The Use of Cisapride in Veterinary Medicine

Cisapride Monohydrate is a drug primarily used to treat gastrointestinal motility disorders in various animal species, including dogs, cats, horses, and small mammals such as rabbits and guinea pigs. This medication is particularly effective in managing conditions like gastro-oesophageal reflux, chronic constipation, and other motility-related issues that prevent the smooth movement of food through the digestive system.

In dogs and cats, Cisapride is commonly prescribed for treating conditions like megaoesophagus, which causes the oesophagus to lose its ability to move food into the stomach. For cats, it is also used to manage idiopathic constipation and megacolon, where the colon becomes enlarged and inefficient at moving waste. Horses may benefit from Cisapride for treating equine colic or postoperative ileus, while in small mammals, it helps with stasis-related disorders where the gastrointestinal system slows down or stops functioning.

While Cisapride Monohydrate is not specifically licensed for veterinary use in the UK, it is often prescribed by veterinarians under the 'cascade' when no suitable licensed veterinary product is available. This system allows vets to prescribe human medications for animals if it is in their best interest, ensuring that the pet receives the necessary treatment even when veterinary-specific drugs are not an option.

Why Vets Prescribe Cisapride Monohydrate and Important Considerations Before Prescription

Veterinarians may find it necessary to prescribe Cisapride Monohydrate when an animal is suffering from a condition that significantly impairs its quality of life and when other treatments have proven ineffective. For example, in cases where a cat with megacolon does not respond to dietary changes or other medications, Cisapride can offer a solution by enhancing the motility of the gastrointestinal tract and facilitating bowel movements.

Before prescribing Cisapride Monohydrate, several critical considerations need to be made. Firstly, the vet must evaluate the animal's overall health, as Cisapride can interact with other medications and may not be suitable for animals with certain pre-existing conditions, such as heart disease. Furthermore, the vet must comply with the Veterinary Medicines Directorate (VMD) regulations in the UK, particularly when using the cascade. This involves ensuring that the use of the drug is justified and that no suitable licensed alternative exists. The vet must also provide the pet owner with clear instructions on how to administer the drug, including the correct dosage and the importance of adhering to the prescribed course of treatment.

In the UK, Cisapride Monohydrate can be prescribed under strict conditions due to its classification as a human medicine. The two most common dosages available for veterinary use are 2.5mg and 5mg tablets, which can be adjusted depending on the size and needs of the animal. The prescription of such a drug must be carefully considered, with the vet taking into account the animal's specific condition, weight, and any potential risks.

Can I Buy Cisapride Online in the UK?

As Cisapride is not licenced for veterinary use and lacks the VMD's authorisation for online marketing, then the short answer is "no". However, it is legal for a qualified vet to prescribe and supply such unlicenced medication on an ad hoc basis where all of the previously mentioned precautions and requirements have been met. Please complete the form below if you require further clarification on the supply of Cisapride.

Benefits of Cisapride Monohydrate for Pets

The primary benefit of prescribing Cisapride Monohydrate to pets is its ability to restore normal gastrointestinal motility, thereby alleviating symptoms associated with motility disorders. For animals suffering from chronic constipation, megaoesophagus, or other similar conditions, Cisapride can significantly improve their quality of life by easing the passage of food and waste through the digestive system. This can lead to better overall health, increased comfort, and a reduction in the need for more invasive treatments or surgeries.

For cats, in particular, Cisapride has been shown to be highly effective in managing idiopathic megacolon, a condition that can otherwise lead to severe discomfort and potentially life-threatening complications. In dogs, it can help manage gastro-oesophageal reflux, reducing symptoms like vomiting and regurgitation. Horses and small mammals may also benefit from the drug, especially in cases where traditional treatments have failed to stimulate gastrointestinal motility.

Potential Side Effects of Cisapride Monohydrate

While Cisapride Monohydrate can be highly effective, it is not without potential side effects, which can vary depending on the species.

• Dogs: Potential side effects in dogs include diarrhoea, abdominal pain, and changes in heart rhythm. Dogs with pre-existing cardiac conditions may be at a higher risk of adverse reactions, and any signs of distress should be reported to the vet immediately.
• Cats: In cats, side effects are generally mild but can include diarrhoea, vomiting, and lethargy. Cats with underlying heart conditions are also at risk of cardiac side effects, so close monitoring is necessary.
• Horses: Horses may experience colic-like symptoms, such as abdominal pain and diarrhoea. Due to their size and sensitivity, horses require careful dosage management, and any unusual behaviour should be closely monitored.
• Small Mammals: In rabbits, guinea pigs, and other small mammals, side effects might include diarrhoea, bloating, or a reduction in appetite. Given their small size, even minor side effects can quickly become severe, so pet owners should be vigilant and consult their vet if any adverse symptoms occur.

The Importance of Veterinary Supervision

Veterinarians take the prescription of drugs like Cisapride Monohydrate very seriously, understanding the importance of weighing the potential benefits against the risks. Such medications are prescribed only when absolutely necessary and when the vet is confident that it will significantly improve the animal's condition. Pet owners can trust that their vet has carefully considered all factors before recommending Cisapride and will provide guidance on how to monitor their pet while on the medication.

More Questions? Contact Our Vet

If you have any further questions about the use of Cisapride Monohydrate for your pet, please do not hesitate to contact our vet directly using the form provided below. Please note that in order to assist you with the best and safest treatment of your pet we will almost certainly need to speak to the prescribing vet, i.e. your own vet. Your vet is the best resource for advice tailored to your pet's specific needs and can help us to ensure that your furry friend receives the best possible care.

Nick Horniman MRCVS