Denamarin is a liver-protecting supplement used to reduce inflammation in the liver and subsequently, reduce elevated liver enzymes found on blood work. It also reduces the toxic effects of a chemotherapy drug called CCNU (aka lomustine).  It consists of S-adenosylmethionine (SAMe) and silymarin an extract of the milk thistle plant, combined with phosphatidylcholine.1

SAMe is found naturally made by the liver.  When SAMe is metabolized, the liver then produces glutathione, a powerful antioxidant.  Patients who have sustained a toxic injury to the liver, tend to have low levels of glutathione. 1 

Silymarin contains several flavinoids thought to protect the liver through several complex mechanisms.It is considered anti-inflammatory, immunomodulatory and anti-fibrotic. One of the most active flavonoids is Silybin, which is best absorbed when complexed to phosphatidylcholine.

The combination of these compounds was found to reduce the incidence of severe liver injury in dogs treated with CCNU. 1 However, antioxidants can potentially inhibit the efficacy of chemotherapy.  Therefore, we evaluate each patient individually to determine if the potential benefits of Denamarin outweigh the potential risks.   

This supplement seems to be very well tolerated.  Occasionally, it seems to cause a decreased appetite in some dogs, but this is very rare.  If possible, it is best given on an empty stomach.

  1. Skorupski, K.A., et al. Prospective Randomized Clinical Trial Assessing the Efficacy of Denamarin for Prevention of CCNU-Induced Hepatopathy in Tumor-Bearing Dogs. J Vet Intern Med. 2011; 25:838-845.

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