Gastroprotectants in small animal veterinary practice – a review of the evidence. Part 1: cyto‐protective drugs

Bazelle, Julien; Threlfall, Anna; Whitley, Niki

doi:10.1111/jsap.12867

Cited by 3 publications

(5 citation statements)

References 77 publications

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“…Additionally, the owners were instructed to closely monitor the dog's behavior, appetite and feces. Currently, prophylactic administration of gastroprotective drugs was not proven to be beneficial, if NSAIDs were given (39). Our dog did not show any obvious side effects, thus, no gastroprotective agents were administered.…”

Section: Discussionmentioning

confidence: 99%

Successful Treatment of Pneumothorax in a Dog With Sterile Pleural Fibrosis Caused by Chylothorax

et al. 2019

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A 2-year-old, 12 kg, intact male crossbreed dog was presented with respiratory distress, exercise intolerance, and gagging. Plain thoracic radiographs revealed severe pleural effusion. Although bilateral needle thoracocentesis and chest tube placement were performed, no re-expansion of the lung lobes occurred. Pleural effusion was of chylous quality and led to lung entrapment. Computer tomography revealed a highly atrophic and atelectatic right middle lung lobe. The remaining lung lobes were only expanded to ~40%. Visceral pleura and pericardium showed a heterogeneous thickening consistent with pleural fibrosis. Partial pericardiectomy with resection of the middle lung lobe through a right lateral thoracotomy was performed. Ligation of the thoracic duct and ablation of the cisterna chyli was achieved through a single paracostal approach. Histopathology revealed chronic-active proliferative beginning granulomatous pleuritis, fibrotic pericarditis, and partial coagulative necrosis with incomplete granulomatous sequestration in the resected middle lung lobe. Chylothorax resolved after surgical intervention. Active pleural effusion resolved, and lung entrapment changed to trapped lung disease. The remaining lung lobes re-expanded to ~80% over the following 6 days. The dog was discharged 10 days later. Mild to moderate pleural effusion of non-chylic quality was present during the following 4 months. Meloxicam was administered for 4 months because of its anti-fibrotic and anti-inflammatory properties. Fifteen months later, thoracic radiographs revealed full radiologic expansion of the lungs with persistent mild pleural fibrosis. To the authors' knowledge, this is the first case report of pneumothorax due pleural fibrosis caused by chylothorax in a dog with an excellent clinical outcome.

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Section: Discussionmentioning

confidence: 99%

Successful Treatment of Pneumothorax in a Dog With Sterile Pleural Fibrosis Caused by Chylothorax

et al. 2019

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“…Omeprazole is a proton pump inhibitor (PPI) which irreversibly binds with the H + /K + -ATPase proton pump on the secretory membrane of gastric parietal cells, consequently leading to inhibition of acid secretion (Kromer et al 2000, Abelo et al 2002. PPIs are used commonly for the management of oesophageal and gastric acid-related diseases as they are considered the most effective acid blockers in human and veterinary medicine (Jenkins et al 1991, Bersenas et al 2005, Muenster et al 2017, Bazelle et al 2018, Cook et al 2018. The main indications for prescribing PPIs include gastro-oesophageal reflux disease (GORD) and oesophagitis (Wilson & Walshaw 2004, Panti et al 2009, gastric ulceration, gastrointestinal haemorrhage, portal hypertension (Weisse et al 2014) and strenuous exercise in working dogs (Williamson et al 2010).…”

Section: Introductionmentioning

confidence: 99%

Prescribing habits for the use of omeprazole as a gastroprotectant in dogs in a veterinary teaching hospital

Bodnarova

Hall

Duplan

2022

J of Small Animal Practice

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To examine the prescribing habits for omeprazole in a veterinary teaching hospital and to evaluate the effect of a clinical audit on omeprazole prescription.Material and MethOds: Observational study with retrospective clinical audit followed by a prospective study. The evaluated data about omeprazole prescription included the dose, frequency and indication.These were assessed according to published guidelines. A seminar about the audit and current guidelines on the use of omeprazole was organised for all members of clinical staff. Prospective data collection was conducted after the seminar. A comparison of the collected data before and after the clinical audit was made.results: A total of 301 dogs were prescribed omeprazole in the veterinary teaching hospital during the study period (including the retrospective and prospective parts). Complete data were acquired from 240 patients. The prescribed frequency of omeprazole was inappropriate in 23 (16.5%) of the prescriptions in the retrospective section but in only five (5.0%) in the prospective study. Inappropriate indications were reported in 12 (8.6%) patients in the retrospective section and in two patients (2.0%) in the prospective study. Overall inappropriate omeprazole prescription was identified in 34 (24.5%) patients in the retrospective part and in seven (6.9%) patients in the prospective part. There was a statistically significant difference between the two groups in frequency, indication and overall prescription of omeprazole.clinical significance: This study details the frequency of inappropriate prescription of omeprazole in a veterinary teaching hospital and provides some evidence that dissemination of guidelines based on clinical audit can improve prescribing habits.

