Adding Mexiletine to Sotalol

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chrystel

Boxer Insane
Well. Snatch's holter monitor results came in on Monday afternoon.
I am sorry I didn't update you guys sooner.. My crazy work schedule...

Snatch is overall doing ok. The results showed that the number of premature beats have doubled. The cardiologist doesn't seem worried because he thinks these numbers are not "off the roof".

He did notice though that his tachycardia episodes are long.

So he wants to add Mexiletine every 8 hours. He says this gives really good results to smooth everything out.

Holter recheck in 3 weeks.

Mexiletine is $50/month and the holter is $500 each. I think Snatch is costing me my washer and dryer for another month.. ;) (we have recently moved and have been trying to save for a washer and dryer since then...)

Now we have Sotalol 40mg twice a day along with the Soloxine (7am-7pm) and Mexiletine 150mg three times a day .. this one is HARD to fit into our schedule! So we decided to do 6am-1pm-9pm. This is the best we can do. So long sleeping in on the weekends..
I have no idea what to do if we want to go out on Friday or Saturday evening...

seriously.. ??! ... I love love love Snatchoo, but my life cannot really revolve around his pills, can it? DH is patient, but not "that" patient...
 

Cami

Boxer Insane
I know how terribly hard it can be to time all the various meds!
Isn't Mexiletine dosed every 8 hours? You have it set up for every 7 but also 9 hours between the last at night and the first in the morning.
I remember that Cami always had to have food on board with this med as it can cause stomach upset. She also had a reaction at the 150mg dose and we had to drop her down to 120mgs. It can lessen the seizure threshold and she was having head tremors and just not acting right.
 

Tuff Love

Boxer Insane
Glad to hear Snatch is doing ok. I don't know how I would fit meds 3x/day in my schedule- I think we'd have to hire someone to do it lol. Ahh, the things we do for our pups... I hope the new med helps balance things out :)
 

chrystel

Boxer Insane
yes i know.. i cannot set it to the 8 hours intervals...

I work 6.45am to 6.30pm
DH comes home between 12 and 1pm for lunchtime for the dogs.

Snatch's syncopic episodes are always in the afternoon, so we thought the pill between lunch and night should be 8 hours.

I cannot get up at 5am in the weekends. I am exhausted. I seriously need sleep. Also Snatch refuses to eat that early. I wake up at 5.30am every weekday and Snatch is totally passed out at that time (cuddles with DH)

So I usually feed at 6am during the weekdays so i give him then.
The next dose (+8 hours) should be 2pm - but DH 's lunch is set hours (12-1). So he gives him the latest he can, so that is around 1pm. (so that sets a 7hr interval only)
Then the next dose (+8 hours) is 9pm

Then until morning it's is 9 hours until 6am

I am at a loss for the 8 hours interval. We cannot do it. The cardiologist told me it's "ok", to just do my best to keep it as close to 8 hours as possible.
The pharmacist confirmed telling me "do you think old people follow schedules that closely?" he then laughed and said that my schedule is probably better than what most cardiac people follow for themselves..
I am still upset i cannot do the 8hrs...

So far his tummy is "ok".. except the usual gassing at night.. (never during the daytime)
 

Cami

Boxer Insane
You can only do what you can do! I am lucky since my schedule is so flexible. When I can't do something hubby can. He is self employed like me so in these situations it has its perks.
 

Gatorblu

Boxer Insane
Thor was on this for the last couple of months (remember it was not really his heart that finally took him but the tumor) Thor was always hungry so feeding him every eight hours was not a problem but he some supplements that needed food as well and I wasn't comfortable mixing them with meds so he as 5 times a day. (Actually the hardest part of losing him was adjusting to a freer schedule. Yes I know how weird that sounds.)

Another thing to keep an eye on with this medication, is they can become hyper-aware. Someone else had mentioned this in another thread. Thor's wasn't an extreme reaction, but he would raise his head up and look around at noises he has been hearing for years, like the ice maker in the fridge. So even if Snatch sleeps through your morning routine now he may start to wake up. If so you can give him his meds first thing.

I find somehow things always work out. Just do your best, and love your baby as much as you can.
 

Bathel

Super Boxer
My little girl is on Mexiletine also... we sent her Holter test off to Dr Meurs who many regard as the leading expert in cardio myopathy in boxers... see told us not to worry so much about the every 8 hours, but to make sure she gets it three times per day AND WITH FOOD... that was the hard part.

We do a 7am 1pm 7pm schedule for the Mexiletine and a 7am/7pm schedule for her sotalol. I divided up her food into three feedings, but sometimes she's just not that hunger and I have to give her a handful of treats to go with the little bit of food she might eat at her lunch feeding.

She's been on it for about two weeks now, and even though we haven't had the follow up holter yet, I can tell she is doing better. When we play outside she rarely coughs anymore and she seems much more "stable" on her legs when we are playing.

We go for the follow up holter in about two weeks, but our cardiologist only charges 300 bucks for the testing....

BTW, you can send your holter results to Dr Meurs and she'll do an evaluation for 50 bucks. It was nice to get a second opinion and to hear what she had to say about my sweet little girl.

Hope that Snatch does well on it too... good luck! BTW, shop around on that pricing for the meds.. at Publix here in GA I pay 42 dollars for a 90 day supply of 150 mg Mexitetine and 40mg Sotalol is 4 bucks for a months worth at Walmart.
 

cooper22

Boxer Booster
I have Riley on 80 mg of Sotalol at 6 am and 6 pm. He also takes 150 mg of Mexilitine at 6 am, 2 pm, and 9 pm. He has done pretty well on this schedule although he isn't as excited to eat his food, but hasn't had any collapsing episodes since being on this dose. We just do the best we can with respect to the timing of the medication.
 

packblt

Completely Boxer Crazy
I hope the new med works for Snatch.

It does get really tricky when there is a med added that's 3x a day. We had that with a seizure med and it needed to be separated from the soloxine by at least 2 hours which of course needed to be an hour before meals. I didn't know how we would do it at first.

Luckily the partner I work for is a softy with a wonderful heart and I was driving back home (20 - 25 mins) as needed. I was also home on sick leave and working very little for weeks off and on which ironically was a help. We had been looking into a dog sitter that had vet tech training to help out when needed.

Sending hugs and prayers that it all works out.
 

chrystel

Boxer Insane
Thanks everyone! So challenging!

Snatch is doing good. I honestly don't "see" any difference since we added Mexiletine (6 days).

He refused to eat this morning, but I think it's more because it was kibbles ( I was out of raw chicken.. rotten dog!!)

It's hard for me to know when we go for walks if he either is stubborn (he's quite a little feisty boxer.. he decides WHAT and WHEN he wants to do stuff...) or if he is not feeling well..

Earlier we were on a walk.. and he just decided to lay down and rolled over slowly. I don't know if it's because he is not well, or just he doesn't want to walk anymore (he doesn't like our quick walks, they bore him)

ugh.. i hate worrying...
 
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