Vomiting is defined as the ejection of food and/or fluid from the digestive tract (mouth, oesophagus, or stomach) and is a common clinical sign in cats.
Vomiting in cats is of concern if it occurs more frequently than once every three or four days, contains blood (hematemesis), hair or parasites (esp Ollulanus tricuspis).
- See Physiology of vomiting
Table 1. Antiemetic agents used in cats[1].
Drugs | Mechanism of action | Dosage | Indications |
Chlorpromazine | Dopaminergic D2 receptor antagonism | 0.5 mg/kg IM q 8 hrs | Sedation, motion sickness |
Cimetidine | H2 receptor antagonism | 2.5-5.0 mg/kg IV q 8 hrs | Uremia-associated emesis |
Cisapride | 5HT4 receptor antagonism | 0.1-0.5 mg/kg PO q 12-24 hrs | Irritable bowel disease-associated emesis, gastroparesis, megacolon |
Cyclizine | H2 receptor antagonism | 4 mg/kg IM q 8hrs | vomiting associated with travel |
Dextromethorphan | NMDA receptor antagonist | 0.5 – 2.0 mg/kg orally q 6 – 8 hours | motion sickness |
Dimenhydrinate | H1 receptor antagonism | 12.5 mg/kg PO q 8 hrs | Chronic renal disease |
Diphenhydramine | H1 receptor antagonism | 2-4 mg/kg PO, IM q 8 hrs | CNS depression, xerostomia |
Dolasetron | 5HT3 receptor antagonism | 0.6-10 mg/kg IV, PO q 24 hrs | Chemotherapy-associated emesis |
Famotidine | H2 receptor antagonism | 0.5 mg/kg IV, PO q 12 – 24 hrs | Uremia-associated emesis, pancreatitis |
Granisetron | 5HT3 receptor antagonism | 0.1-0.5 mg/kg IV, PO q 12-24 hrs | Chemotherapy-associated emesis |
Ketamine | NMDA receptor antagonist | 0.5 – 2.0 mg/kg orally q 6 – 8 hours | cisplatin-induced emesis |
Maropitant | NK1 receptor antagonism | 0.5-1.0 mg/kg SQ q 24 hrs | Chemotherapy-associated emesis, pancreatitis |
Meclizine | H1 receptor antagonism | 4 mg/kg PO q 24 hrs | Uraemia-associated emesis |
Metoclopramide | Dopaminergic D2 receptor antagonism (CNS effects) | 1-2 mg/kg IV infusion; | |
Adrenergic antagonist (Prokinetic effects) | 0.2-0.5 mg/kg PO, SQ q 8 hrs | Chemotherapy-associated emesis, pancreatitis | |
Mirtazepine | 5HT3 receptor antagonism, H1 receptor antagonism | 3-4 mg/cat PO q 72 hrs | Uremia-associated emesis, pancreatitis |
Omeprazole | Proton pump inhibitor | 0.5-1.0 mg/kg orally once daily | gastritis, gastroesophageal reflux |
Ondansetron | 5HT3 receptor antagonism | 0.1-1.0 mg/kg PO q 12-24 hrs | Chemotherapy-associated emesis |
Prochlorperazine | Mixed α1/α2 antagonism; dopaminergic D2 receptor antagonism | 0.1 mg/kg IM q 6-12 hrs | Pre-anaesthetic sedation, motion sickness |
Promethazine | H1 receptor antagonism | 2 mg/kg PO or IM q 24 hrs | Motion sickness |
Ranitidine | H2 receptor antagonism | 2 mg/kg/day continuous rate infusion; 2.5 mg/kg IV q 8 hrs | Gastritis- and uraemia-associated emesis |
References
- ↑ Allenspach, K & Chan, DL (2010) Antiemetic therapy. In August, JR (Ed): COnsultations in feline internal medicine. Vol 6. Elsevier Saunders, Philadelphia. pp:232