PHARMACOLOGY OF DRUGS ACTING ON DIGESTIVE SYSTEM OF ANIMALS

The major groups of drugs acting on digestive system in monogatsrics include: emetics,
antiemetics, antiulcer drugs, appetite stilmulants, prokinetics, antidiarrhoeal agents,
laxatives and in ruminants include: stomachics, sialics, antisialogogues, antispasmodics,
, rumenotorics, rumenoreticular motolity modifying agenst, antifoaming sgents,
rumenoreticular acidifying and alkalinizing agents.
RUMINORETICULAR ANTACIDS/ ALKALISERS : Indicated in ruminal acidosis.
Magnesium hydroxide (cattle: 100-300 g; sheep: 10-30 g); Magnesium carbonate (cattle:
10-80 g; sheep: 1-8 g). ; Mixed in10 L of warm water to ensure adequate dispersion
through the ruminoreticular contents. Activated charcoal (2 g/kg) to protect the
ruminoreticular mucosa from further injury by inactivating toxins
RUMINORETICULAR ACIDIFYING AGENTS/ ACIDIFIERS: Indicated in ruminal alaklosis as
in conditions of urea/ acute ammonia poisoning. Administration of weak acids in cold
water returns the pH of ruminoreticular content toward physiologic levels, promotes
the uptake of volatile fatty acids. Acetic acid (4-5%) or vinegar (cattle: 4-8 L; sheep: 250-
500 mL), or 13ml glacial acetic acid
RUMENOTORICS. Indictaed in ruminal indigestion, ruminal. Atony, Impaction, loss of
appetite. Fresh ruminal fluid is considered to be the best available ruminotoric as it
contains viable ruminal bacteria and protozoa as well as many useful fermentation
factors . Strained fresh ruminal juice (at least 3 L; 8-16 L is ideal in cattle; sheep require
~1 L) given PO .Formulations that contain glucogenic substrates, minerals, cofactors, and
bitters (eg, nux vomica) , antimony potassium tartarate, Cobalt sulphate, Cobalt
chloride, ferrous sulphate, Copper sulphate, Thiamine, Manganese sulphate, Dried yeast,
sodium acid phosphate,. Zinc sulphate, brassica, antihistaminics, and prokinetics
Mineral oil (1-2 L) or dioctyl sodium sulfosuccinate (DSS, 90-120 mL in 1-2 L of water)
administered PO or via nasogastric tube followed by gentle ruminal massage- helpful in
promoting the dissolution and passage of impacted fibrous ruminal contents.
SALIVARY STIMULANTS/SIALICS/ SIALOGOGUES: Increase the volume and fluidity of
saliva, with the intention iof thereby increasing the appetite or digestibility of food.Eg:
Bitters: gentian, quassia, calumba, cascara, nux vomica, cinchona, calumba, ; Turpentine
oil; Cholinergics: choline
esters(carbachol),cholinomimeticalkaloids(pilocarpine),cholinesteraseinhibitors(physosti
gmine, neostigmine); alpha adrenergic drugs; nicotine; mercurials, iodine, alcohol etc

ANTISIALOGOGUES: Antimuscarinics(atropine, hyoscyamine, glycopyrrolets),
neuroleptics (chlorpromazine, trifluperazine, prochlorpromazine), anticonvulsants
(carbamazepine), antihistaminics (promethazine, diphenhydramibne, dimenhydrinate)


and astringents (alum, potassium sulphate) )are the examples. Indicated mainly as
preanaesthetic medicants and in some poisoning cases

CARMINATIVES (ANTIFLATULENTS): Agents which cause expulsion of gases from the
stomach, indicated in treatment of free gas bloat/tympany. Examples: pure volatile oils
(turpentine oil, peppermint oil, eucalyptus oil; Ginger, powdered aniseed/anise; volatile
compounds( alcohol, ethr, chloroform,ammonia,)s camphor, menthol; cardamom,
cinnamom, coriander, pepper, dill seeds, nutmeg, sodium bicarbonate, asafoetida,
simethicone, dimethylpolysiloxane etc

