Cisapride Use in Cats

Cisapride is useful in treating may gastrointestinal problems in cats

In July 1993 a drug called cisapride was approved in human medicine for treating gastroesophageal reflux in humans. In January of 2000, cisapride was removed from the United States market by the FDA after reports of cardiac side effects such as rapid and irregular heart rate. In veterinary medicine there were never any such cardiovascular effects seen. The drug was extremely helpful in treating many gastrointestinal disorders so it continued to be used, primarily in cats.

Cisapride is very effective in treating certain types of constipation in cats, such as constipation due to hairballs and constipation in cats with a condition called megacolon. Megacolon is a condition where a certain part of the intestine gets dilated causing its regular motion (called peristalsis) to become somewhat paralyzed. Cisapride is also used for gastrointestinal reflux as well as a condition called postoperative ileus.

The positive effects seen from cisapride in cats include accelerated gastric emptying of both liquids and solids, and a decrease in transit time. Although there is another drug called metoclopramide that can be used for similar conditions, cisapride is more potent and has a broader range of activity for many conditions. Cisapride also has much less of an effect on the central nervous system because it does not so readily cross the blood-brain barrier. The blood-brain barrier is one of those very important and regularly studied terms in pharmacy school that signifies whether a certain drug has any effect on the central nervous system or it does not.

Since cisapride has been discontinued in human medicine, the pharmaceutical company that used to market it under the trade name “Propulsid” has decided to stop making it available. For a while this medication was not available in any form. After the realization that this drug was extremely useful in veterinary medicine, certain compound pharmacies were fortunately able to make cisapride available to the millions of suffering pets that have benefited from using it. Cisapride has been considered a ‘miracle drug’ for many pet owners who have continuously watched their pets suffer from certain gastrointestinal conditions.

It is extremely important to watch the dose of cisapride and to make sure the pet does not get a higher dose than that prescribed by the veterinarian. Animals with liver disease may also need to have their dose reduced in order to reduce the chances of bad side effects. Cisapride also has many drug interactions because for one it accelerates the time that certain other drugs pass through the intestines therefore possibly affecting absorption. Other drug interactions include many of the anti-fungal drugs such as ketoconazole, itraconazole, and miconazole. Using this medication along with these anti-fungals has the potential of causing very dangerous ventricular arrhythmias. Cisapride may increase the rate of absorption of cimetidine, ranitidine, and may increase the effects of certain anticoagulants. Other possible adverse reactions and interactions have occurred.

It is important to stay in close contact with your veterinarian and discuss any medications your pets may be taking along with any observed adverse effects seen after administering the drug. A close relationship with the veterinarian is one of the best ways to get the most benefit of any treatment while still managing the dangerous bad effects. Your 1800PetMeds pharmacist is also available to answer any of your medication related questions. When dealing with medication such as cisapride it is so important not to leave any of the questions you have unanswered.

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36 Comments

  1. Hello,
    I have a cat from 10 years. She have many constipation problems. My veterinary said that CISAPRIDE could be the solution but in france (europe) we can’t buy it. Is it possible to place oder if I send you a prescription from my vet.
    Please I appreciate to receive an answer soon

  2. Hello,
    I have a 10 years old cat who have big constipation problems. My vet said that cisapride could be the solution for her problem but I live in france (europe) and I can not buy it here. Is it possible to place order if y send you the prescription from my vet.
    Please y will appreciate an answer from you soon.

  3. Dr. Michael Dym, VMD veterinarianAugust 14, 2013 at 6:56 pm

    I would check with 1800petmeds pharmacist Eddie.

  4. Dr. Michael Dym, VMD veterinarianAugust 14, 2013 at 6:56 pm

    Answered above.

