Page 38 – Second Chance AIHA Dogs

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Keymaster

Alyssa,
Time of day doesn’t really matter in this case. What is important is a “steady” state of hormone in the body. That means exactly every 12 hours. The half life of Soloxine is about 12 hours, so that is why it’s important to dose regularly.

This simply mimics how our body works, attempting to keep homeostasis.

I should note here, and have been remiss in not mentioning this before, it is well known that many dogs respond much differently (and negatively) to generic thyroxine than they do to Soloxine, the brand. I personally always use Soloxine because of this.

I have a friend who breeds Great Danes. One of her females was on thyroid supplementation and the vet prescribed thyroxine. This dog responded to this with seizures. Once she was switched to Soloxine this resolved. Not all dogs respond the same way, but it is important for me to mention that there can be extreme reactions.

Why the difference? It’s pretty simple. Brand drugs develop proprietary manufacturing processes using specific quality fillers. The amount of drug in each tablet is quality controlled. They ensure that there will be homogeneity from one tablet to the next. Generic drugs are not always manufactured with the same care (and are often manufactured in other countries). Why does the government let this happen? They often evaluate drug quality by evaluating the amount of drug in a batch, not necessarily from one pill to the next. If the batch has the right amount then they consider that acceptable.

Certain medications that are critical and can cause life threatening side effects if the dose is different from one pill to the next are put on a list called Critical Dose Drugs. The government wants to apply more rigid controls to the manufacture of these drugs. One such drug, digoxin, can be extremely dangerous if over or under dosed from one pill to the next, even leading to death. I experienced this when treating Chance for a heart condition. His digoxin (a human drug) was recalled for exactly this reason and in fact, he was having collapses because of this. I put him on Lanoxine, the brand drug to avoid this happening again.

Soloxine might not have the same life threatening side effects, but maintaining steady levels of this drug in the blood seems to be critical to many dogs. You might get the same dose in a generic averaged out over the 100 or so pills in the bottle, but they may use fillers that don’t have equivalent bio-availability quality. So one pill that is supposed to be .3mg may be .2mg while the next one may be .4

Something to keep in mind, if you can afford the brand, use it.
my best
patrice

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Patrice

Keymaster

Alyssa,
The two values you are looking at that are above normal are ALT Alanine Transaminase and ALP Alkaline phosphatase, both values that are usually recognized as liver enzyme values. However, they can also sometimes reflect inflammation in other organs as well.

But in general, when a dog is on prednisone these two values will tend to rise and can often be extremely high. The liver is the organ that must process the prednisone and as it performs this function liver cells are destroyed. The enzymes are the byproduct of that cell death. The liver is highly regenerative and can recover, if there was no organic liver disease prior to AIHA, from this insult very quickly once the dose of prednisone is lowered and discontinued.

When Chance was being treated for non-regenerative anemia, both his ALT and ALKP were extremely high, he had been on prednisone for several months at that point. The ALKP was nearly 38x higher than normal. The ALT was also similarly high. These values indicated that his liver was highly inflamed and they needed to come down quickly for his health. I used Denamarin and considered it one of the most important parts of his treatment. Very shortly after starting Denamarin the values began to drop and eventually got down to about 1x normal. It is expensive, but he was in serious trouble and it helped him immediately.

Your chem screen, however, only shows a mild elevation in both ALT and ALP, not even 2x normal. You don’t need to worry at this point too much. Use some high quality milk thistle as a supplement. This supplement is not regulated so it is important to find a manufacturer that ensures the quality.

The glucose values is just barely over the normal high value. Unless this value has been a bit high consistently for a number of chem screens I would say this is probably because she may not have been fasted properly before the blood was drawn and you are seeing the result of a recent meal.

Make sure that she is fasted for 8-10 hours before the blood test, but make sure she has plenty of water. Blood glucose is a dynamic value. Our body is constantly adjusting it throughout the day in response to our food intact and numerous other stimulants like stress.

Talking about stress… Please take some time for yourself tonight, please. A nice hot bath with a good book or if you can get away for a movie. It’s Mommy’s night to reward herself for doing such a good job.

The only other values I see are some indications she may have an infection. Something to discuss with the vet the next time you are there.
my best
patrice

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