The kidneys perform invaluable functions within a cat's body, such as filtering out waste through urine and controlling essential electrolytes such as potassium, calcium and sodium. As the kidneys stop functioning and start failing, waste builds up in the body and poisons the cat in a terminal condition called chronic renal failure (CRF). Along with excessive urinating and drinking, vomiting and nausea are common symptoms of CRF. Fortunately, several medications are available to treat the vomiting and nausea associated with CRF, improving the cat's day-to-day function and quality of life.
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H2-Antagonists
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A common symptom of CRF is an excess of gastrin, a hormone that produces acid used to break down food in the stomach. Typically, gastrin is filtered out of the body by the kidneys, but in the case of CRF, gastrin simply builds up in the body, causing nausea and vomiting. Low doses of H2-antagonists such as cimetidine and ranitidine decrease the production of stomach acid in cats. Injectable cimetidine can be prescribed by a veterinarian. Cats are usually administered doses of three to five mg per pound every six to eight hours. Ranitidine, also sold under the brand-name Zantac, is sold over-the-counter in tablet and effervescent form. The recommended dose for cats is between .25 and 1 mg per pound every eight to 12 hours.
Sucralfate
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CRF can also cause stomach and intestinal ulceration, a painful condition. Sucralfate (also sold as Carafate) helps relieve ulcers by lining affected areas of the stomach and intestines with a paste-like substance that prevents further aggravation. Although generally considered safe, sucralfate tablets can only be prescribed by a veterinarian. Sucralfate can react with other medications such as cimetidine and may cause constipation in some cats. The usual dose for a cat is about .25 to .50 gram every six to eight hours.
Anti-Emetic Drugs
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Anti-emetic drugs such as metoclopramide and chlorpromazine reduce vomiting and nausea in cats by blocking neurotransmitters such as histamine and dopamine, which trigger nausea and vomiting. Metoclopramide, known under the brand name Reglan, is available by prescription only in tablet and injectable forms. Cats usually receive about 0.1 to 0.2 mg per pound every six to eight hours. Side effects may include lethargy, constipation and an increase in frenzied behavior in cats. Chlorpromazine, also marketed as Thorazine, must also be prescribed by a veterinarian and is available in tablet, liquid, extended release capsules, rectal suppositories and injections. Chlorpromazine should be administered with caution for cats suffering from low blood pressure as the drug tends to have a mild sedative quality. Recommended dosages tend to change with severity of nausea and vomiting, cat size and method of medication administration, so check with your veterinarian before giving chlorpromazine to your cat.
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