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Sotalol tips, anybody?

13K views 45 replies 11 participants last post by  159001 
#1 ·
My sweet boy, Hagan, just got put on Sotalol by his cardiologist (after an abnormal Holter test). If your Dobe is on this medication, where do you usually buy it? And also, could you share any experiences when you first started this Rx (side effects, complications, etc.) - thank you in advance for any help!
 
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#2 ·
I think that my friend who has had couple of Dobes on Sotolol found that Costco was the best bargain on it. Unfortunately Sotolol is one of the very expensive anti-arythmics frequently prescribed for arythmias.

This is a drug that I recommend discussing with your cardiologist. All of the anti-arythmics--dosage quantity seems to be pretty critical and although if you are getting any prescription drug from Costco they always provide a very detailed information sheet on the drug and contraindications s well as possible side effects.

And it may be expensive but it is also a very effective drug.

Good luck with it
 
#3 ·
Thank you, dobebug!

Hagan's cardiologist called the Rx to CVS and when I went to pick it up today I found out that it was close to $80 for 100 tabs, so I was curious about other people's experiences (regarding pricing & availability), I called Walgreens and they had the same price. I also called other pharmacies in the area and found it at Walmart for $11 - big difference!

She (Dr. Nancy Morris) warned us about Hagan being tired when we first start the medication, which will be 3/4 tablet for the first 3 days, but I know that Sotalol can cause Torsades de pointes (which can lead to V-Tach in humans)...it makes me a little concerned about my boy, but she's going to do another ECG (and later another Echo & Holter), after tweaking the Rx to the optimum dosage.

Again, I appreciate your response, this is all new to me (another "surprise")! :sadcry:
 
#4 ·
For some other meds (like Vetmedin, for example) ValleyVet is a good online site...they get an authorization from your vet, fill the scrip and mail it to you fairly quickly. They can save your info so you can get refills easily for as long as the scrip is good. It doesn’t look like they carry Sotalol though.
 
#6 ·
@ Zen

Keep you head up and your optimism strong. A few years back our big boy, at about your guy's age, had a life threatening episode of Ventricular Tachycardia. He lived and with meds, including beta blockers, a reasonably long life.

We did end up losing him several years later to a V-Tach episode, but it was quick and seemingly painless.

BTW, I am on a beta bloker (Propanalol, not Sotalol). I notice no side effects.

I hope all works out for your Hagen

John
Portland OR
 
#7 ·
Thank you, John!

It was scary to find out about his crazy arrhythmias (only a couple of weeks ago, by his regular vet, right before his dental prophy), and now we're dealing with this...I always thought that my only stresses would be related to his vWD, but things changed rather quickly.

I'm glad that you're doing OK with your meds, and I hope that Hagan can be like that also, I'm keeping my fingers and toes crossed! It's good to know that your boy lived long, despite his condition, I've read a few other threads that indicate the same - so I'm trying to stay positive.

Maria
 
#13 ·
How wonderful that Baron has been doing well for so long!!! I'm hoping to have Hagan with us for a while also (he'll be 7 on Thursday). Thank you so much for sharing your experience, dax! :)
 
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#19 ·
I found CVS to be astronomically priced on Sotalol. They were ~$80/month initially, and then suddenly skyrocketed to nearly $200/month with no warning. When I requested an explanation, I was told it was something to do with the supplier. I found another local pharmacy that only charged $17/month.

I now live somewhere that I'm able to keep a Costco membership and their price, including my member discount, means I only pay $9/month for Sotalol. Unfortunately, it wasn't doing the trick for one of my dogs and we recently also had to add Mexiletine which costs us $98 at Costco with my member discount (which is close to $100 cheaper, still, than any other pharmacy I've found).

If you're near a Costco I *highly* recommend getting your meds through them. They carry most of the DCM meds. I have found that the least expensive pimobendan is through a compounding pharmacy. Buying the name brand, Vetmedin, through our cardiologist was ~$160/month for one dog (both my girls are on it), and even through other online pharmacies like Drs. Foster & Smith, it was ~$100 per month supply per dog. I'm able to get a 2-2.5 months supply for *both* of my dogs now for $140 (total - not per dog!) through Wedgewood Pharmacy.

