Nearly every pet gets sick now and then. It’s especially tough when we have a diabetic pet that also needs assistance with glucose regulation. If a diabetic is vomiting, it can be tricky trying to guess how much insulin to give! Sometimes when I send home medications with clients I feel their eyes glaze over if I send home more than one medication. Luckily the veterinary software at my clinic allows lots of words on the prescription label printer. I try to squeeze in extra info on the typed label to try to limit my client’s confusion. Today let’s have a pharmacology lesson for some of my favorite GI medications vets use for vomiting pets.
There are lots of causes of vomiting and lots of receptors that we can inhibit when it comes to nausea. Some drugs work better for one type of nausea than another. How do you determine the cause? You don’t always! Luckily, some medications antagonize more than one kind of vomiting receptor.
Cerenia (maropitant) is one of my favorite drugs for vomiting dogs and cats. It can be used as an injectable drug or can be given by mouth. A beautiful quality of Cerenia is that it is long lasting, up to a full day. It is one of my “go to” drugs for vomiting dogs and cats because it works on the brain center, on the GI tract and for motion sickness. It is quite broad spectrum!
Zofran or Anzemet
Drug induced vomiting (say from chemotherapy drugs or antibiotics) is commonly treated with serotonin antagonist drugs like Zofran (ondansetron) or Anzemet (dolasetron). These 2 drugs antagonize vomiting triggers from the GI tract.
If we have a pet with stasis of the GI tract we might choose Reglan (metoclopramide) as it helps decrease nausea and it promotes motility of the GI tract. Of course with this pro-motility quality, we would not use it of we suspected the pet had eaten a foreign object as the cause of vomiting. That could cause the gut to perforate.
If there is a component from motion sickness (stimulation of the 8th cranial nerve which travels through the middle ear), antihistamines may help nausea for dogs. Examples are Meclizine, Benadryl and Dimenhydrinate. Antihistamines don’t affect motion sickness in cats. Luckily we don’t take our cats traveling as often as we take dogs in cars. “Toonces the Driving Cat” may have liked it, but my own felines meow like someone is torturing them whenever I take them in the car. As I mentioned above, Cerenia works quite well for motion sickness for both dogs and cats.
Let’s not forget fluid therapy. Hydration is very important for a pet to heal! Additionally, we often add in an acid blocker such as an H2 blocker (i.e. Pepcid, Tagamet or Zantac) or a proton pump inhibitor (i.e. Prilosec, Protonix or Prevacid). In general, proton pump inhibitors tend to be a bit more effective than the H2 blockers. Proton pump inhibitors can be given once daily whereas H2 blockers need more frequent administration. H2 blockers tend to be more affordable and are available over the counter.
Typically when a pet is vomiting we advise clients to let the stomach rest. Again, this can be tricky for diabetics as pet owners will need to skip or lower the insulin dosage during that time period. Then, once we start feeding again we feed a little bit every few hours rather than start with a full sized meal. It is wise to start back slowly with food after a period of vomiting. The food challenge should be gradual and the food should be relatively bland. Be sure to check the blood glucose often if your diabetic pet is vomiting and make a plan with your vet about insulin dosing.
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NOTE: Consult your veterinarian first to make sure my recommendations fit your pets special health needs.