Intragastric pH in critically ill neonatal foals and the effect of ranitidine

Lc, Sanchez; Gd, Lester; Am, Merritt

doi:10.2460/javma.2001.218.907

Cited by 31 publications

(35 citation statements)

References 19 publications

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“…This prevalence is similar to that reported in a post mortem study (25.2%) from 1980 to 1984 (Wilson 1985). In the 3 decades since post mortem prevalence was estimated, there have been advances in the understanding of gastric acidity in neonatal foals (Baker and Gerring 1993; Sanchez et al . 1998, 2001), the efficacy of antacid medications (Sanchez et al .…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, it is possible that gastric and/or duodenal ulcers develop in foals for reasons other than gastric acidity alone. It has been previously reported that premature neonatal foals often maintain an alkaline intragastric pH and that sick neonatal foals have inconsistent gastric pH profiles compared with clinically normal, term neonatal foals (Sanchez et al . 2001).…”

Section: Discussionmentioning

confidence: 99%

“…1998). However, the intragastric pH in critically ill neonates is more variable and often alkaline (Sanchez et al . 2001).…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of gastric and duodenal ulceration in 691 nonsurviving foals (1995–2006)

Elfenbein

Sanchez

2012

Equine Veterinary Journal

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SummaryReason for performing study: Gastric ulcer disease is reported to be a significant cause of morbidity in foals, but the prevalence of ulcers in this population has not recently been evaluated. Objectives: To determine the prevalence of gastric and duodenal ulceration in nonsurviving foals, and the association of ulceration with the body system of primary diagnosis. Secondary objectives were to evaluate a potential association between age and ulcer prevalence and to evaluate the use of antacid medication in the neonatal hospital population during the study years. Methods: Necropsy records were searched for all equine accessions from 1995 to 2006. Foals aged from one day to 6 months were included. Year, age, breed, sex, diagnosis and the presence of glandular, nonglandular and/or duodenal ulceration were recorded. Diagnoses were divided into groups based on the body system of primary diagnosis, with multiple diagnoses possible. A computerised database was searched for antacid treatment of all neonatal admissions. Results:The overall prevalence of ulcers was 22%, with nonglandular ulcers predominating. Ulceration was significantly associated with gastrointestinal disease. There was no significant change in ulcer prevalence over time, although there was a significant decrease in the use of antacid medications in the later study years. Neonatal foals (<1 month) had a lower ulcer prevalence than older foals. Conclusions:The prevalence of ulcers in foals, although low, has remained stable over time. Gastric or duodenal ulcers are associated with a primary diagnosis of gastrointestinal disease and are less prevalent in neonates. Potential relevance: The prevalence of ulcers in nonsurviving foals is low. Foals with gastrointestinal disease are more likely to have ulcers than foals with other primary diagnoses, and older foals are more likely to have ulceration than neonates. The prevalence of ulceration did not appear to be related to hospital-wide antacid medication use in neonates.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Prevalence of gastric and duodenal ulceration in 691 nonsurviving foals (1995–2006)

Elfenbein

Sanchez

2012

Equine Veterinary Journal

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“…Septikämie). Bei schwer kranken Fohlen sinkt der pH-Wert im Magen wahrscheinlich durch Alterationen in der Magenmotorik und Säuresekretion (Sanchez et al 2001). …”