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“…The study was based upon previous study design 11,12 and comprised of three periods: acclimation (days À13 to À8), baseline (t 1 , days À7 to 0), and treatment (t 2 , days 1-14; t 3 , days [15][16][17][18][19][20][21][22][23][24][25][26][27][28]. During the acclimation period, dogs were administered ivermectin (200 mg SC once, day À13) and fenbendazole (50 mg/kg q24h PO, days À13 to À9).…”

Section: Study Periodsmentioning

confidence: 99%

“… 6 , 8 , 16 , 17 However, gastroprotectants are perceived as safe and so continue to be prescribed. 4,18 On the other hand, probiotics and synbiotics reduce hyperacidity‐, ethanol‐, and stress‐induced gastric ulceration by as much as 90% by increasing prostaglandin and mucus production, decreasing oxidative stress, and decreasing inflammatory cytokine production. 19 , 20 , 21 , 22 , 23 , 24 , 25 Beneficial effects of probiotics are demonstrated for Helicobacter ‐associated dyspepsia and gastric ulceration, ulcerative colitis, inflammatory bowel syndrome, and antibiotic‐ and Clostridium difficile ‐associated diarrhea.…”

Section: Introductionmentioning

confidence: 99%

“…In dogs, neither the incidence nor severity of gastrointestinal bleeding secondary to glucocorticoid therapy is mitigated by administration of misoprostol, sucralfate, cimetidine, or omeprazole (1 mg/kg administered once daily) 6,8,16,17 . However, gastroprotectants are perceived as safe and so continue to be prescribed 4,18 . On the other hand, probiotics and synbiotics reduce hyperacidity‐, ethanol‐, and stress‐induced gastric ulceration by as much as 90% by increasing prostaglandin and mucus production, decreasing oxidative stress, and decreasing inflammatory cytokine production 19‐25 .…”

Section: Introductionmentioning

confidence: 99%

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Clinicopathologic and gastrointestinal effects of administration of prednisone, prednisone with omeprazole, or prednisone with probiotics to dogs: A double‐blind randomized trial

Rak

Moyers

Price

et al. 2023

Veterinary Internal Medicne

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Background The efffect of administering of probiotics or twice‐daily omeprazole on glucocorticoid‐induced gastric bleeding in dogs is unknown. Hypothesis Compare gastrointestinal bleeding among dogs administered placebo, prednisone (2 mg/kg q24h), prednisone with omeprazole (1 mg/kg q12h), or prednisone with probiotics (Visbiome, 11.2‐22.5 billion CFU/kg q24h) for 28 days. Animals Twenty‐four healthy research dogs. Methods Double‐blinded, placebo‐controlled randomized trial. Clinical signs and endoscopic gastrointestinal mucosal lesion scores at baseline ( t 1 ), day 14 ( t 2 ), and day 28 ( t 3 ) were compared using split‐plot repeated‐measures mixed‐model ANOVAs. Results Fecal score differed by treatment‐by‐time ( F [6,40] = 2.65, P < .03), with higher scores in groups receiving prednisone at t 3 than t 1 . Nineteen of thirty‐three episodes of diarrhea occurred in the prednisone with omeprazole group. Gastric mucosal lesion scores differed by treatment‐by‐time ( F [6,60] = 2.86, P = .05), among treatment groups ( F [3,60] = 4.9, P = .004), and over time ( F [2,60] = 16.5, P < .001). Post hoc analysis revealed lesion scores increased over time for all groups receiving prednisone. At t 3 , scores for the prednisone (8.7 ± 4.9) and prednisone with probiotics (8.7 ± 4.9) groups differed significantly from placebo (1.8 ± 1.8; P ≤ .04), whereas scores for the prednisone with omeprazole (6.5 ± 5.5) group did not differ from placebo ( P = .7). Ulcers occurred only in dogs receiving prednisone. Conclusions and Clinical Importance Prednisone‐induced gastric bleeding. Co‐administration of omeprazole partially mitigated bleeding, but a similar protective benefit was not demonstrated by co‐administration of the evaluated probiotic.

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Gastroprotectants in small animal veterinary practice – a review of the evidence. Part 1: cyto‐protective drugs

Cited by 3 publications

References 77 publications

Successful Treatment of Pneumothorax in a Dog With Sterile Pleural Fibrosis Caused by Chylothorax

Successful Treatment of Pneumothorax in a Dog With Sterile Pleural Fibrosis Caused by Chylothorax

Prescribing habits for the use of omeprazole as a gastroprotectant in dogs in a veterinary teaching hospital

Clinicopathologic and gastrointestinal effects of administration of prednisone, prednisone with omeprazole, or prednisone with probiotics to dogs: A double‐blind randomized trial

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