Guest guest Posted December 19, 2006 Report Share Posted December 19, 2006 So how effective have you all seen aminocaproic acid to be in your clinical practice? I'm not asking for statistics or double blind placebo trials, but your clinical observations.Thanks.Amie Amie Lamoreaux Hesbach, MSPT, CCRPPresident, Animal Physical Therapy Special Interest Group, Orthopaedic Section, American Physical Therapy Associationwww.orthopt.orgInstructor, The Canine Rehabilitation InstituteWellington, Florida USAwww.caninerehabinstitute.comCEO, For Paws Rehabilitation, LLCPort Republic, land USAwww.forpawsrehabilitation.comManager, Physical Rehabilitation, The Mid-Atlantic Animal Specialty Hospital, LLCHuntingtown, land USAwww.vetmash.com This is from Plumb's...Aminocaproic AcidPrescriber HighlightsMay be useful for treating degenerative myelopathies in dogs; efficacy not well documentedTreatment may be very expensive, especially in large dogsContraindicated in DICInfrequently causes GI distressChemistryAn inhibitor of fibrinolysis, aminocaproic acid is a synthetic monamino carboxylic acid occurring as a fine, white crystalline powder. It is slightly soluble in alcohol and freely soluble in water and has pKa's of 4.43 and 10.75. The injectable product has its pH adjusted to approximately 6.8. Aminocaproic acid may also be known by the acronym EACA.Storage/Stability/CompatibilityProducts should be stored at room temperature. Avoid freezing liquid preparations. Discoloration will occur if aldehydes or aldehydic sugars are present. When given as an intravenous infusion, normal saline, D5W and Ringer's Injection have been recommended for use as the infusion diluent.PharmacologyAminocaproic acid inhibits fibrinolysis via its inhibitory effects on plasminogen activator substances and via some antiplasmin action.Aminocaproic acid is thought to affect degenerative myelopathy by its antiprotease activity, thereby reducing the activation of inflammatory enzymes that damage myelin.Uses/IndicationsAminocaproic acid has been used as a treatment to degenerative myelopathy (seen primarily in German shepherds), but no controlled studies documenting its efficacy were located. There is interest in evaluating aminocaproic acid for adjunctive treatment of thrombocytopenia in dogs, but efficacy and safety for this purpose remains to be investigated. In humans, it is primarily used for treating hyperfibrinolysis-induced hemorrhage.PharmacokineticsIn humans, the drug is rapidly and completely absorbed after oral administration. The drug is well distributed in both intravascular and extravascular compartments and penetrates cells (including red blood cells). It unknown if the drug enters maternal milk. It does not bind to plasma proteins. Terminal half-life is about 2 hours in humans and the drug is primarily renally excreted as unchanged drug.Contraindications/PrecautionsAminocaproic acid is contraindicated in patients with active intravascular clotting. It should be used when the benefits outweigh the risks in patients with preexisting cardiac, renal or hepatic disease.Reproductive/Nursing SafetySome, but not all, animal studies have demonstrated teratogenicity; use when risk to benefit ratio merits. In humans, the FDA categorizes this drug as category C for use during pregnancy (Animal studies have shown an adverse effect on the fetus, but there are no adequate studies in humans; or there are no animal reproduction studies and no adequate studies in humans.)Adverse Effects/WarningsIn dogs treated, about 1% exhibit symptoms of GI irritation.Overdosage/Acute ToxicityThere is very limited information on overdoses with aminocaproic acid. The IV lethal dose in dogs is reportedly 2.3 g/kg. At lower IV overdosages, tonic-clonic seizures were noted in some dogs. There is no known antidote, but the drug is dialyzable.Drug InteractionsHypercoagulation states may occur in patients receiving estrogens.Laboratory ConsiderationsSerum potassium may be elevated by aminocaproic acid especially in patients with preexisting renal failure.DosesDogsFor adjunctive treatment of degenerative myelopathy (seen primarily in German shepherds):1. In combination with exercise, vitamin support (vitamin B-complex, vitamin E), and analgesia (if required; using acetaminophen): Aminocaproic acid: 500 mg (regardless of size of animal, approximate dose is 15 mg/kg) PO q8h. Mix 