Effectiveness of orally administered maropitant and ondansetron in preventing preoperative emesis and nausea in healthy dogs premedicated with a combination of hydromorphone, acepromazine, and glycopyrrolate

Abstract

OBJECTIVE To compare effectiveness of maropitant and ondansetron in preventing preoperative vomiting and nausea in healthy dogs premedicated with a combination of hydromorphone, acepromazine, and glycopyrrolate. ANIMALS 88 dogs owned by rescue organizations. PROCEDURES Dogs received maropitant (n = 29) or ondansetron (28) PO 2 hours prior to premedication or did not receive an antiemetic (31; control). Dogs were evaluated for vomiting, nausea, and severity of nausea (scored for 6 signs) for 15 minutes following premedication with hydromorphone, acepromazine, and glycopyrrolate. RESULTS A significantly lower percentage of dogs vomited after receiving maropitant (3/29 [10%]), compared with control dogs (19/31 [62%]) and dogs that received ondansetron (15/28 [54%]). A significantly lower percentage of dogs appeared nauseated after receiving maropitant (3/29 [10%]), compared with control dogs (27/31 [87%]) and dogs that received ondansetron (14/28 [50%]), and a significantly lower percentage of dogs appeared nauseated after receiving ondansetron, compared with control dogs. Nausea severity scores for hypersalivation, lip licking, hard swallowing, and hunched posture were significantly lower for dogs that received maropitant than for control dogs, and scores for hypersalivation, lip licking, and hard swallowing were significantly lower for dogs that received ondansetron than for control dogs. CONCLUSIONS AND CLINICAL RELEVANCE Oral administration of maropitant 2 hours prior to premedication with hydromorphone reduced the incidence of vomiting and the incidence and severity of nausea in healthy dogs. Oral administration of ondansetron reduced the incidence and severity of nausea but not the incidence of vomiting.

Ondansetron in dogs with nausea associated with vestibular disease: A double‐blinded, randomized placebo‐controlled crossover study

“…Studies showed a decrease of the nausea score, as well as in the frequency of vomiting. These results have been observed in other experimental studies, such as in dogs with renal disease or when used against preoperative nausea 19,22,35 . After promising results when using ondansetron against vestibular nausea, 28 our current study emphasizes further the potential for the use of ondansetron to treat nausea resulting from vestibular syndrome in dogs.…”

Plasma Concentrations of Oral Ondansetron in Hospitalized Dogs Exhibiting Clinical Signs of Nausea

“…In conclusion, OND is a frequently prescribed anti-emetic and anti-nausea drug in veterinary medicine. IV administration of OND has demonstrated efficacy as an anti-emetic in several populations of nauseous dogs, and oral administration has been shown to reduce the incidence of severe nausea but not vomiting in a population of healthy dogs [ 15 ]. The PK of oral OND has been investigated previously in healthy dogs, but this is the first study investigating the plasma concentrations in a population of hospitalized dogs exhibiting clinical signs of nausea.…”

“…Metoclopramide is another anti-emetic that is also not currently approved for use in dogs. Maropitant and metoclopramide have historically been used more commonly, and although both drugs can be effective anti-emetics [ 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 ], some studies have called into question how well they control nausea [ 7 , 11 ]. This is an important clinical consideration since the control of nausea is often the main therapeutic goal, as nausea can lead to not only vomiting but also ptyalism, lethargy, restlessness, and decreased appetite [ 1 ].…”

“…Recommended dosing of oral OND in dogs ranges from 0.2 to 1 mg/kg every 8 to 12 h [ 18 ]; however, this is not based on pharmacokinetic (PK) or pharmacodynamic data in dogs with naturally occurring vomiting and nausea. One study showed the severity and incidence of nausea were reduced in healthy dogs that received oral OND and were premedicated with glycopyrrolate, hydromorphone, and acepromazine; however, the incidence of vomiting was not reduced [ 15 ]. The bioavailability of oral OND is highly variable between species, including 4% in rats [ 19 ], 32% in cats [ 20 ], and 59% in humans [ 21 ].…”