Metoclopramide

Metoclopramide is a medication that vets use in dogs as an antiemetic – i.e. against nausea and vomiting – as well as to support gastrointestinal motility. It acts at two sites: in the brain, where it suppresses the urge to vomit, and directly in the digestive tract, where it ensures that stomach contents are transported more quickly into the small intestine. It is available as a tablet, as a liquid solution, and as an injection; depending on what the situation requires.

How does metoclopramide work?

Two principles of action make up the medication.

1. Anti-emetic effect: In the brain, metoclopramide blocks dopamine receptors in the vomiting centre. These receptors are responsible for triggering the vomiting reflex. When they are blocked, the reflex does not occur.
2. Prokinetic effect: At the same time, the medication stimulates the muscles of the stomach and upper small intestine. The food bolus moves on faster, the stomach empties more quickly. This also reduces the risk that a full stomach will cause vomiting again.

When is metoclopramide used in dogs?

The areas of application are quite diverse. Everywhere nausea, vomiting or digestive disorders impair the dog’s life, metoclopramide can be a sensible option. The most common situations:

1. Nausea and vomiting: Whether acute or chronic, whether triggered by stomach irritation, an infection, a food intolerance or another underlying condition: metoclopramide is one of the proven remedies here.
2. Reflux diseases: Dogs with gastro-oesophageal reflux (stomach acid flowing back into the oesophagus) can benefit from metoclopramide. Accelerated gastric emptying reduces pressure on the lower oesophageal sphincter and thus reduces reflux.
3. Delayed gastric emptying (gastroparesis): Some dogs simply digest too slowly, whether after surgery, with certain conditions, or for other reasons. Here, the prokinetic effect provides its real benefit.
4. After surgery: Abdominal procedures often cause postoperative nausea. Metoclopramide can alleviate this and get digestion moving again.
5. Chemotherapy-induced nausea: Dogs with cancer undergoing chemotherapy often suffer from drug-induced nausea. Metoclopramide is then used as an adjunct to relieve symptoms.

Dosage of metoclopramide in dogs

The correct dose depends on size, weight, underlying disease and the severity of symptoms. The vet practice determines it individually and adjusts it if necessary – there is no blanket amount here.

In acute cases, such as severe vomiting, the medication can also be administered as an injection in the practice.

Possible side effects of metoclopramide

Most dogs tolerate metoclopramide well. Nevertheless, you should know what can occur in individual cases:

1. Behavioural changes: Some dogs appear restless, nervous or overexcited after taking the drug. Less commonly, the opposite occurs: lethargy and lack of drive.
2. Diarrhoea or constipation: Because metoclopramide directly affects intestinal motility, the gut can occasionally get out of sync in one direction or the other.
3. Muscle tremors or cramps: Very rarely, and usually with overdose or in particularly sensitive animals, dogs show trembling, cramps or coordination problems. A vet should be consulted immediately.
4. Increased salivation: Excessive drooling is possible but generally harmless.
5. Drowsiness or sedation: Especially at higher doses, metoclopramide can have a calming effect and make the dog tired.
6. Allergic reactions: Rare but serious: swelling, skin rashes, itching or breathing difficulties may indicate hypersensitivity. Go to the vet immediately in this case.

Precautions and contraindications

With certain dogs, restraint is advisable or the agent is completely contraindicated:

1. Epilepsy or seizures: Metoclopramide acts on the central nervous system. Extra caution is therefore required for dogs with epilepsy or other neurological conditions.
2. Bowel obstructions or injuries to the gastrointestinal tract: If there is a bowel obstruction or even perforation, metoclopramide is contraindicated. Increased gut motility could significantly worsen the condition.
3. Liver or kidney disease: The drug is metabolised and excreted via the liver and kidneys. In severe organ disease, it may only be used under close veterinary supervision.
4. Pregnancy and lactation: It has not yet been conclusively established whether metoclopramide is safe for pregnant or nursing bitches. Use only after explicit consultation with the vet.