Evaluation of the effect of oral omeprazole on canine cerebrospinal fluid production: A pilot study

Abstract

A B S T R A C TAdministration of omeprazole by ventriculo-cisternal perfusion or intravenously has been shown to decrease cerebrospinal fluid (CSF) production in dogs and rabbits. Oral omeprazole has consequently been recommended to reduce CSF production in dogs with conditions in which clinical signs may be attributable to an accumulation of CSF in the central nervous system (e.g. hydrocephalus, syringomyelia). The albumin quotient (QAlb), the ratio between CSF and serum albumin concentration, has been proposed as a reliable means to evaluate CSF production; decreasing CSF production should cause an increase in QAlb.The aims of this study were to assess the effect of oral administration of omeprazole on QAlb in dogs and to compare two methods to assess CSF albumin concentration. Fifteen healthy Beagle dogs received omeprazole (1.2 mg/kg/day) orally for 14 days; CSF and blood were obtained before and after treatment. CSF albumin concentrations were evaluated by nephelometry and high-resolution protein electrophoresis. Regardless of the method used for measuring albumin, QAlb did not change significantly following oral omeprazole administration, suggesting that CSF production in healthy dogs may not be affected by chronic oral therapy with omeprazole.

Monoclonal antibody exposure in rat and cynomolgus monkey cerebrospinal fluid following systemic administration

“…The CSF turnover rate sets the efficiency of convective clearance out of the CNS. It is well documented that CSF production rates vary under different conditions, including circadian rhythm [ 33 – 36 ], normal aging [ 36 – 39 ], concurrent medications such as the carbonic anhydrase inhibitor acetazolamide [ 40 , 41 ] and the proton pump inhibitor omeprazole [ 42 , 43 ], and in disease conditions such as hydrocephalus [ 26 , 44 ] and Alzheimer’s disease (AD) [ 45 , 46 ]. Alterations in CSF production rates can have profound effects on CNS clearance of medications and waste products.…”

New considerations about Chiari‐like malformation, syringomyelia and their management

“…The principle is that these drugs reduce CSF production thus reducing the driving force contributing to CM-P and SM. However, studies assessing the effect of omeprazole on CSF production by evaluating the albumen quotient (QAlb; ratio between CSF and serum albumin concentration) did not support a CSF-reducing effect (Girod and others 2016), although the validity of QAlb as a surrogate marker for CSF production was later disputed (Girod and others 2019). More importantly, omeprazole may not achieve a therapeutic choroid plexus concentration, so the effect, if any, of antacids on CSF production remains unsubstantiated.…”

Lissencephaly in Shih Tzu dogs

“…One previous report has described no significant effects on recovery of the neurological signs or ventricular volume reduction after treatment with acetazolamide in dogs with hydrocephalus [29]. Furthermore, chronic oral omeprazole therapy in healthy dogs did not affect cerebrospinal fluid production [30].…”