Arrgh! Advice Needed Quickly Re: Amicar Dosage

[MerlinsMum]

Some of you may recall that Sagan's dental was rescheduled due to his platelets being low. Well, it's 1.5 months later and we're going ahead with the dental finally, so I ordered Amicar from Walgreens.

 

But now I'm worried about dosage. I know that it's supposed to be given 3x a day for 5 days following surgery. However, the recommended dosage in Dr. Couto's literature is 500mg on the low end to 1000mg at the high end, or between 15mg and 40mg per kg.

 

I originally got a script for 15 tablets, but then I realized that Sagan is 84lbs and this article mentions the following:

 

55lbs to 79lbs: 500mg (1 tablet)

80lbs to 104lbs: 750 (1.5 tablets)

>104lbs: 1000mg (2 tablets)

 

(The article is about deerhounds, but I don't think that matters, since this information comes from the study conducted on greyhounds.)

 

Does this look right? So am I ok to order 23 tablets? (i.e 1.5 x 3 = 4.5 tablets a day, for 5 days)? The vet tech I've been speaking to hasn't heard back from my vet (who is recovering from surgery herself), and I really want to pick up the Amicar today or tomorrow. Chances are I probably won't be hearing back from the vet today, so I needed to make a decision. The vet tech mentioned getting more if I wanted to (enough for a 1000mg dose 3x a day), but I don't think I want to give him such a big dose.

 

Anyone here with an 80lb+ grey who has used Amicar? How much did you give? I need to know asap if I want the pharmacy to have the correct prescription for me and I need to let the vet tech know by 5pm.

 

Thanks in advance for any advice you can give me! This is my first time using Amicar, and I'm nervous enough about his impending dental...

[3greys2cats]

Never used Amicar so no advice but wanted to wish sweet Sagan much luck for an uneventful surgery.

Edited August 18, 2013 by 3greys2cats

[Wonder]

Did you already order?

Check goodrx.com first for prices.

[Guest budsmom]

You want to start it a day or even 2 before the dental. I will have to check when I get home.

[kudzu]

Check the posts from Freightsmom. http://forum.greytalk.com/index.php/topic/300031-unexpected-bleeding/page-3?do=findComment&comment=5559047

 

She mentions "Heard back on my consult request to OSU....because Freight weights 85 lbs, Dr Cuoto says the dosage of Amicar should be 1000 mg 3 times a day instead of the 500 mg. " Now that is for a dog who was already having a bleeding issue. Don't know if that makes a difference on the dose. It's strictly my personal opinion but I think a 1000 mg dose would be safer for a dog Sagan's size. However, if you really wanted to start with 750 mg, then you could up it to 1000 mg if he had trouble. If it was me though, I'd start with 1000 mg. (Note: I have no medical training though.)

[MerlinsMum]

You want to start it a day or even 2 before the dental. I will have to check when I get home.

 

Really? I was told that Dr. Couto stated that there is no need to start before the dental, just the evening of the procedure. Usually when given before the procedure (if I remember correctly), it is given in liquid form. I don't have it in liquid form and will not have it before the procedure. It was actually taken off the shelves and was supposed to be back on the shelves in July, but I'm not sure whether that's the case or not. In any event, it doesn't really matter for me, since I can't get hold of any.

 

Sagan has no known bleeding issues. His platelets have not gone up but they're within normal range for greyhounds - just lower than usual for him. The vet feels that this is his new normal range and that there is no need to be concerned. But I'm ordering Amicar anyway, because Dr. Couto recommends it for any surgery on greys.

 

Check the posts from Freightsmom. http://forum.greytalk.com/index.php/topic/300031-unexpected-bleeding/page-3?do=findComment&comment=5559047

 

She mentions "Heard back on my consult request to OSU....because Freight weights 85 lbs, Dr Cuoto says the dosage of Amicar should be 1000 mg 3 times a day instead of the 500 mg. " Now that is for a dog who was already having a bleeding issue. Don't know if that makes a difference on the dose. It's strictly my personal opinion but I think a 1000 mg dose would be safer for a dog Sagan's size. However, if you really wanted to start with 750 mg, then you could up it to 1000 mg if he had trouble. If it was me though, I'd start with 1000 mg. (Note: I have no medical training though.)

 

Thanks. I wonder if that's because Freight had bleeding issues. Sagan doesn't. I think that's why the vet tech suggested 23 tablets. I don't want to over-dose....

