For many decades, veterinarians have experimented with and attempted to find better ways to treat liver and gall bladder disease. Back in the '80s, veterinarians began using a dietary supplement known as SAMe. SAMe is S-adenosyl-methionine. It is an essential amino acid nutrient found in foods such as meat and sunflower seeds. It is useful as an antioxidant, detoxifying the liver and supporting liver cell health. When veterinarians first began putting dogs on SAMe, it was usually a supplement purchased at a human health food store.

When the company Nutramax created Denosyl, the active ingredient was SAMe and it became the veterinarian’s go-to supplement when dealing with any form of liver toxicity or chronic liver disease. Given once a day on an empty stomach to increase absorption, positive results were experienced in these cases.

At the same time, another dietary supplement was also making news in the veterinary world as a liver support medicine. It was harder to obtain this drug. Again, for many years, pet owners were sent to the health food store to add this to the pet’s diet. It was silybin, a nutrient derived from the herb milk thistle.

Silybum marianum, also known as milk thistle, is a spikey little purple flower known by naturalists to be supportive of liver health. Silybin, an extract of the milk thistle plant is well known for its liver support properties. It is an antioxidant. It promotes cellular repair and regeneration. It also encourages bile flow from the gallbladder.

And so, when combined, SAMe and Silybin have been found to be the all-natural equivalent of a "one two punch" to liver disease in pets. Nutramax addressed this, creating Denamarin, a once-a-day pill that includes SAMe and Silybin. The results have been very favorable and many dogs with chronic liver disease do very well on Denamarin.

Unfortunately, as with many things these days, Denamarin is unavailable. I do not know the reason, but it is back ordered and cannot be purchased. So, pet owners with dogs on Denamarin are searching for alternative sources of these ingredients.

What’s the dose? That is the question now that we don’t have easy access to a combination drug. Well, the answer is “it depends." It depends on the product source and concentration. Absorption rates vary depending on the treatment of the medication. That is not the easy answer pet owners want.

The good news is I am finding many sources that are made just for dogs. In fact, a quick search on Chewy.com reveals several different SAMe and milk thistle options. I believe that is the best bet for getting the proper dosage.

The benefits of both the SAMe and the milk thistle will have to be realized by using two different products. The most common side effect to these two nutrients is gastrointestinal upset. It would be best to start one product and use for a week or so before adding the other so if one makes your pet sick you will know which one is causing the problems. Some of the milk thistle products are concentrated, some are not. So read the label and use as directed. 

Have a question for Dr. Johns? Email her at JohnsDVM@aol.com. Write to Pet Peeves, P.O. Box 2949, Fort Walton Beach, FL 32549. Johns is a Niceville veterinarian.