Maropitant for stasis?

[Bunny Bride]

Just wondering if anyone is familiar with Maropitant to treat stasis? My rabbit was progressing in stasis recovery, but not as fast as the vet would like so they switched us to subq fluid and meds over oral. Along with metacam & metoclopramide, they now added a new anti nausea med called Maropitant to help him eat more. I can’t find much info on this med and was wanting to see if any of you had experience with it? Thank you.

[Deleted User]

I’m not familiar with it, but it’s odd they’d give him an anti-nausea drug, considering bunnies can’t vomit. Has he started to eat and poop on his own?

[Muchelle]

Metoclopramide is an antiemetic mainly destined to human consumption (Plasil) and it’s very useful during bad cases of stasis, I can guarantee. Buns obviously can’t vomit, but it helps them get more regular movements in their stomach/guts and also it should make them feel a bit hungry if I recall correctly what my vet told me.

I don’t know about Maropitant, been trying to find infos but there’s just so little… do ask your vet about possible interactions with Metoclopramide and Metacam. If you’re not convinced you could ask to adjust the doses of the meds the bun’s already getting and see how it goes for the next couple of days, maybe?

[Wick & Fable]

No experience, but I did some digging. I have background in looking into drug interactions, so I decoded as best and as accurately as I could based on some cursory findings. Nothing professional-level nor certain.

Maropitant is also known as maropitant citrate, or Cerenia, used for dogs typically for motion sickness. As stated, rabbits cannot vomit, so it’s primary use is not helpful for rabbits, but maybe the mechanisms in how it works may help with GI stasis?

From what I can find, Maropitant occupies the receptor in the brain which, when activated by the correct chemical, causes one to vomit (vomit-center of the brain). Maropitant occupies that vomit-receptor so the correct chemical cannot bind to it and cause that vomit reaction. It looks like this medication, although approved for anti-nausea for dogs, is being investigated for broader purposes.

For medication interactions, it looks like drugs affecting hormones, NSAIDS (anti inflammatory drugs), anti-fungals, certain antibiotics, and some seizure medications may interact with the drug, making it more potent (not necessarily a good thing). Metoclopramide, being a medication which helps things move through the system, may affect the absorption of some drugs, but I’m guessing that’s why its being administered subq, rather than pill or oral.

Symptoms to look for which may indicate an allergic or physical/chemical/toxicological reaction include: Severe eye irritation, stinging, tearing, redness, swelling, and blurred vision. Mild skin irritation. May cause an allergic skin reaction. Dermatitis. Rash.

Found: https://www.zoetisus.com/contact/pages/product_information/msds_pi/msds/cerenia_injectable.pdf

I also found a book from 2012 titled “Ferrets, Rabbits and Rodents; Clinical Medicine and Surgery” that lumps Cerenia with metoclopramide as a recommendation for gastrointestinal complications that arise through chemotherapy.

I also found a PetMD blog post from 2013 about Cerenia use:

A few enterprising veterinarians have started experimenting with using maropitant for other substance P-related conditions including allergic skin disease, sinusitis, joint disease, feline interstitial cystitis, coughing, diarrhea, and more. Initial clinical findings indicate that the drug may be beneficial, particularly in combination with rather than instead of more traditional therapies.

But here comes the potential downside of off-label use. Substance P is also involved in the functioning of the central nervous system (CNS). Using maropitant every day eventually depletes the reserves of dopamine in the CNS and can lead to tremors (think Parkinson’s disease). Since the longest approved duration of use on the product’s label is five days, this wasn’t a problem until doctors began using the drug off label. Veterinarians have determined that giving the medication on a schedule of five days on–two days off, or every other day, prevents this side effect.

— So all in all, I see this as, some people do use it for this purpose, but it’s not as standard as metoclopramide and other drugs for GI stasis treatment. I would ask your vet if they’ve used this in the past successfully with other rabbits (because you’ve discovered its use is uncommon), and what side effects may be expected by the drug on its own and its interaction with others being consumed.

The answers provided in this discussion are for general guideline purposes only. The information is not intended to diagnose or treat your pet. Seek the advice of your veterinarian or a qualified behaviorist.

[Muchelle]

Excellent detective work!! Have a cookie!

[LBJ10]

Studies suggest it can help with visceral pain (e.g. intestinal pain). Whether or not it is appropriate for rabbits, I don’t know.

[Bunny Bride]

Thanks everyone. Wick I really appreciate you doing that much research, so nice of you and very helpful. I am honestly on the fence about giving it tomorrow… it was only for a couple days anyway and I’m just not convinced he is at the point where trying something rogue is necessary. Think I’d rather continue with the standbys since I was seeing progress, although slow. From what I’ve read on the boards, it can vary—some buns seem to recover in a day or two while others can take a couple weeks. Right? At least that’s my interpretation, but I’ve never dealt with stasis before.

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