ANTIZYMOTICS: Agents which prevent or reduce the bacterial/enzymatic fermentation
in rumen. Mainly used for the prevention of further gas production in the rumen in
conditions of frothy bloat in ruminants and flatulent colic in horses.
Eg: turpentine oil, linseed oil, formalin, phenolic compounds, chloroform, surfactants/
antifoaming/antifrothing agents: a) organic silicones Poloxalene, methyl silicone,
Polymerized methyl silicone, PMS, dimethyl poly siloxane, silica in dimethicone
(SIMETHICONE); b) Docusate sodium in emulsified soybean oil (6-12 fl oz containing 240
mg/mL) ; c) Vegetable oils such as peanut oil, sunflower oil, or soybean oil (cattle: 60
mL; sheep: 10-15 mL); d) Ionophores (such as monensin sodium ) in the ration
Antifoaming substances may be included in the feed, drinking water, or sprayed on the
crops. Poloxalene Oral suspension, 830mg/ml, 55%, 25g/30ml Dose. Oral liquid,
poloxalene 830mg /ml, for cattle;(up to 227kg body weight) 30ml diluted in 500 ml
water;(more than 227kg body-weight) 60ml diluted in 500ml water Premix, poloxalene
530 mg /g, for cattle; 22 mg of poloxalene /kg body weight daily. May be increased to
44mg of poloxalene/kg
Dimethicone Oral suspension, 1 %, 2%. Dose. Cattle: 100 ml, sheep: 25 ml

ALIMENTARY DEMULCENTS: The agents coat, protect, lubricate and soothen the
inflamed oral, pharyngeal, esophageal, gastric mucosa; are used to lessen the irritation
of the abraded mucosa. Also indicated to mask the unpleasant taste/odor of the
medicines. Eg: syrups (syrup of squill, jaggery syrup); honey , starch, glycerol, Gums
(gum tragacanth, gum acacia, gum arabica, guargum,) ; methyl cellulose, agar,
Glycerrhiza (liquorice), liquid paraffin , linseed oil, sesame oil
APPETITE STIMULANTS (in monogastrics): include Cyproheptadine (antihistaminic),
vitamin B complex preparations ,glucocorticoids, benzodiazepines(diazepam,oxazepam)
and megestrol acetate, a synthetic progestin
EMETICS: Apomorphine is an opiate drug administered PO, IV,SC, In case of over dose
symptoms like :CNS depression; restlessness;respiratory depression, administration of
antagonist ( e.g. naloxone 0.04mg/kg ) is useful. Xylazine is an
2
-adrenergic agonist, a
reliable emetic, particularly in cats (IV route is preferred over IM). Syrup of ipecac
produces vomiting by acting as a stomach irritant. Hydrogen peroxide (3%) in cats,


aspiration of foams may cause aspiration pneumonia. Salt (1-3 tsp) in warm water /
Sod. carb. (washing soda) applied on the posterior side of pharynx induce emesis
ANTIEMETICS: Phenothiazine tranquilizers: also have antihistaminic and weak
anticholinergic action. Affect almost all centrally origin emesis except those of
labrynithitis . The agents are acepromazine, triflupromazine, chlorpromazine, and
prochlorperazine perphenazine, trifluoperazine etc. Potential side effects: sedation,
hypotension needing fluid therapy.
Anticholinergic (antimuscarinics )drugs:. Alone, they are less effective than the other
emetics. The agents are methscopolamine., glycopyrrolate, dicyclomine, propantheline,
and isopropamide. The last two are commonly used in small animals for the control of
motion sickness. They ameliorate spasm of the gastrointestinal smooth muscles,
inhibition of entro-gastric secretions, dont cross blood brain barrier ,delays gastric
emptying and should not be used more than 3 days . Side effects: drowsiness,
xerostomia. Methoscopolmine is contraindicated in cat.
Antihistaminics: include diphenhydramine, dimenhydrinate, promethazine (a
phenothiazine with H
1
-blocking effects), cyclizine, and meclizine; preferred for
controlling motion sickness related vomition, associated with journey; cause sedation.
Cyclizine,meclizine are teratogenic.

