Metoclopramide Reversal of Decreased Gastrointestinal Myoelectric and Contractile Activity in a Model of Canine Postoperative Ileus

Abstract

Postoperative ileus is characterized by decreased gastrointestinal myoelectric activity and motility. Metoclopramide was used to treat experimentally induced postoperative ileus in six dogs. Contractile activity was monitored by extraluminal strain gages on the pyloric antrum and proximal segment of the duodenum, and myoelectric activity was measured by recording bipolar electromyograms (EMGs) at the pyloric antrum, pyloric canal, proximal segment of the duodenum, proximal and distal parts of the jejunum, and ileum. Measurements were obtained from animals without ileus (baseline) and those with ileus that were either untreated or treated with metoclopramide. Adynamic ileus was induced by rubbing a 50 cm segment of jejunum with a dry sponge for 5 minutes and exposing the bowel to the air for 30 minutes. Treated dogs received metoclopramide (0.4 mg/kg 4 times daily [QID] intravenously [IV]), whereas untreated dogs received a saline placebo, starting 1 hour after celiotomy closure. Recordings were made for 26 hours after induction of ileus. The phases of the migrating myoelectric complex (MMC) were identified and motility index values were determined. During ileus, the MMC phase II duration was increased at the duodenum and phase III duration was decreased at the antrum, pylorus, duodenum, and proximal segment of the jejunum (p less than 0.05). Motility index values were decreased at the antrum and duodenum during ileus (p less than 0.05). Treatment with metoclopramide reversed the MMC phase III inhibition at the antrum and pylorus, and partially reversed the inhibition at the duodenum and jejunum (p less than 0.05). Motility index values were restored to preoperative baseline values with metoclopramide treatment (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Immunosuppression with a combination of the leflunomide analog, FK778, and microemulsified cyclosporine for renal transplantation in mongrel dogs

“…In both our studies, dogs were treated with an opioid (morphine or oxymorphone), which increases intestinal smooth-muscle tone and decreases propulsive activity, and is reported to reduce the prevalence of intestinal intussusception in dogs after transplantation (22). Intussusception may be secondary to segmental ileus, and dogs were treated with a prokinetic drug, metoclopramide, which has been recommended as a treatment for postoperative ileus in dogs (23). In addition, a surgical technique was employed to reduce the risk of intestinal intussusception in dogs.…”

Gastrointestinal effects following acupuncture at Pericardium‐6 and Stomach‐36 in healthy dogs: a pilot study

“…Pharmacologic agents such as cisapride and metoclopramide, used to treat GI motility disorders, are associated with unwanted consequences such as cardiac effects, abdominal cramping, constipation and behavioural changes (Graves et al . , Drici et al . ).…”

“…More specifically, ileus is especially common after abdominal surgery involving direct manipulation of the GI tract (Tinckler , Harrower , Graves et al . , Behm & Stollman , Yanagida et al . , Senior et al .…”

“…General anaesthesia can predispose patients to varying degrees of GI dysfunction, which may result in delayed return to feeding and increased morbidity, length of hospital stay and mortality (Mythen 2005). More specifically, ileus is especially common after abdominal surgery involving direct manipulation of the GI tract (Tinckler 1965, Harrower 1968, Graves et al 1989, Behm & Stollman 2003, Yanagida et al 2004, Senior et al 2006). In addition, virtually all inhaled and injectable anaesthetics have been implicated in the development of decreased GI motility (Tinckler 1965, Schurizek et al 1989, Durongphongtorn et al 2006, Boscan et al 2014.…”

Postoperative Ileus: Pathophysiology and Treatment

“…Metoclopramide treatment may be beneficial in the treatment of canine postoperative ileus by increasing myoelectric and contractile activity of the proximal gastrointestinal tract. Graves et al (1989) reported that treatment with metoclopramide partially reversed the MMC phase III inhibition at the duodenum and jejunum. Motility index values were restored to preoperative baseline values with metoclopramide treatment.…”