From:
<grape_apes@charter.net>
Date: 2006-10-26 16:03:21 UTC
Subject: [ferrethealth] 1. Carafate 2. Cholangeohepatitis treatment starting
To: ferrethealth@smartgroups.com
""Isn't it usually Carafate, Flagyl & Amoxi for treatment of ulcers? And
I believe the reason you give the Carafate at least one hour before meds
is that it will block the absorption of the meds. "
The reason Carafate/sucralfate is given some time prior to other meds and food (preferences seem to vary, but we usually say a minimum of 20-30 minutes prior to ingesting other oral meds or food at our clinic) is to give it a chance to coat the GI tract and __adhere to__ (kind of "cover") any ulcers; this reduces irritation of an already irritated area and reduces discomfort and pain for the pet when they ingest the food and other meds. (Carafate itself is only minimally absorbed in the GI tract, and it has local effects, not really systemic ones.) Simply put, Carafate sticks to the ulcers and helps keep other things out of the ulcers and protects them from further irritation and damage. This gives them a better chance to heal.
Carafate can be used without the Flagyl and Amoxi; Flagyl is also commonly used to help resolve diarrhea caused by a number of agents (parasites, bacterial infections, etc), and amoxi and flagyl both help counteract any bacterial/microbial infective agents. The Carafate/sucralfate is not always used in conjunction with the other two, though this is certainly a common ferret GI cocktail. Pepcid is also a common component here, and also can benefit animals with GI upset.
As an example, my ferrets usually preemptively get at peast the pepcid after any surgery to help ward off GI upset from stress. Sucralfate is in Daisy's regimen now after her second adrenalectomy-she also has cholangeohepatitis (probably secondary to last year's biliary duct obstruction and resection), crappy kidneys, insulinoma, and some other minor stuff. She eats like a champ, though, and the sucralfate helps keep it that way-she was tooth grinding a bit while eating postop, and so we added the sucralfate to her regimen and then ended up bumping her pepcid up to Prilosec (omeprazole) instead, with better effect.
Incidentally, if there are any others looking for cholangeohepatitis info (this happens to pertain to one with bilateral adrenalectomies who really needs to stay on the florinef/fludrocortisone b/c she crashes without it; she is also on pred b/c her insulinoma kicks in without it, and she is also post-partial pancreatectomy):
We are starting Daisy on a protocol that will continue her on 0.1mg prednisone BID (we will likely be switching to prednisolone because of her liver), 0.025mg fludrocortisone/florinef once a day; Prilosec/omeprazole 1mg once a day; sucralfate/Carafate 75mg BID to TID.
We will be adding Denosyl (SAM-E) and a Clavamox taper-I'll email the doses and durations for these when I have it in front of me, but the Denosyl will be once a day for life for her liver, and the Clavamox is a taper over a few weeks.
I'll let everyone know how her bloodwork changes after these medication trials and if this helps.
Best,
April AC (vet tech, not a vet, and I don't claim to know everything... :) )
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