Metoclopramide: controls emesis induced by chemotherapy, nausea and vomiting
associated with delayed gastric emptying, reflux gastritis, and viral enteritis. It readily
crosses the blood-brain barrier causes adverse effects known collectively as
extrapyramidal signs: involuntary muscle spasms, motor restlessness, and inappropriate
aggression. Concurrent use of phenothiazine and butyrophenone tranquilizers to be
avoided since they increases the potential for extrapyramidal reactions, can be reversed
by antihistaminic:diphenhydramine hydrochloride 1.0 mg/kg,IV.GI
obstruction(intussusception), GIT hemorrhages, perforation, seizures to be excluded
before therapy.
Serotonin (5-HT
3
) antagonists: Ondansetron,palonosetron, and dolasetron are
specific inhibitors of 5-HT
3
(serotonin) receptors in the CTZ; are effective antiemetics
used in patients undergoing radiation and anticancerous therapy, not effective for
motion sickness.
Domperidone : is devoid of the extrapyramidal side effects seen with metoclopramide.
Maropitant and casopitant are newer antiemetics, with potent and selective oral
neurokinin
1
receptor antagonist activity; are useful in preventing /treating nausea and
vomition caused by variety of conditions. Midazolam is a short-acting benzodiazepine


with a rapid onset of action efficacious as antiemetic in postoperative emesis resistant to
the usual treatments
ANTIULCER DRUGS : Acetylcholine M
1
Receptor antagonists(anticholinergics) :
Pirenzepine and telenzepine(more potent), selective M
1
cholinergic antagonists. Others:
hyoscine (scolpolamine) ,dicyclomine.HCl, isopropamide iodide. They potentiate effects
of H
2
blockers.
Antacids: neutralize gastric acid to form water and a neutral salt. Usually not
absorbed systemically. Common antacid preparations are combinations of aluminum
hydroxide, magnesium oxide or hydroxide, and calcium carbonate. Antacids frequently
interfere with the GI absorption of concurrently administered drugs. As a general
guideline, it is best not to give antacids within 2 hours of other oral medications. Used in
adjunctive treatment of oesophagitis, gastric hyperacidity, peptic ulcer and gastritis. In
ruminants, magnesium hydroxide is used to increase rumen pH and as a laxative in the
treatment of rumen overload syndrome (acute rumen engorgement, rumen acidosis,
grain overload).
Sodium bicarbonate is systemic, rapid and short acting antacid, may cause metabolic
alkalosis in high dose or in renal insufficiency. Mainly indicated for : metabolic acidosis,
alkalization of urine and as adjunctive therapy in hypercalcemic,hyperkalemic crisis.
Contraindicated in metabolic or respiratory alkalosis. Incompatible with:
,5%dextrose,injectableVit C,codeine,epinephrine, glycopyrrolate ,regular insulin,
oxytetracycline etc.
Magnesium containing antacids: Mg hydroxide ( milk of magnesia), Mg oxide, and Mg
silicate. Repeated administration which may leads to hyper magnesia; are
contraindicated in patients with renal disease. Aluminum-containing antacids may
deplete phosphate, causes muscular weakness, bone resoption and hypocalcaemia.
(Rapid onset of action (less than 30 minutesDue to short duration of action should
beadministered ever 3-4 hours).Adverse effects like constipation with aluminum- and
calcium-containing antacids, and diarrhea or frequent loose stools with magnesium
containing antacids.; hypophosphatemia with aluminum antacids or hypermagnesemia