I'm still spending hundreds of dollars per month on DCM meds because treating one dog is expensive and treating two dogs can be ridiculously expensive, but I've been able to find the most reasonably priced options for all the meds through Costco & Wedgewood.

As far as side effects...none here. Neither of my girls have shown any side effects from Sotalol. Effectivity can vary between dogs. For instance, its been wonderfully effective for one of my girls for a little over 3 years now but didn't do anything for my other girl as far as we can tell, which is why she required an additional antiarrhymia med. But neither has had any problem tolerating it at all. Considering the turnaround and results I've seen in one of my girls, I can wholeheartedly say its always worth a try at the very least if you've got a dog with an arrhythmia problem.

Good luck!
 
#20 ·
Thank you very much for this info, brw! I'm sorry that you're going through this with both of yours, I can only imagine!

Yeah, CVS also gave me a lame excuse when I questioned their prices, something like "dogs usually don't have insurance so we charge more" - ludicrous! I'll look into Costco as well, even though Hagan just started on Sotalol, who knows what's next after his follow up with the cardiologist in a few days.

Maria
 
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#24 ·
Hi, Coco! How nice of you to ask!!! :x

We had to postpone last week's follow up due the nor'easter, but Hagan is seeing the cardiologist tomorrow afternoon - I'm hopeful to hear that this dosage of the Sotalol is working, or we'll have to adjust it and take it from there. We've been spending a lot of time cuddling on the couch, playing, and savoring every moment together! I'll post an update when we find out how things are progressing, thank you for your kindness and concern!
 
#26 ·
Yesterday's visit went OK: the ECG didn't show anything alarming (but neither did the previous one), Dr. Morris said that the heart rate is slower now (thank you, Sotalol), and Hagan is wearing a Holter monitor again - which he hates! So, the plan is to wait for the results (we'll drop off the monitor on Monday) and repeat the Echo in 6 months; we'll do a chest X-ray as well, after getting the Holter results.

Thank you all for the support, advice, and encouraging words!
 
#27 ·
Sotalol or Sotalol AF

Sotalol or Sotalol AF is a generic of Betapace or Betapace AF. They are different. A Google search will provide plenty of good information on the drug. It is used to treat us humans with various forms of A-Fib and more. I've been taking this med for over 10 years now. The drug, as I understand it does not per se change the heart's rhythm but my analogy is that it acts more like an engine governor thereby limiting the heart's rate when an abnormal arrhythmia occurs. This allows the heart an opportunity to recover. The problem, at least in people is that even though the heart rate is lower it may get stuck in this abnormal rhythm and require some intervention. When I feel this I force myself to cough and 99% of the time that corrects things. A dog will not know this. Prolong abnormal arrhythmia in people can cause stroke. Not sure if this is the same for dogs but it begs the question whether an aspirin / blood thinner rigimine is in order, again like people. Also, is there a way to monitor the dog's rhythm to alert you when there is an abnormal situation, like a smart phone app tethered to a appliance.

Finally, I would contact Kathryn Meurs at the North Carolina State University (https://cvm.ncsu.edu/directory/meurs-kathryn/) Dr Meurs has been heavily involved with the development of DCM genetics testing including DCM2.

Good Luck

Dan C
 
#28 ·
Prolong abnormal arrhythmia in people can cause stroke. Not sure if this is the same for dogs but it begs the question whether an aspirin / blood thinner rigimine is in order, again like people.

Good Luck

Dan C[/QUOTE]



Yes, an ischemic CVA in dogs is always a strong possibility with arrhythmias (especially A-Fib), but anticoagulant therapy would probably be contraindicated for Hagan, since he is affected with von Willebrand disease.

We should be getting results from the second Holter soon, but in the meantime I'm just glad that he doesn't show cardiac enlargement on the Echo (at least, not yet)! Thank you very much for input, Dan.

Maria
 
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#30 ·
We're doing OK, thank you for thinking of us! :)

We got the second Holter results yesterday, and he's still having short runs of SVTs, so the cardiologist increased the Sotalol dosage. She wants to repeat the Holter in a month, so we have to be patient, I guess (6 more weeks before we know where we stand). Hagan is still playing, eating, and loving as usual - no obvious disease symptoms, nor medication side effects, so far. We're just hoping that the new regime works!
 
