Why Prescribe Metronidazole?

[Laurie, Wally & Charlotte]

I would like to know why vets often prescribe Metronidazone for upset stomaches when there is neither a fever nor a positive stool test.

[Laurie, Wally & Charlotte]

To clarify, when there is an upset stomach without infection and without Giardia, why would a veterinarian prescribe Metronidazole?

[Kate, Mel, Tenley & Harper]

Following... I have ALWAYS wondered this.

[Jill, Woody & Maxi]

That is a great question…I would also like to know that answer.  We recently had Maxi at the emergency clinic, diarrhea and vomiting. The vet tried to send us home with it, I asked why (she had a negative fecal) and her reply was.."it was a stool hardener."  Needless to say, I declined metro.

[Kate, Mel, Tenley & Harper]

That's the reply I have gotten in the past too. I said I wasn't comfortable using an antibiotic as a stool hardener and she sent us home with some beet pulp tablets and he was good as new in 24 hours. 

Whenever I question people using metro with a negative fecal, they always say, "I have always used it and it works every time." I reply, "Are you sure it's the metro working or just time itself?"

[Karen, Jasper and Jackdoodle]

Add me to the list of those who would like to know the answer to this question. 

For years and years, I thought metronidazole was a benign diarrhea medicine for dogs. I had no idea it was the same drug (Flagyl) that is prescribed for certain kinds of human protozoal infections (trichomonas, dysentery) nor that it could have severe digestive and neurotoxic side effects. My vets prescribed it any time a dog had diarrhea, and before JD, I did not question anything or ask for explanations of veterinary treatments. I followed whatever my vet recommended. I am embarrassed and sorry about that. 

I really do think that many vets were just taught to give metro for diarrhea and maybe have forgotten what it really is, or never even knew. I don't know if much pharmacology is taught in vet school, but I doubt it.  The fact that a vet told Jill it is a "stool hardener" would seem to bear this out. Education is so specialized these days, it seems the focus of study (in all disciplines) is narrower every year. Just as vets are not nutritionists and don't study nutrition in vet school, they are also not pharmacists and probably don't study pharmacology in depth, either. Maybe most of what they know about prescribing drugs comes from the drug company sales reps and possibly outdated treatment guidelines. I hate to believe that, but i can't think of any other explanation. 

[Laurie, Wally & Charlotte]

Our vet explained that it is given, not because it is an antibiotic per se, but because one of its side effects is that it calms the colon. Charlotte has pancreatitis and the Metronidazole would be helpful since it has anti-inflammatory properties.

[Karen, Jasper and Jackdoodle]

That's interesting, because metronidazole has actually been shown to increase the risk of acute pancreatitis. 

http://www.ncbi.nlm.nih.gov/pubmed/15709992

I think there are better choices of anti-inflammatories. 

[Laurie, Wally & Charlotte]

Thanks, Karen. I found that article, too. Besides being prescribed Metronidazole to calm her colon (twice a day for five days), Charlotte was prescribed three day's worth of Metoclopramide for nausea. At the animal hospital, yesterday and on Sunday, she was given a shot of Cerenia, plus subcutaneous fluids. In your opinion, what would be a better choice than Metronidazole, and what are your thoughts about Metoclopramide? I have read that it could affect blood flow to her digestive system. Thanks, in advance, for your thoughts.

[Karen, Jasper and Jackdoodle]

I used to take it myself for reflux, lol. From what I've read, side effects in dogs are minimal. I didn't see anything about restricting blood flow to the digestive system. This is a pretty good article: http://www.veterinarypartner.com/Content.plx?A=523

But Cerenia works pretty darned well for nausea, all by itself. I think they may also be using the Reglan for its effects on stomach contractions, as described in the link.

However, if you are dealing with pancreatitis, I would not take treatment advice from anyone other than the vets who are caring for her, including me.  I don't want to scare you, but the fatality rate from acute pancreatitis is very high. It's a very serious illness. 

I hope she gets better soon. 

 

[Karen, Jasper and Jackdoodle]

Jane's excellent article about pancreatitis: http://www.doodlekisses.com/group/healthandmedicalissues/forum/topi...

[Laurie, Wally & Charlotte]

Thanks for both articles. I took Charlotte to our regular vet today - that makes three vet visits in four days. She said that the SNAP test (done yesterday at our Cape Cod vet) doesn't give a definitive diagnosis of pancreatitis. Regardless . . . she gave Charlotte fluids again, since she hadn't eaten or had anything to drink in almost two days. I am happy to report that she has had a few very small meals this evening, which is quite a relief. 

Interestingly, I have discovered on three occasions that her hind quarters have been soaking wet. She doesn't seem to know that she's wet, and the fluid is clear and odorless. Since she's had subcutaneous fluids three times -- once on Sunday night, once yesterday, and again today, I'm wondering if there's a connection. She is still going outside to urinate regularly. I am going to speak with our vet tomorrow to try to figure out what's going on. 

[Jill, Woody & Maxi]

Thats great that she is eating...

Maxi had to have subcutaneous fluids as well, and it would literally squirt out of her back with certain movements…as far as the wet hindquarters..do you think she is urinating herself?