with magnesium-containing antacids; hypercalcemia, hypophosphatemia and gastric
acid rebound phenomenon with calcium carbonate are possible.
Histamine (H
2
)-receptor Antagonists: effectively block pepsin and gastric acid secretion
from parietal cells by blocking the H
2
receptor. Cimetidine, ranitidine, nizatidine and
famotidine are the commonly used H
2
-receptor antagonists. Potencywise: . famotidine >
nizatidine >ranitidine >cimetidine.They strengthen the gastric mucosal defenses against
ulceration and enhances cytoprotection. Among these agents, Cimetidine reduces the
metabolism of other drugs by inhibiting hepatic microsomal enzyme systems.and has
got adverse effects like antiandrogenic, effects: gynecomastia , azospermia and
decreased libido, skin rashes, and diarrhea .
Proton-pump inhibitors (H+ K+ ATPase Inhibitors): These agents (e.g., omeprazole,
lansoprazole, pantoprazole, rabeprazole, esomeprazole) inhibit the sodium/potassium
proton pump (H
+
K
+
ATPase) at the luminal surface of the parietal cell that secretes
hydrogen ions into the gastric lumen. Omeprazole, inhibits gastric acid secretion in dogs
for at least 24 hours after a single oral dose and is as effective as cimetidine in healing
mechanically-induced gastric ulcers, and more effective than cimetidine in healing
aspirin-induced gastritis. It is also a microsomal enzyme inhibitor; decreases metabolism
of :Diazepam,Phenytoin,warfarin Increases gastric PH and decreases absorption of drugs
that need low PH for absorption : Ketoconazole, ester and metal salts of ampicillin.
Indicated for in amelioration in treatment of gastro duodenal ulcers, in cases not
responding to H
2
blockers and gastric ulcers related to NSAIDs
Cytoprotective drugs : Sucralfate is an alkalinizing aluminium hydroxide complex with
sucrose, reacts with gastric HCl, forming a insoluble pasty complex that binds to
exudate protein of the damaged tissue (GIT epithelium) forming a barrier and thus
protecting the damaged tissue from more injuries by acid, bile and pepsin; stimulates
local production of prostaglanidins(PGI, PGE) and nitric oxide which leads to increase in
mucosal blood.flow.
Prostaglandin E
1
analogues: Misoprostol , prostaglandin E
1
analogue, is the adjunctive
drug in treatment/prevention of peptic ulcers related to NSAIDs but is less efficacious


than H
2
-blockers in peptic ulcers not associated with NSAIDs therapy. Due to its
stimulatory effect on uterine contractions, resulting in softness and opening of cervix,
it can also be used as a adjunctive drug in termination of pregnancy.Side effects : GIT
disturbances-diarrhea, abdominal pain, emesis, uterine bleeding and contraction in
female dogs. It is contraindicated in pregnant dogs as it can induce abortions.
PROKINETICS: increase the movement of ingested material through the GI tract by
inducing coordinated motility patterns, are useful in the treatment of GI motility
disorders
Metoclopramide stimulates and coordinates esophageal, gastric, pyloric, and
duodenal motor activity. It increases lower esophageal sphincter (LES) tone and
stimulates gastric contractions; while relaxing the pylorus and duodenum.
Metoclopramide speeds gastric emptying of liquids, but may slow the emptying
of solids. Its prokinetic action is negated by narcotic analgesics and
anticholinergic drugs, such as atropine. Due to accelerated food absorption,
metoclopramide therapy may increase the insulin dose required in diabetics.
Indications include the following: i) gastric emptying disorders-delayed gastric
emptying, an important cause of upper gastrointestinal tract signs, (anorexia and
vomiting, in dogs and cats) in conditions of gastric dilatation, volvulus,
gastroesophageal reflux, infectious and inflammatory gastric diseases. ii) small
bowel motility disorders-. metoclopramide is less effective in the distal small
intestine and colon iii) bloat and ruminal impaction in ruminants (effective by
increasing LES tone accelerated gastric emptying) iv) in disorders of
ruminoreticular motility.
Cisapride,Mosapride and Itopride are with broadest spectrum and potency of
prokinetic activity, but without antidopaminergic effects (antiemetic action) or
extrapyramidal effects (do not cross blood brain barrier). Indications:i).gastric
stasis, idiopathic constipation, gastroesophageal reflux, chronic constipation
with megacolon, postoperative ileus and intestinal pseudo-obstruction in dogs
and cats. ii) in dogs with idiopathic megaesophagus that continue to regurgitate
frequently despite a carefully managed, elevated feeding program.
Domperidone regulates the motility of gastric and small-intestinal smooth
muscle and has very little physiologic effect in the colon. It is superior to
metoclopramide in stimulating antral contractions in dogs, with no effect on
colon motility and dont cross blood brain barrier as readily as metoclopramide.
Antacids and H
2
blockers decrease absorption of drug. It is a good anti emetic
and prokinetic agent in small animal, to be used cautiously in collie dogs.
Acetylcholinesterase Inhibitors: Ranitidine and nizatidine -histamine H
2
-receptor
antagonists with prokinetic action. Neostigmine is recommended for use in large
animals for treatment of paralytic ileus; cause increased secretion into the GI tract,
hence contraindicated in small-intestinal disease.


