There is a wide variety of flavors and preparations made by compounding pharmacies to deal with the problems associated with the bitter taste.
Because of the variety of uses for this drug, dose amount, frequency, and duration of treatment vary widely. Metronidazole is used primarily with other antibiotics to treat mixed bacterial infections in which anaerobic bacteria are present, for example, pleuropneumonia, peritonitis, and abdominal abscesses.
It also is used prophylactically after colic or other abdominal surgery when mixed bacterial infections are a risk. Metronidazole generally is given orally although it also is absorbed rectally. Rectal administration is used occasionally in the very sick patient when anorexia and weight loss are a problem. Barbara Forney is a veterinary practitioner in Chester County, Pennsylvania.
She has a master's degree in animal science from the University of Delaware and graduated from the University of Pennsylvania School of Veterinary Medicine in She began to develop her interest in client education and medical writing in Some states restrict the information we may provide about controlled substances.
Please select your state below. This content is intended for counseling purposes only. No claims are made as to the safety or efficacy of mentioned preparations. Fecal PCR analysis for pathogens may also be performed at this time. Next, the patient should be classified based on the severity of disease: either having minimal signs and no debilitation that should first be treated symptomatically or cases having severe disease obviously requiring an in-depth GI workup.
For the animal with relatively mild diarrhea I prefer to use trial therapy involving anthelmintic therapy, dietary food trials, and lastly antibiotic therapy. If the patient fails to improve with such therapy, then further GI evaluation is indicated. Additional diagnostic testing may include imaging studies ultrasonography is preferred as barium studies are rarely helpful , serology or PCR testing folate, cobalamin , and endoscopy or surgery for intestinal biopsies.
Parasites must always be considered in any patient experiencing chronic GI signs. I will empirically treat with anthelmintics such as fenbendazole or pyrantel.
Giardia are usually diagnosed using proper fecal examination techniques. In cats, Giardia lives in the lower small intestine dogs in upper intestine and signs can often be associated with colitis-like large bowel signs. The treatment of choice for years has been metronidazole.
Other suggested Giardia therapies include fenbendazole or febantel for five days. With treatment failure, one should make sure that Giardia is truly the cause or that subsequent recontamination following therapy is not occurring.
Infection with Giardia does not confer immunity. In resistant cases, combined fenbendazole and metronidazole therapy has been suggested. High-fiber diets, probiotics, silybin milk thistle substrate and intestinal antibiotics may help lessen reinfection when given during the therapy. It is controversial whether to treat healthy cats that test positive for Giardia because Giardia is generally not considered a significant human health risk. I recommend treating the asymptomatic, positive cat and, if on recheck evaluation, the patient is still positive but subclinical, I will repeat therapy using a different agent.
If the animal remains positive after two therapies, I simply recheck the patient again at the next yearly health evaluation.
Some animals are chronic asymptomatic carriers and are very difficult to clear. The trophozoite Tritrichomonas foetus TTF has been identified as a cause of chronic diarrhea in young cats. Most of the affected cats are under 1 year of age and are reported to have a watery to sometimes mucoid diarrhea.
It is most often observed in cats coming from humane shelters or catteries, but Abyssinians and Bengal cats appear to be overrepresented or to have a more resistant disease. The incidence of TTF may be higher than previously thought. There are several ways to diagnose TTF.
In some cases, a diagnosis is made by performing a wet mount fecal prep and identifying the organism. A small amount of very fresh stool is thinned with warm saline solution, a coverslip applied, and the feces examined at 40x.
Tritrichomonas foetus is identified by its progressive forward motion due to its undulating membrane In contrast, Giardia has a falling leaf motion. With these pouches, a very small amount of stool is placed in the broth and cultured at room temperature.
The bag is then examined under a microscope 24 to 72 hours later for evidence of motile organisms. Fecal PCR for TTF is offered by many commercial labs and is considered the test of choice for confirming the infection. Ronidazole is the only antiprotozoal shown to have efficacy in treating TTF infection. Ronidazole has a very narrow therapeutic range; higher doses or a longer duration can result in neurotoxicity.
Ronidazole is not approved for use in the United States and must be obtained through a reliable compounding pharmacy. It is very bitter and therefore should be given via capsule; liquid solutions are not recommended. Treatment failures can occur, and a fecal PCR should be performed if a cat fails to respond to therapy because a negative PCR result means TTF is a less likely cause of the diarrhea.
When left untreated, many cats eventually do become normal, especially young cats under 1 year of age. The role of these asymptomatic carriers in disease transmission remains unclear. GI signs may resolve by simply changing a patient's diet.
Food-responsive diarrhea includes both true dietary allergies and dietary intolerances. Allergies result from a reaction with a protein antigen, whereas intolerances occur in response to some substance in the diet, such as a preservative or food coloring.
Clues in the laboratory testing include hypoproteinemia or eosinophilia. Antigen testing did not identify food-responsive cases.
Most cats responded within one week of dietary change and beef, wheat and corn were most common proteins incriminated.
The most frequent side effects that can appear in cats who take metronidazole include vomiting, nausea, and showing a lower appetite. In some cases, metronidazole has also prompted seizures. If you see symptoms of a seizure in your cat, then you must contact your veterinarian immediately. Has your cat ever taken metronidazole for a medical condition?
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