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Metronidazole and liver disease.

Species: Dog
Breed: wire-haired dachshun
Age: 2-5 years
My dog was diagnosed with sudden liver failure brought on by Interceptor. He got very sick 2 days after taking it.

He was immediately put on NovaMoxin, Nova Sucralate, Zentonil, Vitamin K, Vitamin E, Milk Thistle and Metronidazole.

Here is my problem - he throws up every time after I give him Metronidazole so I did some research and am reading that Metronidazole should not be given to a dog with a compromised liver. He has been on it for three months now and is getting worse. My concerns are falling on deaf ears. I have so little hope but I feel I should stop the Metronidazole. I think I am losing him regardless but what is your opinion regarding Metronidazole for a dog in liver failure?

Thank you so much.


Online vet, Dr. Marie

Dr. Marie replied:

Oh, I am sorry to hear that this happened to Louie.

I can understand why you are unsure about the Metronidazole as the information that is available about Metronidazole is confusing.

Metronidazole is actually commonly given to animals with liver disease. It is known to help fight the type of bacteria that can complicate liver disease and also helps with inflammation in the liver as well. It's really a good drug to help the liver.

Metronidazole can cause liver enzymes to appear artificially higher than they are, but this doesn't mean that it is damaging the liver.

However, an important thing to note is that when we use Metronidazole for a dog with liver disease we tend to use a lower dose than we would with a healthy animal. So, let's assume your dog weighs 25 lbs. In a healthy dog I would be prescribing approximately 250mg metronidazole twice daily. But for a dog with some liver problems I would be using 27-100 mg twice daily.

If a dog with liver disease was receiving too much metronidazole, it doesn't make the liver disease worse. Instead, the diseased liver is not able to metabolize the metronidazole properly and so it is similar to a dog receiving way too high a dose. The symptoms we would see would be neurological symptoms like tremors and seizures, but not vomiting.

I don't think we can blame the metronidazole for Louie's vomiting. I know he is on a lot of medicines already but you may want to ask your vet about putting him on an anti-vomiting medicine. Sucralfate does have some protective effect on the stomach, but there are other drugs that can help with the vomiting and nausea as well.





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Disclaimer: Although Dr. Marie is a qualified veterinarian, the information found on this site is not meant to replace the advice of your own veterinarian. AskAVetQuestion.com and Dr. Marie do not accept any responsibility for any loss, damage, injury, death, or disease which may arise from reliance on information contained on this site. Do not use information found on this site for diagnosing or treating your pet. Anything you read here is for information only.

Customer reply:

Thank you so much for your response. I am feeling a little bit better regarding the vomitting. Louie is 40lbs, well 37 as of three days ago, and he is getting 200mg every 12 hrs which seems high. We have noticed some pacing and head pressing. I think we are losing this battle. Thank you so much for your answer, We will contunue to fight as long as he is fighting. Thank goodness for vets like you who offer this service.


Online vet, Dr. Marie

Dr. Marie replied:

200mg of metronidazole every 12 hours is a little higher than I would normally give to a dog with liver disease.

You may want to ask your vet if they would recommend lowering the dose. The dose that I use for dogs with liver disease is 7.5mg/kg twice daily. This would be closer to 125 mg twice daily. However, the extra 75 mg is really not likely to be causing problems.

Poor Louie. The head pressing is a cause for concern. This can mean that the liver is not detoxifying ammonia properly. You may want to ask your vet about adding some lactulose which is a medication that can help to fight that.

Keep fighting with Louie! I pray that he makes a full recovery. The liver is an amazing organ and if there is any healthy liver present then there is a chance for recovery.



Customer reply:

Thank you Dr. Marie. You are a saint. I will make another appointment to ask for a reduction in dosage and to add lactulose. I wish I would have found your services two months ago. Keep on doing what you are doing. You are providing such a wonderful service for people who would like another professional opinion. I have bookmarked your site. We own 4 dogs so I am sure I will be back. Bless you.


Online vet, Dr. Marie

Dr. Marie replied:

Thanks for the kind words! Feel free to come back if you have more questions!!!



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Dr. MarieDr. Marie is a veterinarian who practices in a busy animal hospital in Ottawa, Ontario. She created Ask A Vet Question as a resource for good, accurate veterinary advice online. Dr. Marie treats dogs, cats, hamsters, guinea pigs, and rats. She has been a vet since 1999.

Is an online vet visit just as good as a trip to your veterinarian? No! But, many times, asking an online veterinarian a question can help save you money. While Dr. Marie can't officially diagnose your pet or prescribe medications, she can often advise you on whether a vet visit is necessary. You can also ask Dr. Marie for a second opinion on your pet's condition.