ANTIDIARRHOEAL AGENTS
Mucosal Protectants and Adsorbents : Protectants make a lining layer to protect GIT
epithelium form further irritation by noxious agents. Absorbents bind physically with
chemicals and hinder their absorption.Kaolin-pectin formulations absorb toxins and
make protective layer which prevent gastric mucosa from further injuries; are used for
the symptomatic treatments of acute diarrhea. It may change the consistency of the
feces but neither decreases the fluid or electrolyte loss, nor shortens the duration of the
illness. Nevertheless, it is often administered to small animals, foals, calves, lambs, and
kids. used every 4-6 hours. Kaolin-pectin products may adsorb or bind other drugs
administered PO and reduce bioavailability. Activated charcoal is the broadest
spectrum,rapid acting absorbentuseful in the emergency treatment of intoxications It
forms stable complexes with noxious agents& enhances Administration every 6 h for 1-2
days increases elimination of systemic absorbed toxins their excretion. It also adsorbs
many drugs and toxins and prevents GI absorption, so it is a common nonspecific
treatment for intoxications.
Bismuth salts: Bismuth sub salicylate, bismuth sub nitrate, bismuth sub carbonate.
Bismuth subsalicylate is the absorbent, anti endotoxin,weak antibacterial that is
hydrolyzed to bismuth carbonate and salicylate,while most effect are related to
bismuth, which adsorbs bacterial enterotoxins and endotoxins to have a GI protective
effect; salicylate has antiprostaglandin activity to control secretory diarrhea..By making
a protective lining layer and formation of insoluble complexes with noxious agents, it
can be useful in improving indigestion, useful in the treatment of flatulence . Salicylate
toxicosis is possible, especially in cats.
Motility-modifying Drugs: Anticholinergic drugs themselves have profound systemic
pharmacologic effects. Intestinal motility is already impaired in many animals with
diarrhea, and these drugs may actually worsen the diarrhea . Possible side effects
include severe ileus, xerostomia, urine retention, cycloplegia, tachycardia, and CNS
excitement and intestinal atony. Atropine ,because of its systemic effects, is not used
for an antidiarrhoeal effect. To avoid CNS excitement, quaternary amines such as
hyoscine, aminopentamide, isopropamide, propantheline and dicyclomine are
preferred since they do not cross the blood-brain barrier; are used for the treatment of
acute abdominal spasm, tenesmus, pylorospams,hyperthropic gastritis and related
emesis, emesis & diarrhea in dogs and cats.
Opiates have both antisecretory and antimotility effects. Diphenoxylate and
Loperamide are two synthetic opiates that have specific action on the GI tract, without
other systemic effects is used in small animals and neonates. They are generally used
for the symptomatic treatment of acute diarrhea and are contraindicated in infectious
diarrhea, hepatic diseases and obstruction of the GIT and urinary tract . Loperamide In
dogs adverse effects: abnormal pupillary response to light, circling, constant or
increased vocalization, head pressing, mydriasis and constipation cats and collie dogs:
paralytic ileus, toxic megacolon, pancreatitis, and CNS stimulation.. Antimicrobials:


Antimicrobials-frequently combined with motility modifiers, adsorbents, and
intestinalprotectants;erythromycin,clindamycin,tylosin,tetracycline,metronidazole,amoxi
cillin,fluoroquinolones,cephalosporin and aminoglycoside (gentamicin, amikacin).
Non steroidal Anti-inflammatory Drugs (NSAID): These (meloxicam )may directly inhibit
fluid and electrolyte hypersecretion by the intestinal cells, can be used in calf scours.
Theyare administered cautiously due to the adverse GI, hepatic, and renal effects.
Glucocorticoids: Prednisolone, prednisone, hydrocortisone, are generally used for the
treatment of moderate inflammatory intestinal diseases that involve rectum or colon.
LAXATIVES (CATHARTICS): They increase the motility of the intestine or increase the
bulk of feces. Clinically, these are administered to increase passage of gut contents
associated with intestinal impaction, to cleanse the bowel before radiography or
endoscopy, to eliminate toxins from the GI tract, and to soften feces after intestinal or
anal surgery.
Stimulant (irritant) laxatives: The vegetable oils - Castor oil a potent rapid acting
cathartic, used mainly in nonruminants and preruminant calves. The duration of action
is 4-8 hours in small animals, 12-18 hours in large animals. Raw linseed oil (cooked
linseed oil is toxic) in smaller doses and olive oil is a mild lubricant laxative and a source
of fatty acids for horses. Oils are contraindicated in intestinal obstruction and non
diagnosed rectal hemorrhage . Phenolphthalein is effective only in primates and pigs.
Bisacodyl administered by mouth or by enema in dog and cat and only 5% of any dose
is absorbed.
Osmotic (Saline) laxatives: Adequate water intake must be assured. Magnesium
salts(sulphate): Mg. sulfate containing compounds often not to be used in horses.
Sodium salts: - commonly administered as sodium biphosphate or sodium phosphate
enemas. Not to be used in cats because of fatal hyperphosphatemia, hypocalcemia, and
hypernatremia. Sugar alcohols, such as mannitol and sorbitol, are poorly absorbed and
fermented in the terminal ileum and large intestine. Lactulose is a synthetic
disaccharide is used to treat chronic constipation in cats.
Hydrophilic Colloids (Bulk) laxatives: Cellulose and hemi cellulose undergo bacterial
fermentation in large intestine, make volatile fatty acids which precipitate laxative effect
by osmotic character. Examples include methylcellulose, carboxy methyl cellulose ,
psyllium, prunes, wheat bran, and canned pumpkin.


