Medications used in the treatment of gastrointestinal disorders

These lists of medications are not complete and while sometimes or often used, many of the medications are not licensed for use in cats and dogs.

Medication	Dose	Comments
Anti-emetics (check for obstruction before using as they may mask signs)
Metoclopramide	1-2 mg/kg/24 hr CRI or 0.2-0.5 mg/kg im, sq or po	D2 dopaminergic antagonist. Upper GI prokinetic, short half life when given orally or sq
Domperidone	0.1-0.3 mg/kg im, iv q 12 hr or 1-2 mg/animal po	D2 dopaminergic antagonist Not commonly used
Maropitant	0.5-1.0 mg/kg q 24 hr sq or 2 mg/ kg po q 24 hr	No known prokinetic effect. Blocks NK-1 receptors in the medullary vomiting centre
Chlorpromazine	0.2-0.4 mg/kg sq q 8 hr	Alpha2 agonist. Affects CRTZ and emetic centre
Ondansetron	0.5-1.0 mg/kg po q12-24 hr	Affects CRTZ, vagal afferent neurones
Cisapride	Dogs: As a promotility agent: 0.5 mg/kg q 8 hr For oesophagitis: 0.25 mg/kg po q 8-12 hr Cats: For chronic	Not a true anti-emetic, but promotility effect may decrease vomiting by enhancing gastric emptying and intestinal transit. Also used for reflux oesophagitis and con- stipation/megacolon (cats) No longer commercially available, must be obtained from a compounding phar-

	constipation (e.g. megacolon): In combination with a stool softener (e.g. lactulose) 0.1-1 mg/ kg q 8-12 hr po or 5 mg per cat (total dose) po q 8-12 hr	macy or imported Contraindications: hypersensitivity, GI perforation/obstruction, haemorrhage
Drugs for diarrhoea
Diphenoxylate	0.1-0.2 mg/kg po q 8 hr	Narcotic analgesic
Loperamide	0.1-0.2 mg/kg po q 8 hr	Narcotic analgesic
Antibiotics sometimes used for bacteria induced diarrhoea and other GI disorders
Ampicillin	10-20 mg/kg iv q 6-8 hr, sq, po	Anaerobic infections
Cephalathin	22-44 mg/kg q po 6-8 hr	Gram-negative organisms
Clarithromycin	4-12 mg/kg po q 12 hr	As part of treatment for Helicobacter spp.
Clavulanate-po- tentiated amoxicillin	8.75 mg/kg iv q 8 hr 8.75 mg/kg im or sc of 24 hr 12.5 mg/kg po q 8-12 hr	As part of treatment for Helicobacter spp.
Enrofloxacin	3-5 mg/kg po q 12 hr	Gram-negative organisms and Boxer histiocytic colitis. Caution with use in cats due to potential blindness.
Erythromycin	10 mg/kg po q 8 hr	Campylobacter only, may cause diarrhoea
Erythromycin	0.1-50 mg/kg po q 8 hr	Low dose to promote fasting motility, mimics motilin in dogs
Gentamicin	2.2 mg/kg sc, iv, q 8 hr	For sepsis only, nephrotoxic, ototoxic
Tylosin	10-20 mg/kg po q 12 hr	Aids in some cases of colitis/enteritis
Metronidazole	7- 15 mg/kg po q 8- 12 hr	IBD, anaerobic bacteria, Giardia. Teratogenic and may be carcinogenic.
Immunosuppressive or anti-inflammatory drugs
Prednisolone	0.5-3 mg/kg po q 12-48 hr depending upon condition	Taper higher doses over several months (e.g. 20% decrease q 2-3 weeks)
Ciclosporin	Dogs (older than 6 months): 5 mg/kg po q 12 -24 hr	Contraindicated or caution with drugs that inhibit cytochrome P450 enzymes, e.g. cimetidine. CI with hyperkalaemia Potential nephrotoxicity, especially if used with other potentially nephrotoxic drugs
Azathioprine	2 mg/kg po q 24 hr until remission then 0.5-2 mg/kg po q 48 hr	Bone marrow suppression is the most serious potential adverse reaction, monitor haematology
Olsalazine	10-20 mg/kg po q 12 hr	Local colonic NSAIDs. Less risk of KCS cf sulfasalazine
Sulfasalazine	Dogs: 15-30 mg/ kg po q 8-12 hr (max 6 g/day) Cats: 1-20 mg/kg po q 8-12 hr	Local NSAIDs. Risk of KCS
H2 receptor blockers (used to decrease gastric acidity)
Cimetidine	Dogs: 5-10 mg/kg iv, im, po q 8 hr Cats: 2.5-5.0 mg/ kg iv, im, po q 12 hr	Slows metabolism of other drugs by binding to hepatic microsomal cytochrome P450 and may increase their plasma concentrations. No known promotility effect
Ranitidine	2 mg/kg sc, iv or slow iv 8-12 hr	Some prokinetic effect via muscarinic AchR
Famotidine	0.5-1.0 mg/kg po q12-24 hr	Does not have the interaction of cimetidine, may or may not have prokinetic effects
Cytoprotective drugs
Sucralfate	Dogs: 500 mg/dog po q 6-8 hr for dogs up to 20 kg, 1-2 g/dog po q 6-8 hr for dogs >20 kg Cats: 250 mg/cat po q 8-12 hr	Aluminium ion binds to proteinaceous exudates forming a barrier over ulcerated areas. Promotes bicarbonate and prostaglandin E production which aids mucosal defense and repair. May decrease bioavailability of other drugs, especially tetracyclines
Misoprostol	Dogs: 2-7.5 pg/kg po q 8-12 hr Cats: 5 pg/kg po q 8 hr	Aids in protection of the GI ulcers due to NSAIDs. Side effects include diarrhoea, vomiting, abortion

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Source: Chandler M.. Small animal gastroenterology. Saunders,2011. — 588 p.. 2011

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Medications used in the treatment of gastrointestinal disorders

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