192 ml of the 250 mg/ml injection with 96 ml of hematinic compound (e.g. Lixotinic®) producing a 288 ml final volume. Give 3 ml per dose (500 mg). Store solution in refrigerator. Clinical improvement seen within 8 weeks. (Clemmons 1991)Client InformationDrug costs to treat a German shepherd-sized dog can be substantial.Dosage Forms/Approval Status/Withholding TimesVeterinary-Approved Products: NoneHuman-Approved Products:Aminocaproic Acid; Tablets 500 mg; Amicar® (Immunex); (Rx)Aminocaproic Oral Solution 250 mg/ml in pints; Amicar® (Immunex); (Rx)Aminocaproic Acid Injection for Intravenous Infusion 250 mg/ml (5 gram) in 20 ml and 96 ml vials; Amicar® (Immunex); generic; (Rx)Aminocaproic acid may also be known by these synonyms and internationally registered trade names: acidum aminocaproicum, CL-10304 CY-116, EACA, epsilon aminocaproic acid, JD-177, NSC-26154, Capracid®, Capramol®, Caproamin®, Caprolisin®, Epsicaprom®, Hemocaprol®, Hemocid®, Hexalense®, or Ipsilon®.--------------------------------------------------------------------->> Hi all. Does anyone have a dosing regimen and a source for the > chemical grade of aminocaproic acid for DM dogs?> Thanks!> Mindy , DVM CCRT pending> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 19, 2006 Report Share Posted December 19, 2006 Haven't used it much so very limited experience, but saw no significant improvement. As an aside, I think that acupuncture for these animals helps them cope by helping the ancillary degenerative joint pain so that they can compensate for the DM better. Don't think it helps the DM Meryl Lessinger, VMD CVA CCRT Re: Re: Degen Myelopathy So how effective have you all seen aminocaproic acid to be in your clinical practice? I'm not asking for statistics or double blind placebo trials, but your clinical observations. Thanks. Amie Amie Lamoreaux Hesbach, MSPT, CCRP President, Animal Physical Therapy Special Interest Group, Orthopaedic Section, American Physical Therapy Association www.orthopt.org Instructor, The Canine Rehabilitation Institute Wellington, Florida USA www.caninerehabinstitute.com CEO, For Paws Rehabilitation, LLC Port Republic, land USA www.forpawsrehabilitation.com Manager, Physical Rehabilitation, The Mid-Atlantic Animal Specialty Hospital, LLC Huntingtown, land USA www.vetmash.com This is from Plumb's...Aminocaproic AcidPrescriber HighlightsMay be useful for treating degenerative myelopathies in dogs; efficacy not well documentedTreatment may be very expensive, especially in large dogsContraindicated in DICInfrequently causes GI distressChemistryAn inhibitor of fibrinolysis, aminocaproic acid is a synthetic monamino carboxylic acid occurring as a fine, white crystalline powder. It is slightly soluble in alcohol and freely soluble in water and has pKa's of 4.43 and 10.75. The injectable product has its pH adjusted to approximately 6.8. Aminocaproic acid may also be known by the acronym EACA.Storage/Stability/CompatibilityProducts should be stored at room temperature. Avoid freezing liquid preparations. Discoloration will occur if aldehydes or aldehydic sugars are present. When given as an intravenous infusion, normal saline, D5W and Ringer's Injection have been recommended for use as the infusion diluent.PharmacologyAminocaproic acid inhibits fibrinolysis via its inhibitory effects on plasminogen activator substances and via some antiplasmin action.Aminocaproic acid is thought to affect degenerative myelopathy by its antiprotease activity, thereby reducing the activation of inflammatory enzymes that damage myelin.Uses/IndicationsAminocaproic acid has been used as a treatment to degenerative myelopathy (seen primarily in German shepherds), but no controlled studies documenting its efficacy were located. There is interest in evaluating aminocaproic acid for adjunctive treatment of thrombocytopenia in dogs, but efficacy and safety for this purpose remains to be investigated. In humans, it is primarily used for treating hyperfibrinolysis-induced hemorrhage.PharmacokineticsIn humans, the drug is rapidly and completely absorbed after oral administration. The drug is well distributed in both intravascular and extravascular compartments and penetrates cells (including red blood cells). It unknown if the drug enters maternal milk. It does not bind to plasma proteins. Terminal half-life is about 2 hours in humans and the drug is