Tucker’s Trashcan Adventures Amanda Laffoon Pharmacology and Pharmacy Fall ‘15 Tarleton State University

Table of contents: Animal history and disease/condition being treated. Tucker’s exam. What drug was prescribed to treat Tucker’s G.I. upset? How is this drug metabolized? How is this drug eliminated through the body? Was this drug used as an antagonist or agonist? Conclusion Reference

Animal History Tucker is a 3 year old castrated male wire fox terrier. Patient is UTD on all vaccines, heartworm preventative and flea/tick treatment. The owner forgot to put Tucker up in his kennel before she left for work. When owner arrived home, Tucker had knocked over the trash can and consumed expired lunch meat. The owner noticed Tucker had vomited up the lunch meat and multiple small spots of bile on the floor. Concerned about the vomiting, the owner took Tucker into be seen by the veterinarian. (Wire Fox Terrier, n.d) Trash in kitchen, n.d.)

Tucker’s Exam Weight: 16.2lbs (7.3kg) BCS: 3.5/5 TPR: 102F- Rectal, 110bpm, Panting CRT: <2sec MM: Pink, moist General appearance: QAR Skin/coat: WNL Eyes/fundic exam: WNL Ears/otoscopic exam: WNL Oral cavity: WNL Musculoskeletal: WNL Cardiovascular: WNL Gastrointestinal: Borborygmus Respiratory: WNL Genitourinary: Castrated Nervous system: WNL Tucker is quiet but alert. Owner is not aware of the last vomiting episode. No diarrhea noted. Patient is not showing signs of clinical dehydration at time of presentation. Upon auscultation of abdomen borborygmus can be heard. Upon palpation patient does not show signs of pain in abdomen. Lab work: WNL. Fecal: Stool was mucoid and soft. No parasites seen. No frank blood, no RBC on direct. WBC: 2-5/HPF. Radiographs: (R-LAT/VD) at present time show no signs of obstruction. Gas is present in small intestine.

What drug was prescribed to treat Tucker’s G.I. upset? The veterinarian prescribed Cerenia (Maropitant citrate) to control vomiting and Flagyl (metronidazole) to control any intestinal infection. (Cerenia, n.d.) (Metronidazole, n.d.)

How are these drugs metabolized? The owner is cautious about giving Tucker medications. She asks how are these drugs metabolized? The veterinarian responds with, “Cerenia is metabolized by the CYP3A enzymes. These enzymes are found in the liver and intestine (Cerenia Injectable Solution, 2012) . Hence why we checked Tucker’s labs. Not only to look for infection and dehydration but to check liver function. Flagyl is metabolized by the liver as well. Sometimes patients with decreased liver function do not metabolize this medication fast enough and it can accumulate possibly causing harm (Metronidazole, 2009). But Tucker’s labs look great! He shouldn’t have an issue metabolizing these drugs.”

How are these drugs eliminated from the body? The owner is curious how these medications leave the body? The veterinarian explains, “Cerenia is eliminated through the liver by hepatic clearance. As the drug is metabolized the drug is then broken down more by protein binding and liver enzymes geared toward eliminating the drug (Hepatic Clearance, n.d.). Small amounts can be seen eliminated in the urine and feces (Cerenia Injectable Solution, 2012) . Metronidazole is eliminated via the urinary system and some amount can be seen in the feces as well (Metronidazole, 2009).

Agonist or Antagonist. What does that mean Agonist or Antagonist? What does that mean? What class are these drugs in? Agonist- Agonist drugs mimic the effects of neurotransmitters naturally found in the human brain. There are two main categories of agonist drugs: direct-binding agonists and indirect-acting agonists (New Health Guide, 2015). Antagonist- In contrast to agonist drugs which bind to the neurotransmitters in the brain, antagonist drugs do the opposite: they block the brain’s neurotransmitters. There are two main types of antagonist drugs: direct-acting antagonists and indirect-acting antagonists (New Health Guide, 2015). Cerenia (Maropitant) is a neurokinin (NK1) receptor antagonist that blocks the pharmacological action of substance P in the central nervous system (CNS) (Cerenia Injectable Solution, 2012). Flagyl (Metronidazole)- is an antibiotic that is bactericidal against anaerobic bacteria. I can not find any information confirming whether or not this medication is agonist or antagonist (Bactericide, 2015).

Conclusion… Tucker was diagnosed with gastrointestinal upset by eating spoiled meat from the trash. If Tucker can keep his medications down and consume a prescribed gastric diet he should heal well. If the vomiting and diarrhea continue Tucker will need further diagnostic labs and hospitalization. Tucker was prescribed Cerenia 16mg tablets. One 16mg tablet once daily for five days (Cerenia for Dogs, n.d.). Flagyl 250mg tablets. One 250mg tablet once daily for five days (Metronidazole for Dogs, n.d.). A diet of Hills i/d [½ can] twice a day for five days is recommended.

References 1. Bactericide. (2015, February 6). Retrieved September 13, 2015, from https://en.wikipedia.org/wiki/Bactericide 2. Cerenia. (n.d.). Retrieved September 13, 2015, from http://www.vetsonline.com/img/cafeolix/cerenia-packshot.jpg 3. Cerenia Injectable Solution for Animal Use - Drugs.com. (2012, February 1). Retrieved September 13, 2015, from http://www.drugs.com/vet/cerenia-injectable-solution.html 4. Cerenia For Dogs | Veterinary Place. (n.d.). Retrieved September 13, 2015, from http://www.veterinaryplace.com/dog-medicine/cerenia-for-dogs/ 5. New Health Guide. (2015, September 12). Retrieved September 13, 2015, from http://www.newhealthguide.org/Agonist-Vs-Antagonist.html 6. Hepatic Clearence. (n.d.). Retrieved September 13, 2015, from http://sepia.unil.ch/pharmacology/index.php?id=64 7. Metronidazole (Professional Patient Advice) - Drugs.com. (2009). Retrieved September 13, 2015, from http://www.drugs.com/ppa/metronidazole.html 8. Metronidazole. (n.d.). Retrieved September 13, 2015, from https://tex.org/wp-content/uploads/2014/11/Metronidazole-11.jpg 9. Metronidazole For Dogs | Veterinary Place. (2015, February 17). Retrieved September 13, 2015, from http://www.veterinaryplace.com/dog-medicine/metronidazole-for-dogs/ 10.Trash in kitchen. (n.d.). Retrieved September 13, 2015, from http://www.pawsforaminute.com/wp-content/uploads/2012/02/Trash-in-Kitchen-300x224.jpg 11. Wire Fox Terrier. (n.d.). Retrieved September 13, 2015, from http://www.pets4homes.co.uk/images/classifieds/2013/04/12/276575/large/proven-wire-fox-terrier-for-stud-kc-registered-51f3968e2fb70.jpg