Section: Veterinary Care In-depth
Therapy In-depth
As the above diagnostic tests are underway, your veterinarian may start symptomatic therapy, especially if the problem is severe. The following nonspecific (symptomatic) treatments may be applicable to some pets with melena. These treatments may reduce the severity of symptoms and provide some relief to your pet. However, nonspecific therapy is not a substitute for definitive treatment of the underlying disease responsible for your pet's condition.
Temporarily discontinue all oral liquids and food, especially if the animal is also vomiting. This allows the GI tract to rest and may facilitate healing of the lining of the GI tract. Gradual reintroduction of small amounts of bland food may then be instituted if the clinical signs have subsided.
Subcutaneous or intravenous fluid and electrolyte therapy may be necessary in some patients with melena to correct dehydration, acid-base, and electrolyte abnormalities.
Blood transfusions may be indicated in the patient that becomes anemic from the melena.
Plasma transfusions and vitamin K therapy may be indicated in patients with coagulopathies.
Drugs that decrease acid production by the stomach such as Tagamet® (cimetidine), Pepcid® (famotidine), Zantac® (ranitidine), and Prilosec® (omeprazole) may expedite the resolution of melena, especially if it is secondary to gastrointestinal ulcers.
Gastrointestinal protectants and adsorbents (bind harmful substances) may be considered. Protectants that may be tried include sucralfate (Carafate®) and misoprostol (Cytotec®). Protectants containing bismuth should be avoided because they often turn the stools black and can make it difficult to determine whether the melena has resolved.
In some cases surgical intervention is recommended, especially when a bleeding ulcer, gastrointestinal tumor, foreign body, or malpositioning of the stomach/intestines is diagnosed.
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