  5. Hi,
    We will be able to send you the medication as long as a veterinarian examines your cat and writes a prescription. If you would like, you can place the order online and then email me your customer number, pet name, address, your phone number and your email address. Also If you include your veterinarian’s phone number I will call and hopefully be able to get the prescription over the telephone.
    My email address is ekhoriaty@1800petmeds.com
    Phone number: (888) 738-6331 ext: 8209

    Hoping to hear from you soon,
    Eddie Khoriaty RPh

  6. Hi, I have a cat who has been on cisapride for around two years. The liquid compounded form is fairly expensive, can I use the capsule form and put the cisapride into the gravy of her food? She won’t take pills. Also, is it true that compounded liquid cisapride only has a 14 day shelf life?
    Thank you, and thank you for the informative article.

  7. Dr. Michael Dym, VMD veterinarianFebruary 3, 2014 at 11:58 pm

    I am not sure about compounded cisapride having shortened half life. I see no problem putting the capsule form into her food.

  8. Thanks again, Doctor. You saved me some money since I can now try the capsules.

  9. I have a cat that will eat a lot of her food (dry) and then we will find she has vomited a huge pile of non digested food. Any suggestions? We have changed food several times and since we have five cats we have to be careful because they all eat out of the same dishes. The brand food we are using is Professional Adult Cat Complete formula. Thank you so much. Deidre

  10. Dr. Michael Dym, VMD veterinarianApril 26, 2014 at 3:51 pm

    I would have vet check to make sure no underlying medical issues in your kitty. You could try pepcid AC at dose of 5 mg twice daily but a vet check is recommended.

  11. I have a 2 1/2 year old cat a rescue at 6 months I adopted from the shelter. His symptoms started about a year after adoption….projectile vomiting…vet put him on hills science diet I.D. And reglan. But reglan wasn’t strong enough so his life consists of 1 can I.D. In small amounts through out the day and Cisapride 2.5 mg twice a day and it has been 3 months and the longest he has gone with out vomiting is three weeks but it is no longer projectile…he gets no foods that are crunchy. I am now documenting everything he has been
    X rayed and had a ultra sound but the vet doesn’t see a reason to scope him. He also has gingivitis and horrible breath….Oliver is a sweet and loving cat very active and playful…any ideas?

  12. Dr. Michael Dym, VMD veterinarianOctober 5, 2014 at 2:35 pm

    Ultrasounds can be totally normal in cats with inflammatory bowel disease(IBD) I would proceed with a scope and biopsies or surgical biopsies. HE may need prednisone or other immune suppressive meds if he has IBD

  13. My young cat (1 1/2 years) as a previous stray suffered a pelvic fracture a year ago He recovered well from it but suffers from constipation off and on. The vet recently prescribed cisapride for him at 1 ml every 8 to 12 hours with his food. This was after he needed two enemas. Is Cisapride considered a preventative of constipation? In other words is it a life-long twice a day ritual now? We had been mixing a 1/4 teaspoon of Miralax with his food AM and PM. We offer him re-hydrated Primal and Stella and Chewy’s because the of the ability to add more water that doubles as broth to make sure he gets enough of that.

    I wonder if I should move him back to straight canned food (which doesn’t interest him since he loves the re-hydrated freeze dried meals). The freeze dried food has ground bone for the calcium and I wonder if it is too much for a cat with his tendency and past injury.

    Also

  14. Dr. Michael Dym, VMD veterinarianOctober 26, 2014 at 8:17 pm

    I would stick with dehydrated primal and/or stella and chewys…. the cisapride may need to be used chronically because of the fracture and scar tissue. You could also add 1/4 teaspoon of psyllium husks to meals as well as wheat bran which may help as well.

  15. I have a 14 year old Maine Coon diagnosed with mega colon 3 months ago. He is administered cisapride 2.5 three times a day along with a liquid stool softener. For the last two days the cat has not tolerated two doses. Once at his 11:00 pm dosage and the following day’s second dosage. He has thrown up the pill in a liquid form. Nothing appears mixed with the medicine (food, hair, etc.), He does not appear sick but I’m wondering why this is occurring. Any suggestions?

