Evaluation of the effectiveness of preoperative administration of maropitant citrate and metoclopramide hydrochloride in preventing postoperative clinical gastroesophageal reflux in dogs

Ciaran T. Jones 1Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA 99164.
2ChesterGates Veterinary Specialists, E & F, Telford Ct, Chestergates Rd, Chester, CH1 6LT, England.

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 MVB, MRCVS, MS
and
Boel A. Fransson 1Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA 99164.
1Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA 99164.
2ChesterGates Veterinary Specialists, E & F, Telford Ct, Chestergates Rd, Chester, CH1 6LT, England.

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 DVM, PhD

Abstract

OBJECTIVE

To investigate the prophylactic effectiveness of preoperative administration of maropitant citrate and metoclopramide hydrochloride in preventing postoperative clinical gastroesophageal reflux (GER) in dogs and to identify risk factors for clinical postoperative GER in dogs.

ANIMALS

93 client-owned dogs undergoing surgery at the Washington State University Veterinary Teaching Hospital between March 2016 and February 2017.

PROCEDURES

Dogs were randomly assigned to either the intervention group (preoperatively received maropitant and metoclopramide) or the control group (did not preoperatively receive maropitant and metoclopramide). After surgery, all dogs were recovered and monitored, and occurrences of GER were noted. The prophylactic effectiveness of maropitant and metoclopramide was evaluated, and univariate and multivariate logistic regression analyses were performed to identify variables associated with postoperative clinical GER in dogs.

RESULTS

No meaningful difference in the incidence of clinical GER during the postoperative period was detected between the control and intervention groups. Results indicated that variables associated with significantly increased odds of postoperative clinical GER included the male sex (OR, 9.2; 95% confidence interval [CI], 1.26 to 195.0), an overweight BCS (OR, 12.3; 95% CI, 2.1 to 135.1), gastrointestinal surgery (OR, 30.5; 95% CI, 3.0 to 786.9), and requirement for a dexmedetomidine constant rate infusion after surgery (OR, 9.6; 95% CI, 1.3 to 212.5).

CONCLUSIONS AND CLINICAL RELEVANCE

Findings indicated that incidence of clinical GER during the postoperative period was not lower for dogs that received preoperative prophylactic administration of metoclopramide and maropitant, compared with incidence dogs that did not receive the prophylactic treatment. Further research is required into alternative measures to prevent postoperative clinical GER in dogs.

Abstract

OBJECTIVE

To investigate the prophylactic effectiveness of preoperative administration of maropitant citrate and metoclopramide hydrochloride in preventing postoperative clinical gastroesophageal reflux (GER) in dogs and to identify risk factors for clinical postoperative GER in dogs.

ANIMALS

93 client-owned dogs undergoing surgery at the Washington State University Veterinary Teaching Hospital between March 2016 and February 2017.

PROCEDURES

Dogs were randomly assigned to either the intervention group (preoperatively received maropitant and metoclopramide) or the control group (did not preoperatively receive maropitant and metoclopramide). After surgery, all dogs were recovered and monitored, and occurrences of GER were noted. The prophylactic effectiveness of maropitant and metoclopramide was evaluated, and univariate and multivariate logistic regression analyses were performed to identify variables associated with postoperative clinical GER in dogs.

RESULTS

No meaningful difference in the incidence of clinical GER during the postoperative period was detected between the control and intervention groups. Results indicated that variables associated with significantly increased odds of postoperative clinical GER included the male sex (OR, 9.2; 95% confidence interval [CI], 1.26 to 195.0), an overweight BCS (OR, 12.3; 95% CI, 2.1 to 135.1), gastrointestinal surgery (OR, 30.5; 95% CI, 3.0 to 786.9), and requirement for a dexmedetomidine constant rate infusion after surgery (OR, 9.6; 95% CI, 1.3 to 212.5).