primarily renally excreted as unchanged drug.Contraindications/PrecautionsAminocaproic acid is contraindicated in patients with active intravascular clotting. It should be used when the benefits outweigh the risks in patients with preexisting cardiac, renal or hepatic disease.Reproductive/Nursing SafetySome, but not all, animal studies have demonstrated teratogenicity; use when risk to benefit ratio merits. In humans, the FDA categorizes this drug as category C for use during pregnancy (Animal studies have shown an adverse effect on the fetus, but there are no adequate studies in humans; or there are no animal reproduction studies and no adequate studies in humans.)Adverse Effects/WarningsIn dogs treated, about 1% exhibit symptoms of GI irritation.Overdosage/Acute ToxicityThere is very limited information on overdoses with aminocaproic acid. The IV lethal dose in dogs is reportedly 2.3 g/kg. At lower IV overdosages, tonic-clonic seizures were noted in some dogs. There is no known antidote, but the drug is dialyzable.Drug InteractionsHypercoagulation states may occur in patients receiving estrogens.Laboratory ConsiderationsSerum potassium may be elevated by aminocaproic acid especially in patients with preexisting renal failure.DosesDogsFor adjunctive treatment of degenerative myelopathy (seen primarily in German shepherds):1. In combination with exercise, vitamin support (vitamin B-complex, vitamin E), and analgesia (if required; using acetaminophen): Aminocaproic acid: 500 mg (regardless of size of animal, approximate dose is 15 mg/kg) PO q8h. Mix 192 ml of the 250 mg/ml injection with 96 ml of hematinic compound (e.g. Lixotinic®) producing a 288 ml final volume. Give 3 ml per dose (500 mg). Store solution in refrigerator. Clinical improvement seen within 8 weeks. (Clemmons 1991)Client InformationDrug costs to treat a German shepherd-sized dog can be substantial.Dosage Forms/Approval Status/Withholding TimesVeterinary-Approved Products: NoneHuman-Approved Products:Aminocaproic Acid; Tablets 500 mg; Amicar® (Immunex); (Rx)Aminocaproic Oral Solution 250 mg/ml in pints; Amicar® (Immunex); (Rx)Aminocaproic Acid Injection for Intravenous Infusion 250 mg/ml (5 gram) in 20 ml and 96 ml vials; Amicar® (Immunex); generic; (Rx)Aminocaproic acid may also be known by these synonyms and internationally registered trade names: acidum aminocaproicum, CL-10304 CY-116, EACA, epsilon aminocaproic acid, JD-177, NSC-26154, Capracid®, Capramol®, Caproamin®, Caprolisin®, Epsicaprom®, Hemocaprol®, Hemocid®, Hexalense®, or Ipsilon®.--------------------------------------------------------------------->> Hi all. Does anyone have a dosing regimen and a source for the > chemical grade of aminocaproic acid for DM dogs?> Thanks!> Mindy , DVM CCRT pending> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 19, 2006 Report Share Posted December 19, 2006 So how effective have you all seen aminocaproic acid to be in your clinical practice? I'm not asking for statistics or double blind placebo trials, but your clinical observations. If you look at the research by Dr Clemmons in Florida the Aminocaproic acid only helps with German Shepherd DM. Laurie McCauley, DVM TOPS Veterinary Rehabilitation Grayslake, IL drmc@... www.tops-vet-rehab.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 19, 2006 Report Share Posted December 19, 2006 There was a recent study out of Europe that took a number of GSD and followed the Clemmons protocol and no difference was found. I believe Steve and Amie talked about this at the CRI Neuro rehab course? Jeff Bowra DVM Certified Canine Rehabilitation Practitioner drjeff@... Aldergrove Animal Hospital www.familypetdoc.com The Spaw Canine Sports Medicine & Rehabilitation www.thespaw.ca 26841 Fraser Highway Aldergrove, BC, Canada V4W 3E4 From: VetRehab [mailto:VetRehab ] On Behalf Of Dr. Laurie McCauley Sent: 19 December 2006 09:29 To: VetRehab Subject: RE: Re: Degen Myelopathy So how effective have you all seen aminocaproic acid to be in your clinical practice? I'm not asking for statistics or double blind placebo trials, but your clinical observations. If you look at the research by Dr Clemmons in Florida the Aminocaproic acid only helps with German Shepherd DM. Laurie McCauley, DVM TOPS Veterinary Rehabilitation Grayslake, IL drmc@... www.tops-vet-rehab.com Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.