Antidiarrheal drugs

• * Indicates product not licensed for use in this species.
• Causes of diarrhea include diet, infection, neoplasia/dysplasia, inflammation, drug treatment and stress.
• Treatment must address causative agent, supportive therapy (fluid   Fluid therapy: overview    Fluid therapy: for diarrhea  /electrolyte replacement   Fluid therapy: for electrolyte abnormality  ), and diet   Dietetic diet: for acute intestinal absorptive disorders  .
• Antibacterials   Therapeutics: antimicrobial drug  can be useful, eg if poorly absorbed from gastrointestinal tract (neomycin   Neomycin  , some sulfonamides, some nitrofurans   Nitrofurantoin  , dihydrostreptomycin   Streptomycin  ); or if diarrhea related to systemic conditions, especially in neonates - ideally base selection on bacterial sensitivity tests.
• Probiotics   Probiotics and intestinal health  to help re-establish normal intestinal microbiota.

Adsorbents

• Given by mouth to adsorb toxins (and note, possibly drugs)   →   prevent mucosal irritation and erosion.
• See also treatment of poisoning   Poisoning: overview  .
• Ispaghula husk* and sterculia   Sterculia  : absorb water   →   increase fecal mass.
• Bismuth salts  Bismuth  , charcoal   Charcoal activated  and kaolin   Kaolin  : available in compound preparations, for non-specific diarrhea, variable in their absorption of different kinds of toxins.

Antidiarrheal drugs that reduce motility

• Opioid derivatives   →   decrease intestinal motility but increase segmental contractions for treatment of non-specific acute and chronic diarrhea.
  May exacerbate diarrhea by increasing retention time of enterotoxins.
• Metabolized in liver; can have sedative effect.
• Loperamide*   Loperamide  .

Drugs/other used in the treatment/management of chronic diarrhea

• Sulfasalazine*   Sulfasalazine  : for chronic colitis and maintenance of remission.
  Prolonged treatment with mesalazine, olsalazine or sulfasalazine can lead to irreversible keratoconjunctivitis sicca   Eye: keratoconjunctivitis sicca  .
  If canine dose of sulfasalazine used in cats this may induce salicylate poisoning.
• Corticosteroids: to control inflammatory bowel disease   Inflammatory bowel disease: overview  , including lymphocytic-plasmacytic or eosinophilic infiltrates.
• Probiotics   Probiotics and intestinal health  to help re-establish normal intestinal microflora.

Anti-emetics and emetics

Laxatives

Modulators of intestinal motility

Antacids and ulcer-healing drugs

Others

Further Reading

Publications

Refereed papers

• Recent references from PubMed and VetMedResource.
• Hickman M A, Cox S R, Mahabir S et al (2008) Safety, pharmacokinetics and use of the novel NK-1 receptor antagonist maropitant (Cerenia) for the prevention of emesis and motion sickness in cats. J Vet Pharmacol Ther 31 (3), 220-229 PubMed.
• Ho C M, Ho S T, Wang J J et al (2001) Effects of dexamethasone on emesis in cats sedated with xylazine hydrochloride. Am J Vet Res 62 (8), 1218-1221 PubMed.
• Colby E D, McCarthy L E, Borison H L (1981) Emetic action of xylazine on the chemoreceptor trigger zone for vomiting in cats. J Vet Pharmacol Ther 4 (2), 93-96 PubMed.