Capsule endoscopy detects insufficient treatment of gastric bleeding in a dog with chronic hepatitis

Abstract

A five-year-old dog was presented for a chronic non-regenerative anaemia, copper-associated chronic hepatitis and suspected portal hypertension. The anaemia was suspected to be from gastrointestinal (GI) bleeding and persisted despite chronic omeprazole treatment (1.1 mg/kg orally every 12 hours). Capsule endoscopy confirmed severe gastric bleeding. A pH capsule was orally administered to evaluate the efficacy of gastric acid suppressant treatment. The mean gastric pH of the dog over the three-hour monitoring period was 4.7, and the percentage time that the intragastric pH were ≥3 and 4 were 100 per cent and 99 per cent, respectively. Substantial upper GI bleeding persisted despite excellent gastric acid suppression, bringing into question the value of routinely recommending such therapy in dogs with hepatic failure without additional monitoring for adequacy of treatment.