  16. Hi, my cat is on Cisapride 2.5 mg every 12 hours and we are very faithful with the 10 am and 10 pm. He can’t eat dry food or any treats..I give him Hills prescription diet I.D. And so far the longest he has gone without vomiting was 2 1/2 months and when he vomited it was lime green. Just liquid. My cat is petite and weighs 8 pounds….sometimes he will sleep all day and not eat until night -equal to about a half can all day. Other days he eats 1 1/2 cans.

  17. Thank you for the information. The two times our cat vomited was a lime green liquid substance. The pill form of Cisapride is green. He also was eating Science Diet Hair Ball control at the time. He mostly eats wet Science Diet but will occasionally sneak from the other cat’s bowl. I will make sure the dry cat food is not available. Hope it helps. Thanks again!

  18. Dr. Michael Dym, VMD veterinarianDecember 6, 2014 at 7:07 pm

    HI Nancy. May be worthwhile to ask your vet about an exact diagnosis of why your cat is vomiting. Many cats have underlying metabolic issues like liver or pancreatic issues like pancreatitis, as well as possibly inflammatory bowel disease, which is treated with more specific meds and diet than just cisapride.

  19. Dr. Michael Dym, VMD veterinarianDecember 6, 2014 at 7:08 pm

    Some cats with megacolon will vomit if they get quite backed up with stool. You could try giving hime pepcid AC at dose of 5 mg twice daily. If problem persists, best to see your vet for recheck.

  20. My vet said that it is normal for cats to vomit…my cat cannot even have real solid food! No treats because he would vomit anything back up. He eats a very strict diet of Hills prescription diet canned food and boiled chicken minced. I have a German Shepherd and if he doesn’t eat all of his food I have to cover it or the cat will get into it.
    Should I have the doctor do blood work on my cat? I believe the only reason he vomits much less often is because I got my Reiki 1 certificate and I offer Reiki to him – I know it isn’t medical that I am doing but I do believe it helps in some way. Thank you for taking the time to write. Oliver is an excellent kitty, thin and strong – most awesome cat

  21. Dr Dym, Oliver doesn’t have that kind of problem. My sister and I clean the litter box 2-3 times a day…Oliver refuses to use a used litterbox! He meows and demands and for months I documented everything about him – like a case study. He rarely drinks water, excellent mouser. Could gingivitis cause this problem?
    Again thank you.

    Nancy

  22. Dr. Michael Dym, VMD veterinarianDecember 25, 2014 at 10:25 am

    I dont think gingivitis the issue here

  23. Dr. Michael Dym, VMD veterinarianDecember 25, 2014 at 10:28 am

    Hi NAncy. Given your holistic slant, I would recommend consulting with a more holistic/homeopathic veterinarian like myself, who work with people across the country on raising the health of pets naturally. I am not fan of those prescription diets, as they lead to other issues when eaten long term. Blood work never a bad idea, but learn more about constitutional classical homeopathy by seeing the booklet on the website http://www.beyondflatearth.com as well as the information on my website http://www.doctordym.com Many of us do offer phone consultations. I also highly recommend the books The Natural Cat by Anitra Frazier, as well as Dr PItcairn’s guide to natural health for dogs and cats by Richard Pitcairn, DVM, phd Let me know if anything else I can do to help.

  24. My cat seems to be getting worse instead of better. He has vomited 4 times this month including today and the only food he gets is Hills Prescription I.D. Can…I am afraid there is no cure for him. he sleeps under blankets for hours at a time – he doesn’t go off by himself he wants to be with us – other times he is running around howling up and down the stairs. His stools are not normal anymore and sometimes his ribs wing out…this is all I have noticed. The other times he is the most loving and affectionate cat – most cats don’t care if you are around or not very independent but my cat is not at all like any cat I’ve ever known. I took animal reiki last month and he wants reiki all the time but if what he needs is a doctor – I told the doctor on the 24 th and she called back and said she will have to think on it and call us again today – the 26th of December she may want to increase meds –

