Ondansetron in dogs with nausea associated with vestibular disease: A double-blinded, randomized placebo-controlled crossover study

Henze, Lea; Foth, Sarah; Meller, Sebastian; Twele, Friederike; Charalambous, Marios; Kenward, Hannah; Elliott, Jonathan; Pelligand, Ludovic; Volk, Holger

Abstract

Background: Nausea and emesis can be, among other signs, common manifestations
of acute vestibular system dysfunction in dogs. Currently, antiemetic drugs, such as
maropitant and metoclopramide, are used commonly, but do not appear to control
nausea. A non-placebo-controlled preliminary study suggested good efficacy of 5-
HT3-receptor antagonists, such as ondansetron, against nausea in dogs with vestibular
syndrome.
Objectives: To assess and confirm the effect of ondansetron on behavior suggestive
of nausea in dogs with vestibular syndrome.
Animals: Fourteen dogs with vestibular syndrome and clinical signs of nausea presented
to a neurology service.
Methods: Placebo-controlled, double-blinded, crossover study. Behavioral assessment
was performed hourly for 4 hours using an established numerical rating scale.
The criteria salivation, lip licking, vocalization, restlessness, lethargy, and general nausea
were scored. The occurrence of emesis was recorded. After scoring at T0 (predose)
and T2 (2 hours post-dose) either ondansetron (0.5 mg/kg) or placebo was
injected IV. Two hours post-dose, treatments were switched. Blood samples were
collected to measure serum arginine vasopressin (AVP) concentration, which previously
has been shown to correlate with clinical signs of nausea.
Results: Clinical resolution of nausea was observed 1 hour after administration of
ondansetron, whereas serum AVP concentration decreased 4 hours after ondansetron
administration.
Conclusion and Clinical Importance: Administration of ondansetron IV is beneficial
for dogs with nausea secondary to acute vestibular syndrome. Ondansetron substantially
and rapidly decreased clinical signs of nausea behavior and stopped emesis.

Citation

Henze, L., Foth, S., Meller, S., Twele, F., Charalambous, M., Kenward, H., …Volk, H. (2022). Ondansetron in dogs with nausea associated with vestibular disease: A double-blinded, randomized placebo-controlled crossover study. Journal of Veterinary Internal Medicine, https://doi.org/10.1111/jvim.16504

• Journal Article Type: Article
• Acceptance Date: Jul 17, 2022
• Online Publication Date: Jul 30, 2022
• Publication Date: Jul 30, 2022
• Deposit Date: Aug 2, 2022
• Publicly Available Date: Aug 2, 2022
• Journal: Journal of Veterinary Internal Medicine
• Print ISSN: 0891-6640
• Publisher: Wiley Open Access
• Peer Reviewed: Peer Reviewed
• DOI: https://doi.org/10.1111/jvim.16504