 

I end up giving him 1000mg 3x a day, that's 30 tablets total. Maybe I should just get 30 in case, and then just give him less if the vet gets back to me and feels he can do with just 750mg 3x day....?

 

Of course Walgreens told me a month and a half ago that it would cost me $75 for 40 tablets (instead of the $185 that the vet mentioned!), but yesterday they called me to say it would be $55 for just 15 tablets... If I'd known, I would have gone online and looked elsewhere again. Unfortunately I have no time now as his dental was supposed to be on the 27th but was pushed back earlier to next Tuesday the 20th...

Edited August 16, 2013 by MerlinsMum

[MaryJane]

 

Really? I was told that Dr. Couto stated that there is no need to start before the dental, just the evening of the procedure. Usually when given before the procedure (if I remember correctly), it is given in liquid form. I don't have it in liquid form and will not have it before the procedure. It was actually taken off the shelves and was supposed to be back on the shelves in July, but I'm not sure whether that's the case or not. In any event, it doesn't really matter for me, since I can't get hold of any.

 

Sagan has no known bleeding issues. His platelets have not gone up but they're within normal range for greyhounds - just lower than usual for him. The vet feels that this is his new normal range and that there is no need to be concerned. But I'm ordering Amicar anyway, because Dr. Couto recommends it for any surgery on greys.

 

 

Thanks. I wonder if that's because Freight had bleeding issues. Sagan doesn't. I think that's why the vet tech suggested 23 tablets. I don't want to over-dose....

 

I end up giving him 1000mg 3x a day, that's 30 tablets total. Maybe I should just get 30 in case, and then just give him less if the vet gets back to me and feels he can do with just 750mg 3x day....?

 

Of course Walgreens told me a month and a half ago that it would cost me $75 for 40 tablets (instead of the $185 that the vet mentioned!), but yesterday they called me to say it would be $55 for just 15 tablets... If I'd known, I would have gone online and looked elsewhere again. Unfortunately I have no time now as his dental was supposed to be on the 27th but was pushed back earlier to next Tuesday the 20th...

 

 

There should not be a need to start the pills before the dental - just start the day of the dental. Start with the regular dose of 1 pill and if there is any excessive bleeding, increase to the 1 1/2 pill.

[MerlinsMum]

 

 

There should not be a need to start the pills before the dental - just start the day of the dental. Start with the regular dose of 1 pill and if there is any excessive bleeding, increase to the 1 1/2 pill.

 

Ok thanks, but just to be clear, you recommend starting on just 1 500mg pill even though he is 84lbs and the 500mg pill dosage is for greys between 55 and 79lbs? I'm confused... I am all for giving the lowest dose possible, of course, as long as it's safe... sorry if I'm being dim! Just a bit out of my depth on this one!

Edited August 16, 2013 by MerlinsMum

[TheFullHouse]

Joey had surgery yesterday and unexpectedly started bleeding last night and we had to rush him to the e-vet. He's on 500 mg. and weighs 73lbs.

[MerlinsMum]

Oh Judy, I'm so sorry! Poor Joey. I'll keep him in my thoughts! :goodluck

[TheFullHouse]

Thanks Kerry. It was very scary but he's doing much better today.

[MaryJane]

 

Ok thanks, but just to be clear, you recommend starting on just 1 500mg pill even though he is 84lbs and the 500mg pill dosage is for greys between 55 and 79lbs? I'm confused... I am all for giving the lowest dose possible, of course, as long as it's safe... sorry if I'm being dim! Just a bit out of my depth on this one!

 

 

He's only 5 lbs over so not very critical ... more critical is to start the pills and watch to make sure no issues for at least 3 days. If there is a hint of excessive bleeding, up the dosage. Also, find out if there was excessive bleeding during the dental, if yes, then start at the higher dose. My interpretation of Amicar is that it is not a drug that "needs to build up to a level", if someone knows differently, hopefully they will correct.

 

Also, make sure that you are not giving any fish oil pills as they act like aspirin and discourage clot formation. Supplements like this should be stopped 5 to 10 days before surgery.

Joey had surgery yesterday and unexpectedly started bleeding last night and we had to rush him to the e-vet. He's on 500 mg. and weighs 73lbs.

 

 

Just saw this -- hope Joey is OK.

[MerlinsMum]

MaryJane,

 

Thank you for that! Sagan isn't on any fish oil supplements, but I didn't know about that, so good to know.