  25. Dr. Michael Dym, VMD veterinarianJanuary 7, 2015 at 11:21 am

    Given your interest in Reiki, I would consider consultation with a veterinarian trained in classical constitutional homeopathy. To learn more and find one go to http://www.drpitcairn.com as well as see my website http://www.doctordym.com

  26. My 16 yr old maincoon was diagnosed with gastric immobility complete bloodwork normal done 2x in a yr. cisipride 2x daily with Pepcid ac 5mg 2x daily. She stopped vomiting for 5months than started a few times a week again. Everything else is normal. This week she has vomited almost everyday 1x. Vet said next step ultrasound or endoscopy. I have reservations about anesthesia at 16 & endoscopy can make things worse. What is your opinion.

  27. Dr. Michael Dym, VMD veterinarianMarch 24, 2015 at 12:14 am

    I would go for ultrasound first over endoscopy and anesthesia, and based on ultrasound, incorporate some form of presumptive treatment. I would only use endoscopy and biopsy as last resort

  28. I have a cat that I’m having trouble with being constipated and vomiting. I took him to the vet and he said no dry food and to give him a dulcolax pill everyday and he wrote me prescriptions for cisapride and lactulouse. My question is will these cause a runny stool because we are having problems with him using the litter box because of these issues?

  29. Do you know of or could you help find any cisapride suppliers in Asia? Because it is very difficult to find in Malaysia and stock is limited. My cat is taking it and has improved drastically. Poops daily. thank you very much

  30. Cisapride was a godsend for my cat with hypertrophic cardiomyopathy. He was having semi-annual enemas until the vet recommended cisapride several years ago. Though it sometimes causes diarrhea when he can’t always get to one of our multiple litter boxes, the occasional clean-up is a lot easier to deal with than a trip to the vet for another enema. He used to really struggle to eliminate, now it comes easy (even if occasionally too easy!). Yes, it’s expensive, but to see our HCM cat enjoying his now senior years instead of suffering with constipation, I would say it’s worth it.

  31. can someone help me? can prednisolone and cisapride be given together to a cat

  32. Is it still save to give cisapride to a cat? Is it better to give mosapride instead of cisapride?

  33. Stella and Chewy’s is what aggravates the constipation. My cat became seriously blocked when I fed Natures Variety canned and Stella and Chewy’s freeze-dried rehydrated. It’s concrete in the bowel. There is too much bone in these products.

    My cat is doing much better on high moisture canned food. I’ve been feeding him Tikki cat beef and chicken, grain free, and adding Miralax and more water. Also drink’s organic goat’s milk. He does not drink water at all.

    I switched him to raw at one point and he blocked up again.

  34. My 15 year old femaie cat named Xena has been on cisapride mg tablet and 1ml ratio-lactulose every 12 hours for the last 2months. She has severe constipation and 90% kidney failure — no vomiting. She was taken off Royal Canin fibre response which helped her for many years — now she is just on vet renal support canned wet food. She is loosing weight and is still forcing on the litter box. I am afraid if something doesnt change that she will suffer too much and i will have to put her down. Can you help please. thank you

  35. Sharman, Kidney failute is irreversible in every animal. 🙁 dialysis is an option but…that won’t save them. 🙁 I’m really sorry to hear that.

  36. My little Houtan is on Cisapride 5mg, 0.5ml 2x a day for Mega colon and constipation. Last check up also showed some Renal Failure so we have altered his diet, and have him on 0.2ml of Benazepril 2x a day. With this we give him 2 small scoops of Aventi in his food. Both Meds are liquid and mix into his food too. We add different Meds at different times through out the day. We used to use Mirilax for last few years with good results, until it stopped working. BMs were getting further apart. The new Meds are working fine, until he started becoming Fecal incontinent, (much to his mortification) We don’t make a big deal of it. So question is, could he be on too high a does of Cisapride. It for motility after all. I also worry that with food passing through faster is he getting enough Nutrition? Can I safely lower the dose 0.1 ml.? Thank you

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