Metoclopramide (Reglan): Cat Kidney Disease Glossary

Metoclopramide is a "pro kinetic" medication used to treat vomiting and motility disorders. In the Chronic Kidney Disease (CKD) cat, it occupies a specific niche for cats whose nausea is caused by a stomach that refuses to empty.

The "Plunger" Effect (Motility) Unlike other anti emetics that primarily work on the brain, Metoclopramide works mechanically on the gut.

The Action: It tightens the muscle at the top of the stomach (preventing reflux) and relaxes the muscle at the bottom (pylorus). Simultaneously, it stimulates the stomach muscles to contract.
The Result: It forces stomach contents down into the intestines like a one way street. This is vital for CKD cats suffering from Gastroparesis (stomach paralysis), where food sits in the stomach for hours, eventually leading to vomiting undigested food.

The Central Effect It also works in the brain.

Dopamine Blockade: It blocks dopamine receptors in the Chemoreceptor Trigger Zone (CRTZ). This helps dampen the nausea signal caused by uremic toxins floating in the blood.
Potency: While helpful, it is generally considered less potent against severe uremic nausea than Zofran (Ondansetron) or Cerenia (Maropitant).

The Danger Zone (Obstruction) There is one absolute rule with this drug.

Contraindication: You must never give Metoclopramide if there is any suspicion of a physical blockage (like a hairball or foreign object) in the intestines.
The Risk: Because the drug forces the stomach to contract, pushing against a blockage can cause the intestine to rupture (perforation).

Side Effects: The "Frenzy" Metoclopramide crosses the blood brain barrier and can affect dopamine levels in the brain.

Behavioral Change: A rare but distressing side effect is "mentation changes." The cat may become hyperactive, aggressive, or disoriented (frenzied).
Resolution: These symptoms typically stop once the drug wears off, but it usually means the cat cannot take this medication again.

Usage

Forms: Available as pills, syrup, or injection.
CRI: In the hospital, it is often given as a Constant Rate Infusion (CRI) alongside IV fluids to keep the gut moving continuously during a uremic crisis.

Disclaimer: This content is for educational purposes only and does not constitute veterinary medical advice. Always consult with your primary care veterinarian or a veterinary internal medicine specialist regarding your cat’s specific condition.

The "Plunger" Effect (Motility) Unlike other anti emetics that primarily work on the brain, Metoclopramide works mechanically on the gut.

The Action: It tightens the muscle at the top of the stomach (preventing reflux) and relaxes the muscle at the bottom (pylorus). Simultaneously, it stimulates the stomach muscles to contract.
The Result: It forces stomach contents down into the intestines like a one way street. This is vital for CKD cats suffering from Gastroparesis (stomach paralysis), where food sits in the stomach for hours, eventually leading to vomiting undigested food.

The Central Effect It also works in the brain.

Dopamine Blockade: It blocks dopamine receptors in the Chemoreceptor Trigger Zone (CRTZ). This helps dampen the nausea signal caused by uremic toxins floating in the blood.
Potency: While helpful, it is generally considered less potent against severe uremic nausea than Zofran (Ondansetron) or Cerenia (Maropitant).

The Danger Zone (Obstruction) There is one absolute rule with this drug.

Contraindication: You must never give Metoclopramide if there is any suspicion of a physical blockage (like a hairball or foreign object) in the intestines.
The Risk: Because the drug forces the stomach to contract, pushing against a blockage can cause the intestine to rupture (perforation).

Side Effects: The "Frenzy" Metoclopramide crosses the blood brain barrier and can affect dopamine levels in the brain.

Behavioral Change: A rare but distressing side effect is "mentation changes." The cat may become hyperactive, aggressive, or disoriented (frenzied).
Resolution: These symptoms typically stop once the drug wears off, but it usually means the cat cannot take this medication again.

Usage

Forms: Available as pills, syrup, or injection.
CRI: In the hospital, it is often given as a Constant Rate Infusion (CRI) alongside IV fluids to keep the gut moving continuously during a uremic crisis.