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Reply To: Prokinetics in cats and dogs

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#60226

Hello again!

I have popped on a couple of posts about the different prokinetic options. Treatment of dysmotility is multimodal and should be implemented by taking individual patient factors into account. Early enteral nutrition appears to stimulate the return of normal bowel function and exerts a prokinetic effect. Adequate hydration and electrolyte balance should be maintained, but gut edema should be avoided at all times when implementing a fluid resuscitation plan. Alternative modes of analgesia, including local anesthesia, should be utilized, especially when attempting to decrease opioid use in postoperative patients. Prokinetic therapy in patients with dysmotility of critical illness is recommended; however, due to the lack of evidence for a single prokinetic, a multimodal approach should be utilized. Human and animal studies have suggested that early judicious nutritional support in addition to a combination of prokinetic drugs based on GI localization of clinical signs is superior to delayed EN and monotherapy with prokinetic agents.

It is likely that the cisapride/erythromycin combination is the best choice.

The following is a really good review:

Prokinetic Review

Hope this helps.

Scott 🙂