Placement of an indwelling percutaneous gastrotomy (<scp>PEG</scp>) tube for the measurement of intra‐gastric <scp>pH</scp> in two horses

Sykes, B. W.; McGowan, Catherine; Mills, Paul C.

doi:10.1111/eve.12395

Cited by 8 publications

(29 citation statements)

References 14 publications

(26 reference statements)

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“…The objective of this study was to further investigate the duration of intraday acid suppression achieved with two doses of omeprazole under two different dietary conditions using a recently described gastric cannulation model [11] that allows continuous monitoring of gastric pH under normal feeding conditions. We hypothesised that both diet and dose would impact on the ability of omeprazole to raise ventral gastric pH in the horse.…”

Section: Introductionmentioning

confidence: 99%

The effects of dose and diet on the pharmacodynamics of omeprazole in the horse

Sykes

Underwood

Greer

et al. 2016

Equine Veterinary Journal

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The overall efficacy of omeprazole in raising ventral gastric pH was less than previously reported. Both dose and diet may play a role in the efficacy of omeprazole in the horse. Therefore, the use of singular dosing recommendations that encompass all horse types and management conditions may not be appropriate and dosing recommendations that take into account the diet of the horse may be advantageous.

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Section: Introductionmentioning

confidence: 99%

The effects of dose and diet on the pharmacodynamics of omeprazole in the horse

Sykes

Underwood

Greer

et al. 2016

Equine Veterinary Journal

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“…Each horse was instrumented with a percutaneous gastrotomy tube (PEG) as previously described [107]. The location of the PEG tube was confirmed by gastroscopy to be within the ventral glandular fundus approximately 10 -15 cm below the margo plicatus adjacent to the lesser curvature in each horse.…”

Section: Horsesmentioning

confidence: 99%

“…To achieve this; the pH probe was attached to a continuous data logger (ZepHr pH ® ) and calibrated prior to placement each day as per the manufacturer's instructions. The probe was then inserted a previously determined distance and secured as previously described [107]. Data was recorded at 2 points; measurement point 1 was located approximately 10 -20 mm from the glandular mucosa and measurement point 2 was 5 cm further within the stomach as shown in figure 6.1 [107].…”

Section: Gastric Ph Measurementmentioning

confidence: 99%

“…The probe was then inserted a previously determined distance and secured as previously described [107]. Data was recorded at 2 points; measurement point 1 was located approximately 10 -20 mm from the glandular mucosa and measurement point 2 was 5 cm further within the stomach as shown in figure 6.1 [107]. Data recording commenced at 8 am and continued until 7 am (23 hours).…”

Section: Gastric Ph Measurementmentioning

confidence: 99%

“…The The objective of this study was to further investigate the duration of intra-day acid suppression achieved with two doses of omeprazole under two different dietary conditions using a recently described gastric cannulation model [107] that allows continuous monitoring of gastric pH under normal feeding conditions.…”

Section: Introductionmentioning

confidence: 99%

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Factors affecting the pharmacokinetics and pharmacodynamics of omeprazole in the horse

Sykes¹

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Equine Gastric Ulcer Syndrome (EGUS) is a common condition of the horse, affecting a broad range of horse usages and types. Recently the terminology of the syndrome has been expanded to include terms Equine Squamous Gastric Disease (ESGD) and Equine Glandular Gastric Disease (EGGD) to describe diseases of the squamous and glandular mucosa of the stomach, respectively. Omeprazole, a proton pump inhibitor that blocks acid production, is considered the treatment of choice for EGUS and it has been widely used for this purpose for nearly 20 years. Yet, surprisingly, despite its widespread use little is known about the factors that affect its efficacy, such as the impact of formulation, diet and dose. Further, although it is commonly believed that the once daily administration of omeprazole results in durations of acid suppression exceeding 24 hours, there is conflict in the literature as to the validity of this belief. Recent clinical studies have demonstrated that the healing rate for EGGD is inferior to that of ESGD, raising further questions as to the efficacy of omeprazole under clinically relevant conditions. One potential reason for this observation is that the duration of intra-day acid suppression required for healing of ESGD may be less than that for EGGD. This, coupled with the possibility that once daily administration of omeprazole may not result in acid suppression for the entire 24 hour treatment interval, provides a potential explanation for the poor EGGD healing rates that have been recently reported. The purpose of this thesis was to investigate the factors that affect the efficacy of omeprazole in the horse. The studies were conducted in four parts; firstly, the effect of formulation and diet on the pharmacokinetics of omeprazole were investigated; secondly, a model that allows continuous intra-gastric pH measurement under clinically relevant conditions was developed; thirdly, the impact of diet and dose on the pharmacokinetics and pharmacodynamics of omeprazole were investigated; and lastly, the relationships between key pharmacokinetic and pharmacodynamic variables were investigated. The findings of the study suggested that some method of physical protection is required to protect the omeprazole from degradation in the acidic environment of the stomach and to improve bioavailability. However, significant differences were not present between formulations utilising the two most common forms of protection, namely the use of enteric coated granules in paste or buffering of the formulation. This suggests that the method of protection, buffering of the formulation or the use enteric coated granules in paste, used is less important than protection per se. The earlier studies of the thesis 3 suggested that an effect of feeding may be present on the pharmacokinetics of omeprazole but a statistically significant effect could not be demonstrated. Similarly, the latter studies suggested that diet may play a role in bioavailability with ad libitum roughage diets impairing absorption, but no statistically signi...

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Gastric juicepHmeasurement in horses: Three‐quarters of a century of history!

Andrews

2015

Equine Veterinary Education

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Summary Inhibition of gastric acid and increased stomach pH>4.0 is currently accepted as the mainstay of treatment for gastric ulcers in horses. Measurement of gastric pH is complicated and requires placement of a cannula and collection of gastric juice or placement of pH electrodes in the stomach. Since the distance from the nares to the stomach is approximately 200 cm, finding a system with a pH electrode with this length is difficult, not to mention difficult to maintain. There has been a fascination with the measurement of gastric juice pH in horses that has covered three‐quarters of a century starting with a fistula model in 1933 and culminating in a recent technique described in this issue. Placement of gastric cannulas and various pH electrodes have been used to measure gastric juice pH in horses in the past and present, but the future may require more sophisticated methods as we look at the efficacy of different formulations of acid suppressive drugs for treatment of equine gastric ulcer syndrome.

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Placement of an indwelling percutaneous gastrotomy (PEG) tube for the measurement of intra‐gastric pH in two horses

Cited by 8 publications

References 14 publications

The effects of dose and diet on the pharmacodynamics of omeprazole in the horse

The effects of dose and diet on the pharmacodynamics of omeprazole in the horse

Factors affecting the pharmacokinetics and pharmacodynamics of omeprazole in the horse

Gastric juicepHmeasurement in horses: Three‐quarters of a century of history!

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