Do Denamarin supplements actually do anything to protect my dogs liver?
August 30, 2018 2:17 PM   Subscribe

My dog is on 5mpg Enalapril. After 2 weeks a blood test shows it's doing something his liver & he now needs denamarin supplements. Are they an actual medically proven to help supplement?

My dog has a mild heart murmur, grade 1 almost 2, he's 10 years old & otherwise fit & healthy. After having an echocardigram of his heart it was determined it was basically old age working on his mitral valve & it's not closing as well anymore. (can't remember technical name for it). The vet prescribed 5mg of Enalapril daily. He's been on the drug 2 weeks & went in for a blood test & now apparently it's damaging his liver & I need to give him Denamarin supplements to protect it & pay for another blood test in 4 weeks.

My mother is currently days away from dying of heart failure, I'm sleep deprived, stressed & overloaded and now my child substitute is suffering from the start of the same problem, My brain is overloaded, all I want to do is curl up & cry & I can't sort anymore medical shit right now. Basically I need someone to hold my hand & tell me is this a real thing, this "supplement" I can buy of amazon that shows up with essential oils & slippery willow when I search for it is an actual real medical product that does something. If you could also tell me what it does in simple terms that'd be great? Is giving my dog meds that have side effects so bad they need other meds to counter them normal in cases like this? Am I being ripped of?

Extra bonus points if you can reassure me that the meds are the right thing to give him right now if they're having side effects with such a low grade murmur.
posted by wwax to Pets & Animals (6 answers total) 1 user marked this as a favorite
I'm not a vet, just a person with a dog that's had compromised liver function for a few years now. She has valley fever because we live in the SW and she's on an anti-fungal for life for that. The anti-fungal is terrible on her liver, but we can't stop the anti-fungal because the valley fever lives in the bones and comes back and will kill her,

Both our regular vet and our internal medicine specialist have recommended the denamarin for liver support. Our dog gets one of the supplements for large dogs daily. The internal medicine specialist told us to do everything we can to support and assist our dog's liver, so she gets daily denamarin, cobalequin, vitamin E, and fish oil along with her anti-fungal, steroids, and other prescription drugs.

I order it from Amazon too, which makes it easier for me, and since both vets recommended it, I want to believe it helps. Trying to keep our dog on this razor edge between these two health problems is tiring but she is a dear, sweet, good girl so I want to do everything that I can/
posted by Squeak Attack at 2:43 PM on August 30, 2018 [1 favorite]

I'm sorry you're going through this. Short answer, yes, it's a real medical product. The entry on denamarin has copious footnotes to studies.

Highlight: Denamarin chewable tablets contain 225 mg S-Adenosylmethionine and 82 mg Silybin-phosphatidylcholine complex...

A deficiency of S-Adenosylmethionine... may initiate or contribute to abnormalities of cellular structure and function in the liver as well as many other body tissues, including the brain... administration of S-Adenosylmethionine has been shown to result in improvements in hepatocellular function in both in vivo and in vitro studies, without cytotoxicity or significant side effects.

Silybin is a biologically active component of an extract from milk thistle known as silymarin, and its absorption is enhanced by phosphatidylcholine. Silybin/silymarin has been shown to have beneficial effects on liver function.

It's a supplement you'd give your pup for a month, and then you'd re-assess. I think it'd be okay to try it for the coming month. I'm so sorry about your mom.
posted by Iris Gambol at 2:45 PM on August 30, 2018

Oh further thoughts - our dog doesn't have noticeable side effects from the denamarin - nothing that stands out amongst all her other health problems.
posted by Squeak Attack at 2:46 PM on August 30, 2018


If your dog's liver values (ALP, ALT, GGT) are elevated, that could indicate liver damage. Sam-E is an antioxidant. If I see high liver values in one of my patients, it will be one of my first recommendations. After 1 month, typically I will recheck blood work and see those values decrease because it helps resolve the liver damage. Enalapril is metabolized by the liver so that's why they're concerned.

And the veterinary formulation (ie. Denamarin) works far better (in dogs) than any human variety you may pick up at Whole Foods.* Because they (Nutramax) commit years of research towards formulation such that it is absorbed well. There is a new chewable formula that dogs like a lot. It would stink if you gave the human form for a month then paid for blood work that doesn't show improvements because it wasn't absorbed well.

Also, Denamarin is ONLY sold at your vet. So if you see it on Amazon or Chewy or wherever, it is diverted product. That means it could have fallen off a truck and been stored at 105 degrees in a warehouse or that it could be counterfeit. Your money, your risk.

I'm sorry about your mom, and your pup. <3

* The version from Whole Foods should only be taken before going out drinking, or the morning after. So I hear.
posted by Seppaku at 2:55 PM on August 30, 2018 [5 favorites]

I have no idea how silymarin (also called milkthistle) works in dogs, but it has long been used to reduce inflammation in human livers by people with hep C, though its use is anecdotal more than scientific. This was based on extrapolating benefit in people who had ingested deadly amanita mushrooms, and who recovered in greater numbers after taking silymarin, with reducing liver inflammation from viral causes. It gained a mythic benefit in the hep C patient cybercommunity. We were never able to validate these claims because these were individual patients, not subjects in a double blind study. Like I said, anecdotal.

Your best bet might be (after talking to your vet) checking into published studies in dogs that might mirror your own dog's situation. Silymarin just might be helpful, but without studies we really don't know what's actually accurate.

I concur with Seppaku above, who recommends paying attention to the source of the drug. Quality control is important. If our patients wanted to take silymarin, we recommended sourcing German compounds, since Germany is the only country I know of which regulates the manufacture of supplements, but for vet use YMMV,
posted by citygirl at 6:54 PM on August 30, 2018

It's a real thing. Our dog has been on Denamarin because of super-high liver levels on multiple occasions and there was a measurable improvement each time, with no obvious side effects. We've been advised to just keep her on it indefinitely now.

We've bought it from Amazon in the past but now order through a legit online pet pharmacy that requires a vet prescription and has pretty much the same prices as Amazon.

I'm so sorry to hear about what you're going through now.
posted by theory at 7:40 PM on August 30, 2018

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