Vomiting is a nonspecific clinical sign that could be attributed to many different underlying diseases. Common GI diseases include foreign bodies, gastroenteritis, inflammatory bowel disease, neoplasia, parasitism, and canine parvovirus. Common non-GI diseases include hypoadrenocorticism, hyperthyroidism, kidney disease, liver disease, and pancreatitis. Toxins (eg, lead) and medications (eg, digoxin, chemotherapies) may also cause vomiting.
Stopping vomiting addresses the patient's immediate physical needs while identifying and treating the specific underlying cause. The unique mechanism of action of CERENIA® (maropitant citrate) effectively manages vomiting regardless of the underlying cause.
Mechanism of Canine Vomiting
Stimuli travel through one or more pathways to converge within the emetic center. For example, stimuli within the circulation (such as toxins retained by diseased kidneys) are initially carried to the CRTZ via the peripheral indirect pathway, but ultimately end within the emetic center. Alternatively, the peripheral direct pathway carries stimuli from diseased abdominal organs right to the emetic center. The emetic center also directly receives stimuli that induce vomiting from the higher brain via the central pathway. The CRTZ likewise receives stimuli from the vestibular apparatus, which underlies vomiting due to motion sickness.
Once the emetic center and CRTZ receive these stimuli, substance P is released and binds to NK1 receptors within the emetic center and CRTZ. This interaction induces efferent nerve impulses to the abdominal muscles and diaphragm to start the vomiting reflex.
Maropitant is a neurokinin (NK1) receptor antagonist that blocks the binding of the endogenous ligand substance P to NK1 receptors. NK1 receptors are densely distributed within the emetic center and maropitant acts to directly inhibit vomiting by blocking substance P binding at these NK1 receptors in the CNS.
Understanding the Mechanism of Action Behind CERENIA
- Targets NK-1 receptors in the chemoreceptor trigger zone (CRTZ) and emetic center, where all vomiting stimuli converge3,4
- Inhibits binding of Substance P4,5
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Important Safety Information
The safe use of CERENIA has not been evaluated in dogs or cats used for breeding, or in pregnant or lactating bitches or queens. The safe use of CERENIA has not been evaluated in patients with gastrointestinal obstruction, or patients that have ingested toxins. Use with caution in patients with hepatic dysfunction. CERENIA Injectable is recommended for dogs 8 weeks and older for prevention and treatment of acute vomiting and for cats 16 weeks and older for the treatment of vomiting. CERENIA Tablets are recommended for dogs 8 weeks and older for prevention of acute vomiting and for dogs 16 weeks and older for prevention of vomiting due to motion sickness. The most common side effects seen in dogs and cats administered CERENIA are pain/vocalization (injectable), depression/lethargy, anorexia, anaphylaxis, ataxia, convulsions, and hypersalivation, and vomiting.
- Reglan® (metoclopramide): Package Insert.
- Plumb DC. Plumb’s Veterinary Drug Handbook. 5th ed. Ames, Iowa: Blackwell Publishing Professional; 2005: 519-521.
- Washabau RJ, Elie MS. Antiemetic Therapy. In: Kirk RW, Bonagura JD, eds. Kirk’s Current Veterinary Therapy XII Small Animal Practice. Philadelphia: WB Saunders; 1995:679-684.
- Quartara L, Maggi CA. The tachykinin NK1 Receptor. Part II: Distribution and pathophysiological roles. Neuropeptides 1998;32:1-49.
- Gardner CJ, Armour DR, Beattie DT, et al. GR205171: A novel antagonist with high affinity for the tachykinin NK1 receptor, a potent broad spectrum anti-emetic activity. Reg Peptides 1996;65:45-53.
CERENIA is a registered trademark of Zoetis Inc. © 2012 Zoetis Inc. All rights reserved. May 2012 CER0512075