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livingdustmops · 02-26-2006, 05:44 PM

Metronidazole For Veterinary Use
by Barbara Forney, VMD
Overview
Therapeutic Class
Antiprotozoal, antibiotic
Species
Horses, dogs, and cats
Indications
Anaerobic bacterial infections, protozoal infections, non-specific inflammatory conditions of the bowel.
FDA Status
No veterinary approval.

Basic Information
Metronidazole is an antibiotic which is commonly used to treat protozoal infections and anaerobic bacterial infections. It also has anti-inflammatory effects in the bowel. Metronidazole is bactericidal; it kills bacterial microorganisms by disrupting their DNA. It is rapidly absorbed from the GI tract, metabolized by the liver and excreted in the urine and the feces. Because metronidazole only has activity against anaerobic bacteria, it is commonly used with other antibiotics when it is used to treat mixed bacterial infections. It is compatible with many other antibiotics including penicillin antibiotics, aminoglycosides, and some cephalosporins.

Dogs and Cats
Metronidazole is used to treat protozoal infections in cats and dogs including Giardia, Entamoeba, Trichomonas, and Balantidium. It is also used to treat anaerobic bacterial infections. Metronidazole has immune modulating activity and may be prescribed to treat inflammatory bowel disease. It may be used to treat colitis caused by other antibiotics, periodontal disease (especially in cats), Clostridium perfringens enterotoxemia, tetanus, diarrhea of undetermined cause, pancreatic insufficiency (with small intestinal bacterial overgrowth), and complications of severe liver disease. Metronidazole may be used with corticosteroids in the treatment of inflammatory bowel disease, or gum disease (gingivitis/stomatitis) in cats. Topical metronidazole gel is used in the treatment of skin infections, such as feline chin acne.

Metronidazole is usually tolerated better if given with food and there are a wide variety of flavors and preparations made by compounding pharmacies in order to deal with the problems associated with the bitter taste. Because of the variety of uses for this drug, dose amount, frequency and duration of treatment vary widely.

Horses
Metronidazole is primarily used with other antibiotics to treat mixed bacterial infections in which anaerobic bacteria are present, for example, pleuropneumonia, peritonitis, and abdominal abscesses. It is also used prophylactically after colic or other abdominal surgery when mixed bacterial infections are a risk. Metronidazole is generally given orally although it is also absorbed rectally. Rectal administration is occasionally used in the very sick patient when anorexia and weight loss are a problem.

Side Effects
• Most common: clinical signs related to the bad taste, or GI upset.

• Dogs and cats: excessive salivation, gagging, regurgitation, pawing at the mouth, nausea, vomiting, and decreased appetite are the most frequent complaints. Less common or rare side effects include diarrhea, depression, lethargy, weakness, low white blood cell count, liver failure, and blood in the urine, or dark urine due to pigment changes. Neurologic signs may be seen after accidental overdose or, more commonly, with long-term moderate to high-dose therapy as in the treatment of difficult bacterial infections. Signs often begin 7 to 12 days following the start of treatment.

• Horses: side effects are not commonly associated with metronidazole. The major problem with using this drug is its bad taste. Many horses stop eating when this drug is mixed with feed and a reliable method of administration must be found.

Precautions
• Metronidazole causes birth defects in laboratory animals. It should be avoided in pregnant animals, especially in the first trimester. Some metronidazole is excreted in breast milk, and it should not be used in lactating animals.

• Metronidazole should not be used in young puppies and kittens.

• Metronidazole should be avoided or used with caution, at reduced doses, in animals with kidney or liver disease.

Drug Interactions
• Metronidazole is reported to elevate prothrombin time in animals on warfarin or other coumarin anticoagulants.

• Cimetidine can interfere with the liver's ability to break down metronidazole and the dose may have to be reduced.

• Phenobarbital and phenytoin may increase the metabolism of metronidazole.

Overdose
• Dogs and cats: Symptoms of overdose of metronidazole include the gastrointestinal signs (anorexia, vomiting) and neurologic signs including depression, ataxia, disorientation, head-tilt, tremors, bradycardia, rigidity, stiffness, and seizures. Neurologic signs may occur due to acute overdose although they are more commonly seen in animals that are on long-term moderate or high doses (oral doses greater than 66 mg/kg/day). Signs of chronic toxicity often begin 7-12 days following the start of treatment. After the drug is discontinued, it may be several days to two weeks before these neurologic signs begin to diminish.

• No specific information was found on overdose in the horse.

About the Author
Dr. Barbara Forney is a veterinary practitioner in Chester County, Pennsylvania. She has a master's degree in animal science from the University of Delaware and graduated from the University of Pennsylvania School of Veterinary Medicine in 1982.

She began to develop her interest in client education and medical writing 1997. Recent publications include portions of The Pill Book Guide to Medication for Your Dog and Cat, and most recently Understanding Equine Medications published by the Bloodhorse.

Dr. Forney is an FEI veterinarian and an active member of the AAEP, AVMA, and AMWA.

