Vet360 Vet360 Vol 05 Issue 03 - Page 28

CPD ARTICLE Gastrointestinal Therapy Anti-emetics and Antacids Dr. Wilco Botha, BSc BVSc (Hons) MMedVet (Med) Section of Small Animal Medicine, Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria. The drug arsenal available to the veterinarian to treat gastrointestinal related diseases has seen some advances in recent years. The release of maropitant on the South African market has replaced some of the older drugs as the empirical choice to manage nausea and vomiting. Various recent studies in the pharmacokinetics of antacids in dogs and cats have suggested that proton pump inhibitors may very well be the only truly clinically useful drugs to prevent and treat conditions manifesting in intestinal ulceration in these species. ANTIEMETICS Vomiting is a clinical sign for which owners commonly seek veterinary attention for. Anti-emetics are commonly used to address this complaint and to avoid possible consequences such as dehydration vet360 Issue 03 | JULY 2018 | 28 and electrolyte abnormalities due to protracted vomiting. One should however be cautious of using anti-emetics in suspected self-limiting cases as they may mask disease progression. Maropitant Maropitant is one of the most effective anti-emetics. It acts by inhibiting the binding of substance P to neurokinin-1 (NK-1) receptors as an antagonist. These NK-1 receptors are found within the vomiting centre, chemoreceptor trigger zone and in vagal afferent nerves in the gastrointestinal tract 1 (Figure 1). This inhibition gives a relatively broad spectrum of coverage against emetogens, compared to, for example, metoclopramide and chlorpromazine, which are