#32 ·
Well, I have both dogs on monitors as I'm typing this! :crying:

Our regular vet detected arrhythmias on our girl a couple of weeks ago, when she was doing her dental prophy pre-op tests (exactly what happened with our boy). Yesterday we took them both to Dr. Morris, Frauke had her baseline echo (which was OK) and got hooked up for her first Holter, and Hagan got his third one (follow up after the increase in Sotalol dosage). We'll be returning them today and then we'll be waiting for a couple of weeks to find out results.

In the meantime, VetGen lost the swabs for the DCM test (they blamed the carrier, even though the tracking says it was delivered), so I'll do it again and send it directly to NCSU.

It means a lot that you thought about us, thank you!!! This is stressful, to say the least, but I appreciate your support! :x
 
#35 ·
Thank you, Coco!!!

Hagan is finally stable on his current Sotalol dosage (100 mg), some arrhythmias are still present, but "reasonable" on his 3rd Holter. Frauke's first Holter showed some irregularities too, but Dr. Morris didn't feel the need to put her on meds at this time, since they weren't too worrisome.

They were both finally able to have their dental prophys last week, and did great (no cardiac issues during anesthesia, per our regular vet), their chest and belly rads were all OK too! Hagan had an epulis excised also, we're hoping it doesn't grown back, which they sometimes do.

On the down side, Hagan tested positive for both DCM 1&2 (at NCSU), and Frauke was positive for DCM2. It is what it is, at this point I can think a little better, and I'm just glad that it's not too late - we'll just have to be prepared for whatever comes at us later.

They'll both be having echos again in 2-3 months, to check for any heart enlargement, in the meantime everybody is their usual crazy self - they play, eat, and love like nothing is going on. And we, of course, spend as much time as we can with them - spoiling them rotten, to which they don't complain, the brats!

Thank you for checking on us! Hugs...

Maria
 
#38 ·
Hi, suzu! I hope that your Drago continues to be well also, you're obviously taking very good care of him, all we can do is be on top of their meds and tests. Giving them tons of love helps too! Good vibes heading your way... :2smile:
 
#40 ·
Not at all, but we do limit the time they spend running like maniacs; we take them out to play several times a day, in their large fenced yard (they play rough and hard), one of us stays with them outside and/or plays with them too (we're retired, so they're always with us). We don't let them get extremely tired, we bring them inside before they get to that point.

We figured that sudden death can happen anytime, not just when they're active, and we're not going to stop them from having fun (and exercise). Do I worry? Absolutely! But I can't allow my fears (which are many) to take over; when their time comes I know that we'll be unconsolable, but for now we're trying our best to prepare for it, and we're trying to give them a very good life.

I was very upset when this all developed, but I'm calmer now, it helps that my DH is not as emotional as I am. He loves them too, but I'm the one who worries the most. It's not easy, but we have to try our best!
 
#43 ·
ZenChari and Suzukimoto2,

It also sounds like exactly what I opted to do with one of my Dobes--his cardiologist and I had been following the progression of his DCM/arrhythmias for some time--(at least 3 years) and we had discussed the issue of activity. This was a very active dog--still running agility when we knew that he was clearly a candidate for sudden death but because I knew and his cardiologist agreed that it was just as likely that he'd die in his sleep or running squirrels in his yard as running agility which he loved that he could go on doing what he wanted to do.

He was just a couple of month shy of 10 when my friend picked him up early in the morning to go to an local agility trial. I had an appointment that morning so didn't go with them but was home doing something in the kitchen when they came back. My dog bounced in full of wags and grins and went out to get a drink of water. When he came back in he joined me in the kitchen to see if I'd give him whatever I was cutting up.

Two minutes later I realized he wasn't bugging me--that was unusual--I turned around to see what he was doing. He was sitting--this was not a patient dog and I caught the look in his eye and put my hand on his ribs--my friend and I put him my truck and she ran back inside to call the clinic where I work to tell them we were on our way. I made it but my dog did not--I'm 15 to 20 minutes from the clinic depending on traffic. I kept checking him in the mirror--about half way to the clinic he went down.

