Metoclopramide‐induced acute dystonic reactions in the horse

Doherty, Thomas J

doi:10.1111/eve.12594

Cited by 3 publications

(6 citation statements)

References 13 publications

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“…14 The use of intermittent subcutaneous injections of metoclopramide may result in highly variable uptake and a relatively high plasma concentration compared to administration by CRI. 53 .…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, it is important to consider potential drug interactions when multidrug therapy is used. 53 Neostigmine is a parasympathomimetic agent, which acts as a reversible acetylcholinesterase inhibitor. 54 It is thought to enhance intestinal motility by inhibiting cholinesterase activity and thereby prolongs the presence of acetylcholine in the neuromuscular junction.…”

Section: Discussionmentioning

confidence: 99%

“…Adverse extra‐pyramidal effects were reported in a horse following subcutaneous administration 52 and after oral administration, a falling event was observed after mild depression 14 . The use of intermittent subcutaneous injections of metoclopramide may result in highly variable uptake and a relatively high plasma concentration compared to administration by CRI 53 …”

Section: Discussionmentioning

confidence: 99%

“…It is important to note that neither lidocaine nor metoclopramide and neostigmine have veterinary authorisation for administration as prokinetics via infusion. Furthermore, it is important to consider potential drug interactions when multidrug therapy is used 53 …”

Section: Discussionmentioning

confidence: 99%

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Suspected lidocaine toxicity and the use of metoclopramide and neostigmine to treat post‐operative small intestinal ileus in a donkey

Loomes¹,

Loomes²

2022

Vet Record Case Reports

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A 17‐year‐old donkey underwent exploratory laparotomy to correct a caecal impaction via typhlotomy in combination with pelvic flexure enterotomy. Intravenous lidocaine (3 mg/kg/h; lidocaine 2% solution, BOVA Specials, London, UK) was administered throughout general anaesthesia following a loading dose (1.3 mg/kg, intravenously [IV]). The donkey recovered uneventfully. One hour after recovery, shortly after returning to the stable and commencement of lidocaine, the donkey showed ataxia, muscle fasciculations and tachycardia with progression to recumbency. Lidocaine toxicity was presumed, so the infusion was stopped and the donkey returned to standing. On Day 2 after surgery, post‐operative reflux was voluminous, so a metoclopramide infusion (0.04 mg/kg/h IV; metoclopramide 5 mg/ml injection, Siegfried Hameln, Hameln, Germany) was commenced. On Day 3, post‐operative reflux persisted, so a neostigmine infusion (0.008 mg/kg/h IV; neostigmine methylsulfate injection 2.5 mg/ml, Siegfried Hameln, Hameln, Germany) was also administered. Small intestinal motility improved by Day 5 and post‐operative reflux resolved by Day 6. Both infusions were stopped and food was re‐introduced. There was no further indication of gastrointestinal hypomotility and the donkey was discharged 11 days later.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Suspected lidocaine toxicity and the use of metoclopramide and neostigmine to treat post‐operative small intestinal ileus in a donkey

Loomes¹,

Loomes²

2022

Vet Record Case Reports

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“…However, the drug crosses the blood-brain barrier and leads via a dopamine-antagonistic effect to an antiemetic effect and potential side effects (Dowling 1995). In the horse restlessness, excitement (Hunt and Gerring 1986), sweating, abdominal pain (Holcombe 2003), dystonic reactions (Doherty 2016) and extrapyramidal effects (Agass et al 2017) have been described. Side effects are reported at a dosage of 0.25 mg/kg/h continuous infusion (Hunt and Gerring 1986) or every six hours s.c. (Agass et al 2017).…”

Section: Introductionmentioning

confidence: 99%

Chronic gastric dilatation in horses: diagnosis, treatment and feeding management – A survey of 20 clinical cases

Bäuerlein¹,

Vervuert²,

Venner³

2019

PHK

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Chronic gastric dilatation is a rarely diagnosed disease of the horse. The objective of this report was to describe the clinical and ultrasonographic findings of 20 cases of chronic gastric dilatation in horses. Furthermore, horses' clinical history, signalment and clinical and gastroscopic findings were recorded. Medication, feeding management and outcome are presented. Inclusion criteria were: 1) Clinical signs of recurrent abdominal discomfort or resistance to the riders leg; 2a) Repeated ultrasonographic finding of an enlarged stomach (more than five intercostal spaces), or alternatively; 2b) Repeated gastroscopic finding of an impacted stomach in combination with a subsequent sonographical confirmation; 3a) No gastric emptying following 12 hours of starvation, or 3b) Emptying but repeated episodes of dilatation following normal feeding regime; 4) Exclusion of acute gastric impactions and other gastrointestinal disorders. All horses had shown one or several of the following symptoms: repeated signs of discomfort, recurrent mild or moderate acute colic, defensive reaction when fixing the girth or against the riders left leg, chronic weight loss, poor performance and more. With exception of the rectal examination, clinical and laboratory examination was not conclusive. 19 horses showed an enlarged stomach at initial sonography (range: six to eleven intercostal spaces). The initial examination in one horse referred to our clinic was merely by gastroscopy. Gastroscopy was performed in eleven cases. The horses were treated with metoclopramide hydrochloride ( 0.1-0.15 mg/kg twice daily p.o.) and feeding management was adapted according to nutritionist's or veterinarian's recommendations. The mean duration of treatment was 16 months at submission of the manuscript. No side effects were observed. Seventeen of the treated horses survived in the long term. One horse was euthanized 10 days after start of treatment with metoclopramide hydrochloride, at the request of the owner as he had noticed no clinical improvement in that period of time. Two horses were euthanized because of orthopedic problems. Fifteen horses showed complete, and four horses partial clinical improvement after treatment and feeding management was adapted. Metoclopramide hydrochloride seemed effective for the long-term treatment of chronic gastric dilatation. Long-term administration of metoclopramide hydrochloride could be an alternative to bethanechol. Further studies are needed to determine the exact pathophysiologic mechanisms of chronic gastric dilatation and to determine the exact diagnostic findings related to different disease states.

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Chronische Magendilatation beim Pferd – Diagnostik und kombinierter Behandlungsansatz

Bäuerlein¹,

Vervuert²,

Venner³

2023

pferde spiegel

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Metoclopramide‐induced acute dystonic reactions in the horse

Cited by 3 publications

References 13 publications

Suspected lidocaine toxicity and the use of metoclopramide and neostigmine to treat post‐operative small intestinal ileus in a donkey

Suspected lidocaine toxicity and the use of metoclopramide and neostigmine to treat post‐operative small intestinal ileus in a donkey

Chronic gastric dilatation in horses: diagnosis, treatment and feeding management – A survey of 20 clinical cases

Chronische Magendilatation beim Pferd – Diagnostik und kombinierter Behandlungsansatz

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