Feline GI motility disorders present both a diagnostic and therapeutic challenge. The available data on the effect of various prokinetic drugs in cats is tenuous. Therefore most recommendations for drug usage and dosage are based on collective clinical experience. Recently, incretins have been a focus of interest because of their beneficial role in glucose homeostasis and the treatment of type 2 diabetes mellitus. However, their impact on GI motility has not been evaluated. This study assesses the effects of metoclopramide, erythromycin and exenatide on gastric emptying (GE) and gastric motility in comparison to placebo.
In a randomized, double-blind, 4-way crossover design, 8 healthy cats were administered placebo (saline PO or SC), metoclopramide (0.5 mg/kg SC q8h), erythromycin (1 mg/kg PO q8h) or exenatide (1.2 μg/kg SC q12h) for 2 consecutive days followed by a minimum 5-day washout period. Cats were randomized to a treatment group. Sonographic assessment of GE was performed in dorsal recumbency at 0, 15, 30 and 60 minutes following a solid test meal (20% of daily energy requirements), and at 30-minute intervals thereafter for 8 hours. Mean cross-sectional area of transverse images of the relaxed antrum was obtained for each time point, and expressed as a percentage of the maximal antral area. The area under the curve (AUC) was calculated and 25% - 90% GE times (GET) determined. The motility index (MI) of antral contractions was plotted against time. A mixed model ANOVA with cat as a random effect and treatment as fixed effect was used to assess the difference in each fractional GET and MI AUC between treatments. Posthoc pairwise comparisons were examined with the Tukey’s test as appropriate.
The rate of GE following metoclopramide or erythromycin treatment was significantly faster compared to that after placebo or exenatide. There was a statistically significant difference at all fractional GE between GET following metoclopramide and erythromycin treatments when compared to placebo (p = 0.002 – 0.049 and p = 0.001 – 0.015 for metoclopramide and erythromycin respectively) and exenatide (p < 0.001 and p < 0.001 for metoclopramide and erythromycin respectively). The rate of GE following administration of exenatide was significantly slower compared to placebo during the first half of the GE curve (25 - 55% fractional GE; p = 0.013 – 0.046). The total AUC of Ml following administration of erythromycin (1857 ± 415 [mean ± SD]) and metoclopramide (1847 ± 253 [mean ± SD]) was significantly larger (p = 0.034 and 0.042 respectively) than the total AUC of Ml following administration of placebo (1555 ± 286 [mean ± SD]), indicating an increase in the MI of antral contractions. However, the total AUC of Ml following exenatide administration (1509 ± 296 [mean ± SD]) was not different from that obtained after placebo was given.
The results indicate that metoclopramide and erythromycin have a positive gastric prokinetic effect in healthy cats: they shorten GE times and increase the MI of antral contractions. In contrast, exenatide administered to healthy cats delays GE.
Gastrointestinal Laboratory, Texas A&M University, College Station, TX
1993-1999 MVDr, University of Veterinary and Pharmaceutical Sciences, Brno, Czech Republic
1999-2003 PhD, University of Veterinary and Pharmaceutical Sciences, Brno, Czech Republic
2003-2012 Assistant Professor, Department of Internal Medicine Clinic of Dog and Cat Diseases,
Faculty of Veterinary Medicine, University of Veterinary and Pharmaceutical Sciences
2012-2015 Resident, Louisiana State University, Baton Rouge, LA, USA
2016 Diplomate, American College of Veterinary Internal Medicine
(Small Animal Internal Medicine)
2015-2017 Post-doctoral Fellow, Louisiana State University, Baton Rouge, LA, USA
2017-present Research Associate, Gastrointestinal Laboratory, Texas A&M University, College
Station, TX, USA
Thursday, June 14
12:00 PM – 12:15 PM
Thursday, June 14
2:40 PM – 3:30 PM
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