Anti-Diarrheals

Question 1

Bismuth Subsalicylate: brand names (2), effects (2), use

Answer 1

PeptoBismol, Kaopectate

Coated intestinal mucosa

Anti-inflammatory effects

Anti-diarrheal in dogs and horses

Question 2

Bismuth Subsalicylate: cautions (2)

Answer 2

Toxic in cats, metabolized by glucuronyl transferase

Will turn stool and dark greenish-black

Question 3

Diphenoxylate: brand name, controlled?, effect, use, caution(2)

Answer 3

LoMotil

Controlled - opioid

Reduce intestinal motility

Acute diarrhea of non-infectious, non-toxin causes in dogs

Formulated with atropine to prevent abuse

Don’t use in cats - causes excitatory behavior

Question 4

Loperamide: name brand, controlled?, effect, use, cautions (2)

Answer 4

Imodium

Not controlled

Reduce intestinal motility

Acute diarrhea of non-infectious, non-toxin causes

Don’t use in cats - causes excitatory behavior

Contraindicated in dogs with MDR1 mutation

Question 5

Metronidazole: effect, uses (2), administration and cautions (2)

Answer 5

Antibiotic, anti-protozoal, anti-inflammatory

Acute diarrhea due to parasitic protozoa

Chronic diarrhea due to IBD

IV - give very slowly over 30-60 min

PO - tablets are very bitter, can cause drooling, foaming, vocalization

Question 6

Probiotics: types (2), effects (3), use

Answer 6

Probiotics - living organisms that confer a health benefit to host

Gastrointestinal microbiome - all of the micro-organisms in the GI tract

Enhance epithelial barrier

Out-compete pathogenic bacteria

Modulate the immune system

Acute and chronic diarrhea

Question 7

Probiotics: administration timing, limitations (2)

Answer 7

Some brands must be given separately from abx, some are not receptacle to abx

Quality - not legally required to be tested or subjected to quality control

Effectiveness - very little data regarding effectiveness, optimal type and dose