Here’s info on Metaclopramide. Just read it if they try to push it off on you tomorrow.
Metoclopramide (Reglan or Emeprid)
Metoclopramide is a prescription medication which works by regulating stomach contractions. This means it can help with nausea caused by a lack of motility in the stomach.
Pet Place has some information about gastric motility problems in cats.
Since metoclopramide can cross the blood/brain barrier, it also acts on the brain to control feelings of nausea. However, it appears that it is not actually particularly effective in cats.
Current approaches to vomiting in cats and puppies (2013) Gaschen FP, Lee JA, Parnell N, Richter K, Tams TR, Twedt D & Gloyd K
Pfizer Roundtable Discussion states "I don’t use metoclopramide in cats anymore. I am not completely convinced it is that effective as an antiemetic in cats. Evidence suggests that cats don’t have dopamine receptors in the chemoreceptor trigger zone, which is metoclopramide’s site of action."
When I first set up this website in 2000, quite a few people used metoclopramide for their cats if the
histamine H2 antagonists were not sufficient. I do not recall there being too many problems with the medication over subsequent years. In 2009, the
US Food and Drug Administration issued a warning regarding the chronic use of metoclopramide because this had been linked to a condition called tardive dyskinesia, i.e. involuntary and repetitive movements of the body, which may continue even after the treatment is stopped. One such movement mentioned by the FDA is
lipsmacking (although it should be noted that lipsmacking in CKD cats is normally caused by excess stomach acid or nausea,
anaemia or
dehydration). The FDA therefore recommends that products containing metoclopramide should not be used for longer than three months.
In July 2013 the
European Medicines Agency went further and announced that metoclopramide should only be used short term (up to five days) and that it should only be used in adults "for the prevention and treatment of nausea and vomiting such as that associated with chemotherapy, radiotherapy, surgery and in the management of migraine." In addition, it recommended that dosages should be lowered.
Obviously these warnings apply to humans, but since there are now other treatments available as outlined above which are far more effective and carry fewer risks, I would only use metoclopramide as a last resort. Be sure to discuss these warnings with your vet before using metoclopramide.
Veterinary Partner has more information on metoclopramide.
Pet Placealso has some information.
Metoclopramide Dosages
Metoclopramide comes in 10 and 5mg tablets or a liquid. Injectable metoclopramide is also available as 5mg/ml in 2 ml or 10 ml vials. It must be given 20-30 minutes before eating.
A typical dose would be 0.1 to 0.2 mg per pound (0.2 to 0.5 mg per kg) every six to eight hours, so a 10lb (4.5kg) cat would get 1 mg to 2 mg at a time. Plumb's Veterinary Drug Handbook mentions that dosages may need to be reduced in animals with kidney disease, so be guided by your vet.
Metoclopramide Side Effects and Interactions
Please see the important warning above.
Metoclopramide may have various side effects, including constipation, hyperactivity and agitation or drowsiness.
Metoclopramide also lowers the seizure threshold, so should not be given to cats prone to
seizures.
Drugsmentions that it may increase the risk of bronchospasm in asthmatics, and intravenous metoclopramide may worsen hypertension (high blood pressure).
I used to recommend giving metoclopramide at least two hours apart from
famotidine (Pepcid AC) or
ranitidine (Zantac 75) because, according to Plumb's Veterinary Drug Handbook, the metoclopramide could bind with these other medications and reduce their effectiveness. However, the most recent edition of Plumb's does not mention this interaction, so it appears that you do not need to separate metoclopramide from these other medications after all.
Using metoclopramide as well as
mirtazapine (appetite stimulant) increases the risk of serotonin syndrome. You can read more about this and what to watch for
here.
Drs Foster and Smithhave some information about possible side effects. They also mention that metoclopramide is similar to PABA, the sunscreen component, so people who are allergic to PABA should not touch metoclopramide