A Retrospective Clinical Investigation of the Safety and Adverse Effects of Pantoprazole in Hospitalized Ruminants

Abstract

Clinical safety data for the use of gastroprotectants in hospitalized ruminants is lacking. In human patients, multiple adverse effects are possible from the use of pantoprazole including hematologic and electrolyte abnormalities as well as anaphylaxis and edema. The medical records of all hospitalized cattle, goats, and sheep administered pantoprazole over an ∼5-year period were retrospectively analyzed for adverse effects. Seventy-nine eligible patients were observed. Hypomagnesemia was observed after pantoprazole administration in 10 cattle; however, no significant changes were noted when compared to baseline before pantoprazole administration. Significant changes were noted in serum indicators of hepatic and renal function; however, these represented downward trends that were most likely clinically insignificant. Anaphylaxis after pantoprazole administration was not observed; however, seven cattle displayed edema after pantoprazole administration. Veterinary clinicians should be aware of the potential for hypomagnesemia in hospitalized ruminants being administered pantoprazole and monitor patients accordingly. While these preliminary retrospective results indicate that pantoprazole may be a safe adjunctive therapy in hospitalized ruminants, additional studies are necessary to further determine the safety and toxicity of pantoprazole in ruminants.

Pharmacokinetics and Tissue Levels of Pantoprazole in Neonatal Calves After Intravenous Administration

“…Although some cases of post pantoprazole administration anaphylaxis (22,23) and edema (24,25) have been reported in humans, these clinical signs were not observed in our population. While the aim of this study was not to evaluate the clinical safety of pantoprazole in calves, the lack of observed adverse effects correlate with previously reported pantoprazole use in ruminants for case management of cattle (4,26), camels (27), sheep (15,28), yaks (29), and goats (30,31). Adverse effects of pantoprazole administration described people include hyponatremia (32), hypomagnesemia (33), as well as nephritis and hepatotoxicity (34).…”

“…While our study did not report any adverse effect, it was not designed as a safety study. A retrospective study has suggested that pantoprazole may be safe to administer to hospitalized ruminants (15). Future prospective studies will be necessary to determine the clinical safety as well as the efficacy of pantoprazole in cattle.…”

“…The pantoprazole dose (1.0 mg/kg) was determined based on a previous study investigating a similar dose in alpacas (10), as well as a retrospective study describing use of the drug in cattle, sheep, and goats (15). At each sampling time point, blood was collected from the catheter using a 12-mL syringe and placed into sodium heparin tubes (BD Vacutainer, Franklin Lakes, NJ).…”

Case Report: Trochlear Wedge Sulcoplasty, Tibial Tuberosity Transposition, and Lateral Imbrication for Correction of a Traumatic Patellar Luxation in a Miniature Companion Pig: A Case Report and Visual Description

“…With this in mind, and in order to minimize potential adverse effects, such as gastric ulceration, the clients were instructed to observe for bruxism and melena. If suspicion of ulceration was noted, a gastroprotectant, such as ranitidine or pantoprazole could be administered ( 9 , 27 ), or meloxicam could be discontinued. Fentanyl has been used in both commercial and miniature pigs before ( 28 , 29 ), although limited data exists for adverse reactions with this practice.…”

Preliminary Investigation of Bovine Whole Blood Xenotransfusion as a Therapeutic Modality for the Treatment of Anemia in Goats

“…As the mature bovine erythrocyte is approximately 5–6 μm in diameter ( 12 ) and the mature caprine erythrocyte is one of the smallest in domestic herbivores at approximately 3.39 μm in diameter ( 13 ), erythrocyte speciation is evident microscopically based on diameter as bovine erythrocytes are approximately 50% larger than caprine erythrocytes. Serum biochemistry results (BUN: Blood Urea Nitrogen; Creatinine; Total Bilirubin) were evaluated pre-transfusion, as well as 1 and 4 days post-transfusion by a validated biochemistry analyzer ( 14 ) at the Iowa State University Veterinary Clinical Pathology Laboratory. After the transfusion the goats were monitored for a 12-day period.…”