Emollient (Mechanical or lubricant) laxatives: usually contain Mineral oil ( Liquid
paraffin) or white petroleum. Long term use: interference with absorption of the fat
soluble vitamins, nutrients and coadministered drugs, decrease sensitivity and irritability
of intestinal mucosa which can leads to constipation, intestinal and lymphoid absorption
which lead to granulomatous enteritis. They are not suitable for diagnosis or treatment
of GIT obstruction. Fecal Softeners (Surfactants): Docusate sodium, docusate calcium,
and docusate potassium are salts that decrease surface tension and allow water to
accumulate in feces.
Neuromuscular purgatives are the fast acting muscarinic cholinergic agents acting at
small intestine; to be used cautiously in physical obstruction. Eg:
neostigmine,physostigmine, bethanechol,carbachol. Neostigmine,used for ruminal
atony, to enhance urination, stimulation of skeletal muscles contraction and peristaltic
activity in cows, horses, sheep and swine.
DIGESTANTS: These agents promote the digestion of food especially in monogastric
animals. A number of proteolytic, amylolytic and lipolytic enzymes are used as appetite
stimulant , health tonics and digestants.Eg: Proteolytic enzymes (papain, trypsin,
chymotrypsin, enterokinase, carboxypeptidase);amylolytic enzymes (diastase,
takadiastase); Pancreatic enzymes (pancreatin (mixture of amylase, trypsin and lipase),
pancreolipase) are also indicated in chronic pancreatitis, exocrine pancreatic
insufficiency
HEPATOPROTECTIVE DRUGS AND CHOLAGOGUE/ CHOLERETICS: The substances which
cause gall bladder contraction are cholagogues; and the substances which increase the
bile secretion are choleretics. They are indicated in gall bladder disease, cholestasis,
biliary fistula, gall bladder stones, biliary cirrhosis.
Ursodeoxycholic acid (ursodiol): is a naturally occurring bile acid, used in the
dogs with chronic hepatitis and cats with lymphocytic plasmacytic cholangitis..The
hepatoprotective effect may, however, be less in cats and dogs than in humans as the
major circulating bile acid in dogs and cats is taurocholate.Dose: dog, cats- 1015 mg/kg
q.24 h or divided and given q.12 hIt is recommended that ursodeoxycholic acid be
administered for 34 months. Aluminum-containing antacids may bind to it, thus
reducing efficacy. Administration with food, thus improving absorption is recommended.
Colchicine: the antigout drug, has been used in the management of amyloidosis and
chronic hepatic fibrosis. Dogs: 0.0250.03 mg/kg/d. it is teratogenic . NSAIDs increase
the risk of thrombocytopenia, bone marrow suppression ,if used concurrently.
S-adenosyl methionine (SAMe): is an endogenous molecule which is synthesized,
from methionine, by many cells in the body. It is most frequently used as adjunctive
therapy for a variety of hepatic disorders (canine chronic hepatitis,hepatic lipidosis,
cholangiohepatitis, etc.). It may also be beneficial in the treatment of certain
hepatotoxic disorders. The dosing : 5.5 kg- 90 mg POq.24 h; 5.51 kg: 180 mg PO q.24 h;
1116 kg: 225 mg POq.24 h; 1629.5 kg: 450 mg PO q.24 h; 29.541 kg: 675 mgPO q.24
h; 41 kg, 900 mg PO q.24 h, on an empty stomach


Silymarin: Source-Milk thistle, Silybum marianum, Silymarin has been traditionally
used in the treatment of liver disease. Silymarin may:control hepatic cell membrane
permeability and thus prevent toxin penetration; inhibit the cytotoxic, inflammatory and
apoptotic effects; reduce hepatic collagen formation and increase hepatic glutathione
content.
It is most commonly utilized in the chronic hepatopathies, acute hepatic disease and as
a hepatoprotective agent against a variety of hepatotoxic substances. It also may
increase the clearance of drugs which undergo hepatic glucuronidation, e.g.paracetamol
(acetaminophen), diazepam and morphine. Dogs and cats 2050 mg/kg PO q.24 h

pplement Dosages of drugs acting on digestive system in animals.
Appetite Stimulants
Drug Dosage
Prednisone 1 mg/kg, PO, every other day
Stanozolol 0.25-3 mg/kg, PO, SID; 2-10 mg/kg, IM, once weekly
Boldenone undecylenate 2.5 mg/kg, IM, every 2-4 wk
Diazepam Cats: 0.005-0.4 mg/kg, IM or IV, SID; 1 mg/kg, PO, SID
Oxazepam Cats: 2 mg, PO, BID Cyproheptadine
Cat 1-4mg, PO,
BID
Emetics
Apomorphine Dogs: 4 mg/kg, PO; 0.02 mg/kg, IV; 0.3 mg/kg, SC; 0.25 mg in the conjunctival
sac
Xylazine Cats: 0.4-0.5 mg/kg, IV or IM
Syrup of ipecac 3-6 mL/kg, PO
Hydrogen
peroxide
Dogs: 5-10 mL, PO
Antiemetics
Acepromazine 0.025-0.2 mg/kg, IV, IM, SC, max. 3 mg; 1-3 mg/kg, PO
Chlorpromazine 0.5 mg/kg, IV, IM, SC, TID-QID Isopropamide 0.2-1.0 mg/kg,
PO, BID
Prochlorperazine 0.1 mg/kg, IM, TID-QID; 1 mg/kg,
PO, BID
Diphenhydramine 2-4 mg/kg, PO,
TID
Propantheline 0.25 mg/kg, PO, TID Cyclizine 4 mg/kg, PO,
TID
Dimenhydrinate 4-8 mg/kg, PO, TID Meclizine 4 mg/kg, PO,
SID
Butorphanol 0.2-0.4 mg/kg, IM, SID-BID Dolasetron 0.6 mg/kg, IV,
SID
Ondansetron 0.1-0.2 mg/kg, PO, SID-BID ; 0.22
mg/kg, IV, BID-TID