CONCLUSIONS AND CLINICAL RELEVANCE

Findings indicated that incidence of clinical GER during the postoperative period was not lower for dogs that received preoperative prophylactic administration of metoclopramide and maropitant, compared with incidence dogs that did not receive the prophylactic treatment. Further research is required into alternative measures to prevent postoperative clinical GER in dogs.

Supplementary Materials

    • Supplementary Table S1 (PDF 130 kb)
    • Supplementary Table S2 (PDF 103 kb)

Contributor Notes

Address correspondence to Dr. Fransson (boel_fransson@wsu.edu).
  • 1. Davies JA, Fransson BA, Davis AM, et al. Incidence of and risk factors for postoperative regurgitation and vomiting in dogs: 244 cases (2000–2012). J Am Vet Med Assoc 2015;246:327–335.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 2. Warusevitane A, Karunatilake D, Sim J, et al. Safety and effect of metoclopramide to prevent pneumonia in patients with stroke fed via nasogastric tubes trial. Stroke 2015;46:454–460.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 3. Wilson DV, Evans AT, Mauer WA. Influence of metoclopramide on gastroesophageal reflux in anesthetized dogs. Am J Vet Res 2006;67:26–31.

  • 4. Milovancev M, Townsend K, Spina J, et al. Effect of metoclopramide on the incidence of early postoperative aspiration pneumonia in dogs with acquired idiopathic laryngeal paralysis. Vet Surg 2016;45:577–581.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 5. Monnet E, Tobias KM. Larynx. In: Tobias KM, Johnston SA, eds. Veterinary surgery small animal. St Louis: Elsevier Saunders, 2012;1718–1733.

    • Search Google Scholar
    • Export Citation
  • 6. Johnson RA. Maropitant prevented vomiting but not gastroesophageal reflux in anesthetized dogs premedicated with acepromazine-hydromorphone. Vet Anaesth Analg 2014;41:406–410.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 7. Torrente C, Vigueras I, Manzanilla EG, et al. Prevalence of and risk factors for intraoperative gastroesophageal reflux and post-anesthetic vomiting and diarrhea in dogs undergoing general anesthesia. J Vet Emerg Crit Care (San Antonio) 2017;27:397–408.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 8. Hui TT, Fass SM, Giurgiu DI, et al. Gastroesophageal disease and nausea: does fundoplication help or hurt? Arch Surg 2000;135:545–549.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 9. Muenster M, Hoerauf A, Vieth M. Gastro-oesophageal reflux disease in 20 dogs (2012–2014). J Small Anim Pract 2017;58:276–283.

  • 10. Wilson D, Monnet E. Risk factors for the development of aspiration pneumonia after unilateral arytenoid lateralization in dogs with laryngeal paralysis: 232 cases (1987–2012). J Am Vet Med Assoc 2016;248:188–194.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 11. de la Puente-Redondo VA, Siedek EM, Benchaoui HA, et al. The anti-emetic efficacy of maropitant (Cerenia) in the treatment of ongoing emesis caused by a wide range of underlying clinical aetiologies in canine patients in Europe. J Small Anim Pract 2007;48:93–98.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 12. Brainard BM, Hofmeister EH. Anesthesia principles and monitoring. In: Tobias KM, Johnston SA, eds. Veterinary surgery: small animal. St Louis: Elsevier Sauders, 2012;248–291.

