Abstract
BackgroundVestibular syndrome is often accompanied by nausea. Drugs currently approved for its treatment have been developed to stop vomiting but not nausea. The efficacy of 5-HT3 receptor antagonists to reduce nausea has been described for chemotherapy, but not for nausea secondary to vestibular disorders.MethodsSixteen dogs with vestibular syndrome-associated nausea were included in the open-label, multicentre study. The intensity of nausea-like behaviour was analysed before ondansetron administration (0.5 mg/kg i.v.) and 2 h afterwards, using a validated 5-point-scale. The occurrence and frequency of salivation, lip licking, restlessness, vocalisation, lethargy, and vomiting were assessed.ResultsAll dogs initially showed signs of nausea, whereas only 31% showed vomitus. The intensity of nausea was significantly reduced in all dogs (p ≤ 0.0001) 2 h after ondansetron administration, including the clinical signs of nausea analysed in 11 dogs (salivation [p = 0.0078], lip licking [p = 0.0078], restlessness [p = 0.0039], and lethargy [p = 0.0078]) except for vocalisation (p > 0.9999).ConclusionsThe results provide preliminary evidence of the potential benefit of ondansetron in the treatment of nausea, which was present in all examined dogs. Vomiting was only observed in 5 dogs indicating that nausea can occur separately and should not be perceived only as a preceding stimulation of the vomiting centre.
Highlights
Vestibular syndrome is often accompanied by nausea
Medical records containing age, breed, diagnosis, premedication, previous history of vestibular syndrome, and observed events of vomiting are summarised in supplementary Table 1
Ten dogs (62.5%) had no clinical signs of central involvement and symptoms were limited to the peripheral vestibular system
Summary
Vestibular syndrome is often accompanied by nausea. Drugs currently approved for its treatment have been developed to stop vomiting but not nausea. Dysfunctions of the vestibular system do manifest in various neurological clinical signs, such as head tilt, nystagmus, or ataxia [3, 4]. Signs of kinetosis (motion sickness) can occur due to the fact that the nucleus of the solitary tract, which is responsible for nausea and emesis, receives vestibular input [5]. The sensation of nausea has a protective function and is often associated with the urge to vomit. Nausea is not implicitly associated with the result of vomiting. Nausea can be perceived in different intensities and be associated with a preceding stimulation of
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