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
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.
Reglan
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.
Antihistamines
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.
Fluid Therapy
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.
Have a question or comment? Post below or email me at [email protected]. I always enjoy hearing from my readers!
NOTE: Consult your veterinarian first to make sure my recommendations fit your pets special health needs.
Can I give my dog cerenia an hour after I gave him ondansetron because it’s not working.
Yes, cerenia and ondansetron of often used concurrently! 🙂
hello , my cat has stage 2 renal failure , lately she’s been overlicking her mouth, (looks as if she had peanut butter stuck on the roof of her mouth) , excessive sneezing mainly after eating any kind of food. she has no know allergies, and this all seemed to happen after we put her on lactulose and miralax. we were told it could be from nausea , so right now they gave us Cerenia and/ or ondanseltron ,any information is appreciated
There are several fabulous articles on kidney disease in pets at veterinarypartner.com: the article is chronic kidney disease in dogs and cats: where to begin. One of these articles even has a list of resources such as iris-kidney.com. Read those articles and chat with your veterinarian.
Your vet might also give you some Pepcid or Prilosec for your kitty. And they might give IV fluids or teach you how to give subcutaneous fluids.
Both of my ancient cats have kidney disease. I view every day with them as a blessing.
WANTED A QUICK QUESTIONS ABOUT CERNIA IF I COULD GIVE IT TO MY DOG MORE THAN ONCE A DAY SHE IS VOMITING EVERY THING I GIVE HER, AND IT IS DAY BEFORE THANKSGIVING AND EVERYONE IS BOOKED AND WANDERING IF I SHOULD GIVE HER ANOTHER CERENIA ONE THIS MORNING AND I WAS THINKING ONE TONIGHT?
Giving cerenia more often won’t help. It lasts for 24 hours. You could potentially add in another anti-nausea Med such as zofran, but increasing the cerenia is unlikely to help. Do get your sweetie to the vet as soon as possible.