Section: Pathophysiologieunclassified

Diagnostic and treatment of equine stomach diseases

May¹,

Venner²,

Cavicchioli³

et al. 2012

PHK

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ZusammenfassungMagenerkrankungen kommen bei Pferden häufig vor, stellen jedoch für den Tierarzt oftmals eine Herausforderung dar. Dies ist zum einen darin begründet, dass der Magen aufgrund seiner anatomischen Lage schwer zugänglich ist. Schlüsselwörter: Magen / Pferd / Diagnostik / Therapie / Gastroskopie Diagnostic and treatment of equine stomach diseasesGastric diseases are very common in horses but can be a diagnostic challenge for the veterinarian. This is on the one hand caused by the fact that the stomach is not easily accessible due to its anatomic location. On the other hand associated clinical symptoms can be variable as well as non-specific, so it is often not easy to interpret them. Furthermore, symptoms do not correlate with the severity of the diseaseresulting in the fact that a gastric disorder is often diagnosed late in its course. Diagnostic tools are endoscopy of the stomach (gastroscopy), which often enables to diagnose the disease itself, as well as sonography, transendoscopic biopsy, examination of faeces and laboratory tests. Apart from endoscopy, all examination techniques have limited informative value. Gastric ulcers are very common in horses. They occur in both foals and adult horses and their aetiology is often multifactorial including keeping and feeding management, training and stress, as well as NSAIDs. Involvement of Helicobacter pylori/equorum has been previously discussed. For prevention or therapy of gastric ulcers a strict feeding regime has to be introduced and the horses should be treated with omeprazole. Acute and chronic gastric dilations can be causes for abdominal pain in horses, and treatment attempts with nasogastric tubing and lavation should be made. As a consequence of gastric dilation gastric rupture can occur. Prognosis in this case is hopeless. Other gastric diseases can be due to parasites or neoplasia.

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“…It has been questioned, however, whether this practice is warranted or even effective. It has been demonstrated, for example, that critically ill neonatal foals often have intragastric pH profiles that are substantially different from normal or less severely affected foals, with a continuously alkaline intragastric pH demonstrated in roughly 50% of neonates, thus making acid‐suppressive medication ineffective in many foals (Sanchez et al . 2001).…”

Section: Introductionmentioning

confidence: 99%

Treatment with histamine‐type 2receptor antagonists and omeprazole increase the risk of diarrhoea in neonatal foals treated in intensive care units

Furr

Cohen

Axon³

et al. 2012

Equine Veterinary Journal

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SummaryReasons for performing study: The use of anti-ulcer medication in the neonatal intensive care unit (ICU) is common due to the concern for development of catastrophic gastric ulcer disease. In man, however, the use of acid-suppressive medication has been shown in some studies to be a substantial risk factor for the development of Clostridium difficile-associated diarrhoea (CDAD), bacteraemia and neonatal sepsis. Objective: The purpose of the study reported herein is to evaluate the influence of anti-ulcer medications on the development of diarrhoea in the neonatal foal. Hypothesis: The use of anti-ulcer medication does not alter the incidence of diarrhoea in foals treated in an ICU. Methods: The records of 1710 foals from 6 different equine hospitals were examined and the use of anti-ulcer drugs was recorded. The presence of in-hospital acquired diarrhoea, CDAD, Clostridium perfringens-associated diarrhoea, neonatal sepsis and salmonellosis were documented. In addition, the presence of gastric ulceration, duration of hospital stay and short-term outcome were examined. Results: The use of anti-ulcer medications increased the odds of in-hospital diarrhoea by 2.0 (95% CI 1.4-2.9; P<0.0001), relative to the use of no anti-ulcer medication. There was no significant association of anti-ulcer medication with CDAD (P = 0.3189) (OR 2.0; 95% CI 0.4-9.5). Further, results indicated that decreased prevalence of gastric ulceration was not associated with use of anti-ulcer drugs among foals in the study for which these data were known (P = 0.5522). Conclusions: Use of anti-ulcer drugs increases the odds of developing diarrhoea, and may not reduce the incidence of gastric ulceration in hospitalised equine neonates. Potential relevance: The use of anti-ulcer drugs in neonatal foals being treated in a hospital setting should be carefully evaluated on an individual basis to determine if such use is warranted.

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Intragastric pH in critically ill neonatal foals and the effect of ranitidine

Cited by 31 publications

References 19 publications

Prevalence of gastric and duodenal ulceration in 691 nonsurviving foals (1995–2006)

Prevalence of gastric and duodenal ulceration in 691 nonsurviving foals (1995–2006)

Diagnostic and treatment of equine stomach diseases

Treatment with histamine‐type 2receptor antagonists and omeprazole increase the risk of diarrhoea in neonatal foals treated in intensive care units

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