02-26-2006, 05:44 PM	#5
livingdustmops Princess Poop A Lot Donating Member Join Date: Nov 2005 Location: Colorado Posts: 6,728	Metronidazole For Veterinary Use by Barbara Forney, VMD Overview Therapeutic Class Antiprotozoal, antibiotic Species Horses, dogs, and cats Indications Anaerobic bacterial infections, protozoal infections, non-specific inflammatory conditions of the bowel. FDA Status No veterinary approval. Basic Information Metronidazole is an antibiotic which is commonly used to treat protozoal infections and anaerobic bacterial infections. It also has anti-inflammatory effects in the bowel. Metronidazole is bactericidal; it kills bacterial microorganisms by disrupting their DNA. It is rapidly absorbed from the GI tract, metabolized by the liver and excreted in the urine and the feces. Because metronidazole only has activity against anaerobic bacteria, it is commonly used with other antibiotics when it is used to treat mixed bacterial infections. It is compatible with many other antibiotics including penicillin antibiotics, aminoglycosides, and some cephalosporins. Dogs and Cats Metronidazole is used to treat protozoal infections in cats and dogs including Giardia, Entamoeba, Trichomonas, and Balantidium. It is also used to treat anaerobic bacterial infections. Metronidazole has immune modulating activity and may be prescribed to treat inflammatory bowel disease. It may be used to treat colitis caused by other antibiotics, periodontal disease (especially in cats), Clostridium perfringens enterotoxemia, tetanus, diarrhea of undetermined cause, pancreatic insufficiency (with small intestinal bacterial overgrowth), and complications of severe liver disease. Metronidazole may be used with corticosteroids in the treatment of inflammatory bowel disease, or gum disease (gingivitis/stomatitis) in cats. Topical metronidazole gel is used in the treatment of skin infections, such as feline chin acne. Metronidazole is usually tolerated better if given with food and there are a wide variety of flavors and preparations made by compounding pharmacies in order to deal with the problems associated with the bitter taste. Because of the variety of uses for this drug, dose amount, frequency and duration of treatment vary widely. Horses Metronidazole is primarily used with other antibiotics to treat mixed bacterial infections in which anaerobic bacteria are present, for example, pleuropneumonia, peritonitis, and abdominal abscesses. It is also used prophylactically after colic or other abdominal surgery when mixed bacterial infections are a risk. Metronidazole is generally given orally although it is also absorbed rectally. Rectal administration is occasionally used in the very sick patient when anorexia and weight loss are a problem. Side Effects • Most common: clinical signs related to the bad taste, or GI upset. • Dogs and cats: excessive salivation, gagging, regurgitation, pawing at the mouth, nausea, vomiting, and decreased appetite are the most frequent complaints. Less common or rare side effects include diarrhea, depression, lethargy, weakness, low white blood cell count, liver failure, and blood in the urine, or dark urine due to pigment changes. Neurologic signs may be seen after accidental overdose or, more commonly, with long-term moderate to high-dose therapy as in the treatment of difficult bacterial infections. Signs often begin 7 to 12 days following the start of treatment. • Horses: side effects are not commonly associated with metronidazole. The major problem with using this drug is its bad taste. Many horses stop eating when this drug is mixed with feed and a reliable method of administration must be found. Precautions • Metronidazole causes birth defects in laboratory animals. It should be avoided in pregnant animals, especially in the first trimester. Some metronidazole is excreted in breast milk, and it should not be used in lactating animals. • Metronidazole should not be used in young puppies and kittens. • Metronidazole should be avoided or used with caution, at reduced doses, in animals with kidney or liver disease. Drug Interactions • Metronidazole is reported to elevate prothrombin time in animals on warfarin or other coumarin anticoagulants. • Cimetidine can interfere with the liver's ability to break down metronidazole and the dose may have to be reduced. • Phenobarbital and phenytoin may increase the metabolism of metronidazole. Overdose • Dogs and cats: Symptoms of overdose of metronidazole include the gastrointestinal signs (anorexia, vomiting) and neurologic signs including depression, ataxia, disorientation, head-tilt, tremors, bradycardia, rigidity, stiffness, and seizures. Neurologic signs may occur due to acute overdose although they are more commonly seen in animals that are on long-term moderate or high doses (oral doses greater than 66 mg/kg/day). Signs of chronic toxicity often begin 7-12 days following the start of treatment. After the drug is discontinued, it may be several days to two weeks before these neurologic signs begin to diminish. • No specific information was found on overdose in the horse. About the Author Dr. Barbara Forney is a veterinary practitioner in Chester County, Pennsylvania. She has a master's degree in animal science from the University of Delaware and graduated from the University of Pennsylvania School of Veterinary Medicine in 1982. She began to develop her interest in client education and medical writing 1997. Recent publications include portions of The Pill Book Guide to Medication for Your Dog and Cat, and most recently Understanding Equine Medications published by the Bloodhorse. Dr. Forney is an FEI veterinarian and an active member of the AAEP, AVMA, and AMWA. __________________ Cindy & The Rescued Gang Puppies Are Not Products!