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Developed in collaboration with Andrea Johnson, DVM | Co-Founder | PetVet365
Last reviewed: 11/27/2023
Metronidazole is a strong antibiotic and antibacterial medication commonly prescribed by veterinarians for anaerobic bacterial infections, protozoal (parasitic) infections, and non-specific inflammatory conditions of the stomach and large intestines in dogs and cats.
It is used to treat protozoal infections in dogs and cats including diarrhea-inducing agents such as giardiasis, entamoeba, trichomonas foetus (TTF), and balantidium, and to treat anaerobic bacterial infections.
Metronidazole has immune-modulating activity and may be prescribed to treat canine inflammatory bowel disease (IBD) and colitis caused by other antibiotics.
It may also be used to treat periodontal disease (especially in cats), Clostridium perfringens enterotoxemia, tetanus, E. coli, severe diarrhea, chronic diarrhea, diarrhea of undetermined cause, pancreatic insufficiency (with small-intestinal bacterial overgrowth), and complications of severe liver disease.
Topical metronidazole gel is used to treat skin infections, such as feline chin acne.
Your veterinarian may prescribe metronidazole under the brand names Flagyl®, Metizol®, Protostat®, or Metrogel®. It is generally given orally as a capsule, tablet, or liquid suspension. It is also available in topical gel or ointment forms.
An injectable form may be used in a hospital setting, and metronidazole benzoate is sometimes used in cats because it is more palatable.
Metronidazole is bactericidal; it kills bacterial microorganisms by disrupting their DNA and inhibiting repair enzymes in the cells that exist in anaerobic (unoxygenated) environments, resulting in the death of bacterial cells.
It is often used with other antibiotics when treating mixed-bacterial infections because it is compatible with many other antibiotics, including penicillin antibiotics, aminoglycosides, and some cephalosporins.
It also can penetrate the blood-brain barrier to treat central nervous system infections, is absorbed rapidly from the GI tract, metabolized by the liver, and excreted in the urine and the feces.
The most common side effect is gastrointestinal upset. Dogs and cats may also experience excessive salivation, gagging, regurgitation, pawing at the mouth, nausea, vomiting, and decreased appetite.
Less common side effects are diarrhea, depression, lethargy, weakness, neurologic signs, low white blood cell count, liver failure, blood in the urine, or dark urine due to pigment changes.
Neurologic signs may be seen after accidental overdose or, more commonly, with long-term moderate-to-high-dose therapy to treat difficult bacterial infections. Signs often begin seven to 12 days following the start of treatment.
Metronidazole is a short-acting medication. Adverse symptoms of the medication should subside within a day of stopping it. Newer studies do show alterations of the normal GI flora that can persist beyond two weeks after treatment.
Dosing strength begins at 10mg with the most common dosing strengths being 50mg, 100mg, and 250mg. Be sure to follow your veterinarian’s directions carefully.
Wedgewood Pharmacy provides medication options that help ensure accurate dosing, especially for hard to medicate pets. Click below for a complete list of Wedgewood’s dosing forms and strengths.
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Wedgewood Pharmacy provides medication options that help ensure accurate dosing, especially for hard to medicate pets. Click below for a complete list of Wedgewood’s metronidazle dosing forms and strengths.
If you miss giving your pet a dose, give the next dose as soon as you remember or, if it is close to the next scheduled dose, return to the regular schedule. Do not give two doses (double dose) to catch up. If you are not sure what to do, call your veterinarian and follow their directions.
Symptoms of an overdose of metronidazole include gastrointestinal signs (anorexia, vomiting) and neurologic signs including depression, ataxia, disorientation, head tilt, tremors, bradycardia, rigidity, stiffness, and seizures.
Neurologic signs may occur due to acute overdose although they are more commonly seen in animals that are on long-term moderate or high doses (oral doses greater than 66 mg/kg/day). Signs of chronic toxicity often begin seven to 12 days following the start of treatment. After the drug is discontinued, it may be several days to two weeks before these neurologic signs begin to diminish.
Contact your veterinarian immediately if you suspect an overdose.
If you suspect your pet or another animal has accidentally overdosed or has eaten this medication inadvertently, immediately contact your veterinarian or the A.S.P.C.A.’s Animal Poison Control Center at 888-426-4435.
Remember to take your prescription container with you when you take your pet for treatment. If you or someone else has ingested this medication, call the National Capital Poison Center at 800-222-1222.
Wedgewood Pharmacy’s Metronidazole preparations start at $0.11 per dose. Your veterinarian will prescribe a specific dosage based on the pet’s weight, condition, and other factors.
Compounded medicines are prepared for the exact strength your veterinarian prescribes. The price of the medication will depend on the dosage and the medication form, with certain dosage forms and higher strengths generally being more expensive.
In addition, the cost of a medication will depend upon the price of the other active pharmaceutical ingredients and may increase the cost of the finished drug.
Looking for Metronidazole?
We can let your veterinarian know that you are interested in our compounded Metronidazole.
Metronidazole will not cure chronic diarrhea, but it will reduce the time it takes for acute diarrhea to resolve itself.
In addition to prescribing metronidazole for your pet’s acute diarrhea, your veterinarian may prescribe other medications to lessen other symptoms that often come along with it.
Additional treatments include anti-nausea medications, proton pump inhibitors (to reduce acid production), motility inhibitors (to reduce cramping and the sense of urgency), bile acid sequestrants (to control bile acid malabsorption in chronic diarrhea cases), and vitamin B12 (cobalamin, which is often deficient in chronic diarrhea cases). Probiotics can be very beneficial to limit the negative effects of metronidazole on the GI flora.
Possibly. Several studies have shown that metronidazole can make diarrhea worse by reducing populations of beneficial gut microbiome by altering the intestinal mucus, which helps to protect your dog's GI tract from inflammation and infection. Contact your veterinarian if your pet’s diarrhea worsens after taking metronidazole.
Oral and dental infections often affect the digestive tract in pets.
Metronidazole is often prescribed by veterinarians as adjunctive therapy to manage inflammatory bowel disease (IBD) by modulating the immune system and providing anti-inflammatory effects.
This article is meant to provide general and not medical advice. We strongly recommend that a veterinarian be consulted for the specific medical needs of your animal.
American Kennel Club
Metronidazole for Companion Animals
Andrea Johnson, DVM, is co-founder of PetVet365, a franchise company that creates new veterinary practices around entrepreneur owners determined to reinvent the animal healthcare profession and to offer the highest quality care for pets and their families.
She began her career as an associate veterinarian with a practice in Kentucky and eventually became owner and chief medical officer for 15 Banfield Pet Hospital franchises in Kentucky, Ohio, and Indiana, with 75 veterinarians on her team. She was a veterinary consultant for LegacyVet and a self-employed consultant prior to co-founding PetVet365.
She holds a BS degree in biology from Marshall University, an MS degree in Biology and Biological Sciences from Marshall University, and a DVM degree from the University of Georgia College of Veterinary Medicine.
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This content is intended for counseling purposes only. This content is informational/educational and is not intended to treat or diagnose any disease or patient. No claims are made as to the safety or efficacy of mentioned preparations. The compounded medications featured in this content have been prescribed and/or administered by prescribers who work with Wedgewood Pharmacy. You are encouraged to speak with your prescriber as to the appropriate use of any medication. Wedgewood Pharmacy’s compounded veterinary preparations are not intended for use in food and food-producing animals. All product and company names are trademarks™ or registered® trademarks of their respective holders. Use of them does not imply any affiliation with or endorsement by them.