Amicar Dosing For Italian Greyhound

[macoduck]

I have a 9 year old foster italian greyhound who weighs 9.5 lbs. and need to know more about dosing Amicar or Tranexamic Acid for a dog her size before her next vet visit.

 

Bunny's pre-anesthesia lab panel was within normal limits. She was to have a dental with possible extractions and spay at the same time.

 

Vet was only able to do the dental because of the length of time she was under anesthesia. Spay is scheduled for the end of March. There are also 2 small tumors near her groin/nipple area that will be checked/removed as well.

 

During the dental 5 teeth were removed, including the 2 upper canines which nearly fell into his hands. Vet found 2 large fistulas on that upper side that he stitched closed.

She was bleeding from her nostrils at a rate that concerned him. It slowed to a drip but increased with stress. My pickup time that day was pushed back several hours until she was stable.

 

I told him I had Amicar but it was the 650mg pills on hand. His former partner at his previous clinic (they remain on good terms) had used the liquid form of Amicar when my greyhound, Percy, nearly bled out in a dental last year. He called her and had me pick up the vial of Amicar. (Ironically, this was the same vial that was left over from Percy's case.)

 

He administered a drop in each nostril and the bleeding slowed tremendously. I was to continue with a drop in each nostril at home if I saw any more blood drops. Fortunately, this was not necessary.

 

My vet wants to be prepared for the possibility of bleeding when he does Bunny's spay. Because she reacted so well to the drops he is hoping the bleeding is related more to the poor condition of her mouth rather than a bleeding disorder.

 

Prior to her spay he wants another pre-anesthesia panel done. He said rather than running a clotting panel he will do a simple prick test.

He is considering starting Bunny on Amicar for 3 days prior to her spay.

 

We will be discussing this on Bunny's dental followup visit in a few days. I would like to be prepared an know more about dosing for such a tiny dog.

 

Questions about pre-medicating for her spay:

 

Amicar's smallest pill is 650mg. For a 9.5 lb dog, what would the dose be and how small could a pill be cut down? 1/4 pill = 162.5mg, 1/8 = 81.25 (I'd need to have the vet or my pharmacist cut it accurately that small)

 

One vial of Amicar is 20ml. (Label says it must be diluted for IV use. With Percy, that vet directly injected into the bleeding teeth's extraction holes) If we use this for the 3 days leading up to her spay I presume we will only use 1-2 drops per day. Would vet have me give that orally or in her nostrils?

 

I could get an Rx for the compounding pharmacy to prepare the generic Tranexamic Acid in liquid form.

 

A big concern for me is that Bunny has been very difficult to administer the post-dental liquid antibiotic. So I'd worry that she would not get the correct dose of TA if she fights me while squirting it in. I'd rather give her a pill now that her mouth isn't sore.

 

I have great faith in my vet. Cases of excessive bleeding are seen very rarely here. In fact, the vial of Amicar he had on hand had never been used and had expired.

 

 

[macoduck]

Still looking for input.

[JJNg]

Not often that we need to dose a dog that small, but I'd probably go with a proportional dose. A smaller 50 lb greyhound would typically get 500 mg of Amicar, so I'd probably aim for 100 mg per dose, and go with the same protocol of 3x/day for 5 days. No need to start it 3 days prior to surgery. Amicar (aminocaproic acid) and tranexamic acid work by stabilizing clots, so it really doesn't need to be started any earlier than the morning of surgery.

 

I'm assuming the 650 mg tablets you have are tranexamic acid. If you feel that pills will be easier to get into her than liquid, I'd find a compounding pharmacy that can make them into 100 mg capsules for you. I'm not sure how well the injectable form would work if given orally. I'm also not sure how well it is absorbed through the mucous membranes or nostrils. I imagine your vet had you do that after the extractions to get it directly to where it was bleeding, but I honestly don't know if it really works topically/locally.