two tablets. So if you need to get four tablets into Sagan, I would do 2 pill pockets. Also, I now make homemade pill pockets (liverwurst, cream cheese, and pulverized shredded wheat mixed to a playdough consistency), which my two love a lot more than the commercial version.

[EllenEveBaz]

Keeping all paws crossed here for Mr. Sagan.

[seeh2o]

Kerry, I just remembered that I have Dr Couto's slides from his presentation in Solvang this past February. Here is a copy of the text from one of his slides on Amicar. I recall he said they use it for all dentals where there will be extractions. If you want a copy of the slides, let me know and I'll email them to you.

 

 

Aminocaproic Acid
•Standard of care for any “big” Greyhound surgery at OSU
•also after extractions
•500-1,000 mg 3 times a day for 5 days (Amicar®)
•MAKE SURE YOUR VETS KNOW ABOUT THIS!!
•TRASYLOL in Canada