Your Cat’s Prescription Drugs & What You Should Know
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Metronidazole (met-roe-NYE-duh-zole)
Type of Drug:
Antiprotozoal, antibiotic, and anti-inflammatory in the bowel.
Prescribed For:
Protozoal infections in cats (commonly Giardia or Entamoeba) and bacterial infections in cats. Metronidazole may also be prescribed for inflammatory bowel disease, colitis caused by other antibiotics, periodontal (gum) disease, especially in cats, Clostridium perfringens enterotoxemia, tetanus, diarrhea of undetermined cause, pancreatic insufficiency (with small intestinal bacterial overgrowth), and complications of severe liver disease. Metronidazole may be given intravenously by your veterinarian before, during, and after bowel surgery to prevent infection.
General Information:
Metronidazole is used to treat protozoal infections and bacterial infections where anaerobic bacteria (bacteria that grow only where there is no oxygen) are present. Metronidazole also has anti-inflammatory effects in the bowel and may be helpful in certain kinds of diarrhea and in inflammatory bowel disease of unknown cause. The mechanism of this anti inflammatory effect is not well understood. Metronidazole kills microorganisms by disrupting their DNA. This drug is rapidly absorbed from the gastrointestinal tract into the bloodstream. It is metabolized by the liver and excreted in the urine and the feces.
Cautions & Warnings:
This drug is not FDA approved for use in cats or dogs. It is commonly used to treat protozoal and some types of bacterial infections, and it is considered accepted practice.
Metronidazole should be avoided or used with caution at reduced doses in animals with kidney or liver disease.
U.S. federal law restricts the use of this drug by or on the lawful written or oral order of a licensed veterinarian within the context, of a valid veterinarian-client-patient relationship
Possible Side Effects:
Neurologic signs may be seen after accidental overdose or more commonly with long-term moderate to high-dose therapy as in the treatment of difficult bacterial infections. These signs often begin 7 to 12 days following the start of treatment. (See "Overdosage").
Common:Clinical signs related to the bad taste, or gastrointestinal upset. Excessive salivation, gagging, regurgitation, pawing at the mouth, nausea, vomiting, and decreased appetite are the most frequent complaints. The pills are extremely bitter, so the method of giving these pills can be a factor in how well your animal tolerates the drug.
Rare:Diarrhea, depression, lethargy, weakness, low white blood cell count, liver failure, and blood in the urine, or dark urine due to pigment changes.
Drug Interactions:
Animals taking oral anticoagulant (blood thinning) drugs such as Warfarin should have their dose of anticoagulant reduced because Metronidazole increases the effect of anticoagulants.
Cimetidine can interfere with the liver's ability to break down Metronidazole, causing increased levels of Metronidazole in your animal's blood. The Metronidazole dose may have to be reduced if your animal is taking Cimetidine.
Phenobarbital may increase the metabolism of Metronidazole, and make it less effective.
Metronidazole may increase blood levels of Phenytoin by interfering with its breakdown in the liver. This could increase the risk of Phenytoin side effects and might result in the need to adjust your animal's Phenytoin dosage.
Food Interactions:
Probably tolerated better if given with food.
Dosage:
There are very wide ranges in doses, frequency of dosing, and duration of treatment, because metronidazole is used for such a wide variety of conditions.
For Giardia and Entamoeba infection: 5-20 mg/kg orally 1-2 times a day for 5-10 days
For gingivitis/stomatitis/pharyngitis complex: 10-15 mg /kg orally once a day.
Dosing intervals and duration of treatment can vary depending on the animal's condition and which other antibiotics are being used concurrently).
Drug Form
Metronidazole 50 mg tablets
Metronidazole 150 mg /ml suspension (chicken flavor)
Overdosage:
Signs of overdose of Metronidazole include gastrointestinal signs (see "Possible Side Effects"). High doses of Metronidazole can cause problems with the animal's nervous system. Most of the neurologic signs are seen in animals that are long-term moderate or high doses (oral doses greater than 66 mg/kg/day), and often begin 7 to 12 days following the start of treatment. Signs could include loss of coordination, staggering, tremors, head tilt, disorientation, seizures, slow heart rate, rigidity, and stiffness. Call your veterinarian immediately if you think your pet may be having an adverse reaction to Metronidazole. After the drug is discontinued, it may be several days to 2 weeks before the neurologic signs begin to diminish. In case of accidental ingestion or overdose, contact your veterinarian.
Special Information:
When Metronidazole is used to treat bacterial infections, it is frequently used with other antibiotics. This is because Metronidazole is only effective against anaerobic bacteria; it is not at all effective against other types of bacteria. Many infections have more than one kind of bacteria and so the antibiotic therapy will sometimes require more than one drug to kill all the different types of bacteria. This drug is compatible for use with many other antibiotics.
Metronidazole may be used with corticosteroids (or other medications) in the treatment of inflammatory bowel disease or gum disease (gingivitis/stomatitis) in cats.
Because of Metronidazole's bad taste, you may have difficulty giving it to your cat. Ask your veterinarian for advice on how best to give the drug to your pet. Using a "pet piller"(plastic plunger used to place pills in the throats of dogs and cats) or wrapping the pill in food and placing it far into the back of the mouth are two methods that may be helpful. Crushing the pills and placing the dose in empty gelatin capsules is another alternative.
Senior Animals:
Metronidazole is safe to use in older animals if kidney and liver function are normal. If kidney and liver function are impaired Metronidazole should be avoided, or the dose should be decreased.
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