 

I spoke with the vet tech who's been helping me with this another couple of times this afternoon. She's been so patient with me I will pick up enough tablets to have him on 750mg 3xday if needed, and I will talk to the vet after his dental to see of we can start him at the lower dose or medium dose. If I need more, Walgreens can get it within 1 business day, thank goodness.

 

Thank you, everyone!!!

[45MPHK9]

No advice. Just wanted you to know that we are thinking good thougts for Sagan.

[Guest budsmom]

Twiz had liquid, I wasn't aware that it made a difference.

[galgrey]

Sending good thoughts for Merlin's dental.

[Riverhound]

Sagan.

[3greytjoys]

Several of our hounds are excessive bleeders. Our vet instructs us to begin administering Aminocaproic Acid (to all our hounds, bleeders or not) 1-2 days prior to surgery (to help prevent excessive bleeding while in surgery and during hospital post-op). We often begin administering one day prior, plus day of surgery, and through four days post surgery. Our heaviest hound is 75-77 pounds and takes 500 mg every 8 hours. If bleeding becomes problematic, we can increase dosage but it usually isn't necessary for minor surgeries (tooth extractions, minor mass removals, etc.).

 

If you have any extra pills leftover, just notice the expiration date - you may have approximately one year of shelf life to use them. We like to keep a few days of tablets on-hand in case of unexpected bleeding emergency anyway.

(Compounded liquid form has a much shorter shelf life (e.g.,1 to 3 months), but is beef flavored so the hounds enjoy it more like a treat (vs. taking pills).)

 

Costco's pharmacy is the cheapest reliable source I've found for the tablet form of aminocaproic acid.

(Side note: Personally, I would not order any pet medications through the mail. Most medications must be kept within a certain temperature range to remain safe and effective. Drug manufacturers can't guarantee their products will be safe or effective when not kept within a specific temperature range. Medications often can't withstand hot temperatures of mailboxes or porches.)

[Guest freightsmom]

Some of you may recall that Sagan's dental was rescheduled due to his platelets being low. Well, it's 1.5 months later and we're going ahead with the dental finally, so I ordered Amicar from Walgreens.

 

But now I'm worried about dosage. I know that it's supposed to be given 3x a day for 5 days following surgery. However, the recommended dosage in Dr. Couto's literature is 500mg on the low end to 1000mg at the high end, or between 15mg and 40mg per kg.

 

I originally got a script for 15 tablets, but then I realized that Sagan is 84lbs and this article mentions the following:

 

55lbs to 79lbs: 500mg (1 tablet)

80lbs to 104lbs: 750 (1.5 tablets)

>104lbs: 1000mg (2 tablets)

 

(The article is about deerhounds, but I don't think that matters, since this information comes from the study conducted on greyhounds.)

 

Does this look right? So am I ok to order 23 tablets? (i.e 1.5 x 3 = 4.5 tablets a day, for 5 days)? The vet tech I've been speaking to hasn't heard back from my vet (who is recovering from surgery herself), and I really want to pick up the Amicar today or tomorrow. Chances are I probably won't be hearing back from the vet today, so I needed to make a decision. The vet tech mentioned getting more if I wanted to (enough for a 1000mg dose 3x a day), but I don't think I want to give him such a big dose.

 

Anyone here with an 80lb+ grey who has used Amicar? How much did you give? I need to know asap if I want the pharmacy to have the correct prescription for me and I need to let the vet tech know by 5pm.

 

Thanks in advance for any advice you can give me! This is my first time using Amicar, and I'm nervous enough about his impending dental...

 

Kerry,

 

Dr Couto recommended we increase Freights dosage to 1000 mg based on his weight (85.3 lbs) when he had an unexpected severe SQ bleed from a punch biopsy. You can see photos of this under the topic Unexpected Bleed. Freight had never been a bleeder before and this bleed came on immediately rather than the normal delay you see in most greyhounds. He has been on Amicar since 7/29/13 and has been stepped down from 1000mg 3 times daily to 1000 mg once daily. We will finish up the Amicar this weekend.

 

The other thing I would mention is that Freight was due for a dental. Thankfully, I scheduled the appointment with his dermatologist first for the biopsies rather than the dental. The ER vets told me had he had the same bleed and swelling from a dental or tooth extraction we would be looking at a different outcome. So, now after this bleed episode, we have a bottle of Amicar in the house and a standing script for more.

 

I don't want to make you worry more than you already are but wanted to share what happened with us out of the blue. Hugs to you and Sagan!

Edited August 17, 2013 by freightsmom