Metoclopramide 0.1-0.5 mg/kg, IM, SC, PO, TID; 0.01-0.02 mg/kg/hr, IV infusion
Anti Ulcer Drugs
Cimetidine Dogs: 5-10 mg/kg, PO, QID Horses: 4 mg/kg, IV, BID; 18 mg/kg, PO, BID
Ranitidine Dogs, cattle : 0.5 mg/kg, PO, SC, or IV, BID Horses: 1.3 mg/kg, IV, BID; 11 mg/kg,
PO, BID
Famotidine Dogs: 0.5-1 mg/kg, PO or IV, SID Horses: 0.4 mg/kg, IV, BID; 3 mg/kg, PO, BID
Sucralfate Cats: 250 mg, BID-TID Dogs: 500 mg to 1 g, TID-QID Foals: 1-2 g, QID
Omeprazole Dogs: 0.5-1 mg/kg, PO, SID Horses: 4 mg/kg, PO, SID for treatment; 2 mg/kg,
PO, SID


Prokinetic Drugs
Metoclopramide Dogs and cats: 0.2-0.5 mg/kg, PO or SC, TID; 0.01-0.02 mg/kg/hr, IV infusion
Horses: 0.125-0.25 mg/kg, diluted in 500 mL of polyionic solution
Domperidone 0.1-0.5 mg/kg, IM; 0.5-1.0 mg/kg, PO
Cisapride Dogs: 0.1 mg/kg, PO, TID Cats: 2.5 mg/cat, TID for cats <5 kg, and 5.0 mg/cat
for cats >5 kg Horses: 0.1 mg/kg, PO, TID
Ranitidine 1-2 mg/kg, PO, BID Nizatidine 2.5-5 mg/kg,
PO, BID
Neostigmine 0.02 mg/kg, SC, as needed Erythromycin 0.5-1.0 mg/kg,
PO, BID-TID
Lidocaine Horses: 1.3 mg/kg as a iv bolus followed by a continuous infusion of 0.05
mg/kg/min
Antidiarrhoeal Drugs
Kaolin-pectin 1-2 mL/kg, PO, QID Laxatives
Activated charcoal 2-8 g/kg, PO Castor oil Dogs: 5-25 mL, PO Foals:
25-50 mL, PO
Bismuth
subsalicylate
1-3 mL/kg/day
in divided doses, PO
Bisacodyl Dogs: 5-20 mg, PO, SID-
BID Cats: 2.5-5.0 mg, PO,
SID- BID
Aminopentamide 0.1-0.4 mg, IM, SC,
pO, BID
Diphenoxylate 0.05-0.1 mg/kg, PO, QID
Isopropamide 0.2-1.0 mg/kg, PO, BID Loperamide 0.08 mg/kg, PO, TID
Propantheline 0.25-0.5 mg/kg, PO,
BID-TID
Mag.sulfate(Epsom
salt)
Dogs: 5-25 g, PO Cats: 2-5
g, PO Horses: 30-100 g,
Cattle-250-400g, PO
Magnesiumhydroxide
(milk of magnesia)
Dogs: 5-10 mL, PO Cats:
2-6 mL, PO Horses: 1-4 L,
PO
Lactulose Dogs: 5-15 mL, PO, TID
Cats: 2-3 mL, PO, TID
Enzyme Laxatives Lubricants
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