Today's Veterinary Practice provides comprehensive information to keep every small animal practitioner up to date on companion animal medicine and surgery as well as practice building and management.
Issue link: http://todaysveterinarypractice.epubxp.com/i/133843
GI InTerVenTIon: PaTIenT wITh acuTe DIarrhea | Table 4. Medications for Acute Diarrhea: Dogs and Cats MEDICATION NAME DOSAGE Antidiarrheals Diphenoxylate (Lomotil, pfizer. com) Loperamide (Imodium, jnj.com) Dogs: 0.05–0.2 mg/kg Po Q 6–8 h *Cats: 0.08–0.1 mg/kg Po Q 12 h Dogs: 0.08–0.2 mg/kg Po Q 6–12 h *Cats: 0.04 mg/kg Po Q 12–24 h Antimicrobials for Nonspecific Diarrhea Metronidazole Tylosin Dogs: 10-15 mg/kg Po Q 12 h Cats: 62.5 mg Po Q 12 h 10–15 mg/kg Po Q 12–24 h Antimicrobials for Dogs or Cats at Risk for Bacterial Translocation Amoxicillin-clavulanic acid 12.5–22 mg/kg Po Q 12 h Ampicillin 22 mg/kg Po Q 8–12 h Broad-Spectrum Parasiticide Fenbendazole 50 mg/kg Po Q 24 h for 3–5 days Probiotics: Fortiflora (nestlepurina.com) & Prostora (iams.com) *Use with caution in cats. For dosages of antiemetics and gastroprotectants (for diarrhea cases with concurrent vomiting, hematemesis, and/or melena), see Medications for Acute Vomiting: Dogs and Cats, available at todaysveterinarypractice. com/resources.asp#resources. • In cats, excitatory behavior can occur, but appears to be rare; for this reason, though, these drugs should be used with caution in cats. If a toxin or possibly pathogenic bacteria are the suspected cause of acute diarrhea, opioids are contraindicated because they may increase toxin absorption or time for bacterial proliferation. Probiotics Definition. Probiotics are live microorganisms that, when administered in adequate amounts, confer a health benefit on the host (World Health Organization definition). Probiotics include a wide variety of organisms, such as various species of Lactobacillus, Bifidobacter, Bacillus, E coli, Streptococcus, and Saccharomyces. Mechanism of Action. Both live and dead cells in probiotic products can generate beneficial biological responses. • Live probiotic cells influence both GI microbiome and the immune response. • Components of dead cells may have anti-inflammatory effects in the GI tract. In the case of live probiotic organisms, bacterial levels in feces disappear within days when supplementation ceases. Clinical Evidence. To date, limited clinical trials with probiotics have been performed in dogs and cats with GI disorders (see Probiotic Studies in Companion Animals, page 56). Antimicrobial Therapy Nonspecific Use. Routine use of antibiotics in cases of acute uncomplicated diarrhea is strongly discouraged. If an antibiotic is selected for nonspecific use in such cases, metronidazole or tylosin is an appropriate choice. Specific Use. In acute intestinal diseases, antimicrobials are specifically indicated only in animals with:19 • Confirmed bacterial infection (eg, positive blood culture and/or presence of enteropathogenic bacteria on fecal culture, along with signs of sepsis) • Predisposition for bacterial translo- Get rid of ticks, too! Activyl® Tick Plus adds the proven effective tick control of permethrin to the innovative, highly effective flea control in Activyl®. Available strictly through veterinarians. Protected by Merck Animal Health Track & Trace™ technology. Copyright © 2013 Intervet Inc., a subsidiary of Merck & Co., Inc. All rights reserved. Intervet Inc. d/b/a Merck Animal Health, Summit, NJ, 07901 MAH-ACT-16 May/June 2013 Today's Veterinary Practice 55