Advice for Treating Common Motility Disorders

What are some common motility disorders in veterinary patients? Albert Jergens, DVM, MS, PhD, DACVIM (SAIM), professor at the Iowa State University College of Veterinary Medicine, explains what practitioners need to know.

"Probably the most common motility disturbance that we all appreciate is megaesophagus or esophageal abnormalities with regards to motility disturbances and the small and large intestine. I think we should assume that they occur with any type of inflammation or infiltrative disease, so things like inflammatory bowel disease, masses, infiltrating tumors like lymphoma adenocarcinoma, even systemic mycoses like histoplasmosis, again infiltrating to the GI tract. I think we should assume that with that degree of inflammation in host response, that motility disturbances occur. The problem that we have is documenting that. And so we don't currently have good tools for assessing motility. The gold standard would be nuclear scintigraphy, but that's not practical in a clinical situation.

So, just consider a promotility therapy if your primary therapy isn't working. For instance, say you have a dog with inflammatory bowel disease involving the small intestine. Maybe that animal is not responding quite as robustly to your anti-inflammatory therapy, perhaps it's worth the trial in a promotility agent. Also remember that promotility drugs work very specifically. So, we have few excellent promotility drugs that work from the stomach all the way down to the colon. Drugs such as metoclopramide may only work in the stomach, we have other prokinetic agents that work in the small intestine-ranitidine, erythromycin, cisapride would be one. The colon we don't have much out there at all. Probably your best choice would be cisapride."