Chronic use of maropitant for the management of vomiting and inappetence in cats with chronic kidney disease: a blinded, placebo-controlled clinical trial.

OBJECTIVES: Maropitant is commonly used for acute vomiting. A pharmacokinetic and toxicity study in cats indicated that longer term usage appears safe. The aim of this study was to assess the efficacy of maropitant for management of chronic vomiting and inappetence associated with feline chronic kidney disease (CKD).
METHODS: Forty-one cats with stable International Renal Interest Society Stage II or III CKD, no known concurrent illness, and a complaint of chronic vomiting and inappetence attributed to CKD were enrolled in a randomized, placebo-controlled, blinded clinical study. A complete blood count, serum biochemistry, urinalysis, urine culture, T4 and blood pressure were required for entry. Maropitant was administered at a dose of 4 mg orally (median 1.1 mg/kg, range 0.6-2.9 mg/kg) daily for 2 weeks. Owners kept daily logs of vomiting incidence, appetite and activity scores. Physical examination, weight, body condition score and serum biochemistry were performed before and after the trial period. Mann-Whitney statistics were used to compare treatment groups.
RESULTS: Thirty-three cats successfully completed the trial: 21 cats received the drug (nine Stage II cats, 12 Stage III cats) and 12 cats received placebo (seven Stage II cats, five Stage III cats). There was a statistically significant decrease in vomiting in cats with CKD that received maropitant (P <0.01). Cats that received maropitant did not have statistically significant differences in appetite scores, activity scores, weight or serum creatinine compared with placebo. CONCLUSIONS AND RELEVANCE: Maropitant was demonstrated to palliate vomiting associated with CKD, and may be helpful in the nutritional management of cats with CKD. © ISFM and AAFP 2014.