    • Search Google Scholar
    • Export Citation
  • 13. Lorenzutti AM, Martin-Flores M, Litterio NJ, et al. Evaluation of the antiemetic efficacy of maropitant in dogs medicated with morphine and acepromazine. Vet Anaesth Analg 2016;43:195–198.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 14. Domino KB, Anderson EA, Polissar NL, et al. Comparative efficacy and safety of ondansetron, droperidol, and metoclopramide for preventing postoperative nausea and vomiting: a meta-analysis. Anesth Analg 1999;88:1370–1379.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 15. Morris RW, Aune H, Feiss P, et al. International, multicentre, placebo-controlled study to evaluate the effectiveness of ondansetron vs. metoclopramide in the prevention of postoperative nausea and vomiting. Eur J Anaesthesiol 1998;15:69–79.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 16. Stadler M, Bardiau F, Seidel L, et al. Difference in risk factors for postoperative nausea and vomiting. Anesthesiology 2003;98:46–52.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 17. Friedenberg FK, Xanthopoulos M, Foster GD, et al. The association between gastroesophageal reflux disease and obesity. Am J Gastroenterol 2008;103:2111–2122.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 18. Böhm B, Milsom JW, Fazio VW. Postoperative intestinal motility following conventional and laparoscopic intestinal surgery. Arch Surg 1995;130:415–419.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 19. Brown DC. Small intestine. In: Tobias KM, Johnston SA, eds. Veterinary surgery: small animal. St Louis: Elsevier Saunders, 2012;1513–1541.

    • Search Google Scholar
    • Export Citation
  • 20. Galatos AD, Raptopoulos D. Gastro-oesophageal reflux during anaesthesia in the dog: the effect of preoperative fasting and premedication. Vet Rec 1995;137:479–483.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 21. Gan TJ, Meyer TA, Apfel CC, et al. Society for Ambulatory Anesthesia guidelines for the management of postoperative nausea and vomiting. Anesth Analg 2007;105:1615–1628.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 22. Apfel CC, Heidrich FM, Jukar-Rao S, et al. Evidence-based analysis of risk factors for postoperative nausea and vomiting. Br J Anaesth 2012;109:742–753.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 23. Hoareau GL, Mellema MS, Silverstein DC. Indication, management, and outcome of brachycephalic dogs requiring mechanical ventilation. J Vet Emerg Crit Care (San Antonio) 2011;21:226–235.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 24. Poncet CM, Dupre GP, Freiche VG, et al. Prevalence of gastrointestinal tract lesions in 73 brachycephalic dogs with upper respiratory syndrome. J Small Anim Pract 2005;46:273–279.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 25. Takahashi T, Tsuchida D, Pappas TN. Central effects of morphine on GI motility in conscious dogs. Brain Res 2007;1166:29–34.

  • 26. Blancquaert JP, Lefebvre RA, Willems JL. Emetic and antiemetic effects of opioids in the dog. Eur J Pharmacol 1986;128:143–150.

  • 27. Lamata C, Loughton V, Jones M, et al. The risk of passive regurgitation during general anaesthesia in a population of referred dogs in the UK. Vet Anaesth Analg 2012;39:266–274.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 28. Gan TJ, Diemunsch P, Habib AS, et al. Consensus guidelines for the management of postoperative nausea and vomiting. Anesth Analg 2014;118:85–113.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 29. Turkistani A, Abdullah K, Manaa E, et al. Effect of fluid preloading on postoperative nausea and vomiting following laparoscopic cholecystectomy. Saudi J Anaesth 2009;3:48–52.

    • Search Google Scholar
    • Export Citation
  • 30. Apfel CC, Meyer A, Orhan-Sungur M, et al. Supplemental intravenous crystalloids for the prevention of postoperative nausea and vomiting: quantitative review. Br J Anaesth 2012;108:893–902.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 31. Pierre S, Benais H, Pouymayou J. Apfel's simplified score may favourably predict the risk of postoperative nausea and vomiting. Can J Anaesth 2002;49:237–242.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 32. Pierre S, Corno G, Benais H, et al. A risk score-dependent antiemetic approach effectively reduces postoperative nausea and vomiting—a continuous quality improvement initiative. Can J Anaesth 2004;51:320–325.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 33. Laflamme D. Development and validation of a body condition score system for dogs. Canine Pract 1997;22(4):10–15.

  • 34. Murphy DW, Faust KB, Chiantella VM, et al. Assessment of accuracy of intraesophageal pH probe in a dog model. Dig Dis Sci 1989;34:1079–1084.

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