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Treatment for gastrointestinal stasis in rabbits - is metoclopramide or ranitidine better?

Clinical Scenario

One of your clients, Ms Harris, presents her British Giant rabbit Stacey to the clinic as she is concerned about her being off her food and not defaecating in the past 12 hours.  You take a full history from Ms Harris, examine Stacey and diagnose gastrointestinal stasis, and amongst other recommendations, advise the use of a motility modifying agent.  You usually use metoclopramide, but whilst dispensing in the clinic pharmacy you discover that only ranitidine is available.  You wonder if ranitidine works just as well as metoclopramide in terms of shortening the time it takes for normal defaecation to occur....

3-Part Question (PICO)

In [pet rabbits with gastrointestinal stasis] does [treatment with metoclopramide versus ranitidine] result in a more rapid [time to resolution of clinical signs]?

Search Strategy and Summary of Evidence

Search Strategy

MEDLINE(R) In-Process & Other Non-Indexed Citations and MEDLINE(R) 1946 to Present using the OVID interface

(rabbit.mp. OR rabbits.mp. OR lapine.mp. OR Oryctolagus.mp. OR exp Rabbits/)

AND

(bloat.mp. OR bloating.mp. OR ileus.mp. OR gut stasis.mp. OR intestinal stasis.mp. OR gastric stasis.mp. OR GI stasis.mp. OR exp Ileus/)

AND

(metoclopramide.mp. OR reglan.mp. OR MCP.mp. OR primperan.mp. OR maxolon.mp. OR metomotyl.mp. OR ranitidine.mp. OR zantac.mp. OR ranicalm.mp. OR ranisan.mp. OR ranitidina.mp. OR GI stimulant.mp. OR gastrointestinal stimulant.mp. OR prokinetic.mp. OR exp Metoclopramide/ OR exp Ranitidine/)

CAB Abstracts 1910 to Present using the OVID interface

(rabbit.mp. OR rabbits.mp. OR lapine.mp. OR Oryctolagus.mp. OR exp rabbits/ OR exp oryctolagus cuniculus/)

AND

(bloat.mp. OR bloating.mp. OR ileus.mp. OR gut stasis.mp. OR intestinal stasis.mp. OR gastric stasis.mp. OR GI stasis.mp. OR exp bloat/)

AND

(metoclopramide.mp. OR reglan.mp. OR MCP.mp. OR primperan.mp. OR maxolon.mp. OR metomotyl.mp. OR ranitidine.mp. OR zantac.mp. OR ranicalm.mp. OR ranisan.mp. OR ranitidina.mp. OR GI stimulant.mp. OR gastrointestinal stimulant.mp. OR prokinetic.mp. OR exp metoclopramide/ OR exp ranitidine bismuth citrate/)

Search Outcome

MEDLINE

  • 3 papers found in MEDLINE search
  • 2 papers excluded as they don't meet the PICO question
  • 0 papers excluded as they are in a foreign language
  • 1 papers excluded as they are review articles/in vitro research/conference proceedings
  • 0 total relevant papers from MEDLINE

CAB Abstracts

  • 4 papers found in CAB search
  • 2 papers excluded as they don't meet the PICO question
  • 0 papers excluded as they are in a foreign language
  • 2 papers excluded as they are review articles/in vitro research/conference proceedings
  • 0 total relevant papers from CAB

Total relevant papers

0 relevant papers from both MEDLINE and CAB Abstracts

Summary of Evidence

No Summary of Evidence yet.

Comments

At present, no peer-reviewed evidence is available to directly answer this BET question. Good quality research is needed to investigate the use of metoclopramide and ranitidine in rabbits with gastrointestinal stasis.  Whilst neither of these treatments are licensed for use in the rabbit species in the UK, both anecdotally appear to be commonly used for this purpose by vets.  UK-based practitioners should follow the veterinary cascade when making treatment decisions around these products.

Other forms of evidence, such as expert opinion pieces, textbooks and reputable online resources can be of assistance when deciding what the best course of action is.  However, as these forms of evidence tend to be generated in a less robust way, an awareness of the biases associated with these sources will be important.

Bottom line

No peer-reviewed evidence was found to compare the efficacy of metoclopramide and ranitine for treating gastrointestinal stasis in rabbits.

The approach used should be based on veterinarian preference, in-depth discussions with the owner about the treatment risks and benefits, and local guidelines if they exist.

Disclaimer

The BETs on this website are a summary of the evidence found on a topic and are not clinical guidelines. It is the responsibility of the individual veterinary surgeon to ensure appropriate decisions are made based on the specific circumstances of patients under their care, taking into account other factors such as local licensing regulations. Read small print

References

About this BET

First author:
Katriona Bradley
Second author:
Marnie Brennan
Institution:

Tai Wai Small Animal and Exotic Hospital, Hong Kong

CEVM, University of Nottingham

Search last performed:
2018-06-14 13:17:26
Original publication date:
2018-06-29 13:17:26
Last updated:
2018-06-26 13:17:26
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