It was devastating--half of the clinic staff was in the back parking lot at the clinic when I got there--I said to one of the vets--"He's gone..." She already had her stethoscope on him and agreed.

But you know--I'd wish that kind of a departure for any of my pets--that dog died as he'd lived--he didn't just run down and get old and he was never in pain--he had nearly 10 years of exuberant good health and a bad 15 minutes and was gone.

There's rarely a day that I don't think of him and now, mostly, what I think about is how he got to do the thing he loved best on his last day--he went to an agility trial, had a great time and quickly left me to go where the good dogs go...
 
#44 ·
Hello, I just joined this post and started a thread about collapse from ventricular fibrillation followed by recovery. My dog Apache was seen by Dr Morris and was on sotalol, mexiletine, pimobenden (vetmedin) and enalapril. She was on the mexiletine and sotalol until April 15 of 2017 when she had the collapse. I thought she died but then woke up. Dr Morris spent the next several months working with me - texting me several times a day, adjusting meds, I reported back to her signs I would see, she checked Apache almost every week or 2 until the arrhythmias calmed down and became controlled. After that episode, enalapril and pimobenden were added along with spironolactone and furosemide. I have had to go to online places like GoodRx, Discount Drug, Pet Rx, and get coupons to help with the cost of these meds. Another thing you can do is to directly ask the pharamacist if he has any discounts he could apply as sometimes they do (but you have to ask). And to make matters worse, no one will give you the cost of the drug until they get the prescription so sometimes you have to ask the vet to send it to another place to get the bet price. Dr Morris's office was aware of this and worked with me on this. You can go to these websites and enter the drug name, quantity, and dosage, your zip code, and it will give you all the places where you can get it and the price at each place. The last time I got sotalol was Stop and Shop pharmacy in Greenfield Ma for $23 in Feb of 2018 - 80mg tablets qty = 80 and it was with a coupon from Pet Discount Drug card at the following website: https://www.discountdrugnetwork.com/pet-rx-discount-drug-card/. I just checked the website now and for 90 tablets it is $24.53 at Stop and Shop. You have to be aware that once you bring the coupon to the pharmacist, the price may differ but it is not supposed to be that far off. However the way these discounts work is it is a % off the drug from the manufacturer the pharmacy has gotten the drug from so if the manufacturer changes, the price changes. One trick is once you find a pharmacy and a price that works for you, make sure you get the vet to give you refills and the price will always be the same for that prescription for all refills - I've had to question this and ask why it changed and they honored the previous price but once a new prescription is called in, you have to bring in a new coupon and start over.
As far as side affects, Apache had none that I noticed. Everyone is different. I kept a diary and a spreadsheet so I could track any changes I saw once a new med was started. You'd be amazed at how you can attribute something to the time when she started taking X.
By the end of Apache's life, she was on over 12 meds and I was able to tell my vets that within so many hours she developed such and such. She even tried a new drug to help with appetite (Entyce) - and within a day of taking this drug her right paw swelled up. Then we stopped the drug and within 2 days her paw swelling went down. This happened 3 more times as even the drug manufacturer had not known it would cause this issue but this symptom was mentioned on the study they did when they were conducting their trial. And I have pictures.
Yes, I had no life for the last year but I'd do it all over again if it meant it was helping my girl.
I hope this helps you and good luck with everything. Tell Dr Morris I said thank you for taking such good care of Apache for me.
I miss her so much.
 
#46 ·
HI, Apache was 9yrs 4months when she was first diagnosed with "dropping pulses" and heart arrhythmia. Before that all the vets she saw were very pleased with her breathing, pulse, and heartrate. So we were referred to Dr Morris at that time and she was not given the diagnosis of DCM - just arrhythmias or irregular heart beat patterns. By the time she had her collapse she was getting over 7000VPCs and multiple runs of couplets and even triplets on her 24hour holter study. But the heart structure was still good.

I hope your Drago lives a long and happy life. They do not seem to know they have a heart problem. I hope everybody's baby lives a long and happy life. It is so hard when they leave.

I have never found another breed of dog that honestly tries to communicate with you (as much as a canine can communicate with a human anyways).
 
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