Peer-reviewed veterinary case report
Gastrointestinal protectants for dogs and cats - what you need to know
By Marks, Stanley L et al.·Published in Journal of veterinary internal medicine·2018·Department of Medicine & Epidemiology, United States·View original on PubMed →
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Original publication title: ACVIM consensus statement: Support for rational administration of gastrointestinal protectants to dogs and cats.
Plain-English summary
This report discusses how the stomach lining in dogs and cats can be damaged by various harmful substances, leading to serious issues like inflammation and ulcers. It focuses on certain medications, like proton pump inhibitors and sucralfate, that can help protect the stomach by reducing acidity or enhancing its defenses. However, the report points out that there isn't enough research to determine the best dosages for these drugs in pets, and that vets sometimes prescribe them unnecessarily for conditions that don't actually require them. It suggests that while these medications can be helpful, they should be used carefully, especially since long-term use can have negative effects. Overall, the report emphasizes the need for more thoughtful prescribing practices in veterinary medicine.
Abstract
The gastrointestinal (GI) mucosal barrier is continuously exposed to noxious toxins, reactive oxygen species, microbes, and drugs, leading to the development of inflammatory, erosive, and ultimately ulcerative lesions. This report offers a consensus opinion on the rational administration of GI protectants to dogs and cats, with an emphasis on proton pump inhibitors (PPIs), histamine type-2 receptor antagonists (HRAs), misoprostol, and sucralfate. These medications decrease gastric acidity or promote mucosal protective mechanisms, transforming the management of dyspepsia, peptic ulceration, and gastroesophageal reflux disease. In contrast to guidelines that have been established in people for the optimal treatment of gastroduodenal ulcers and gastroesophageal reflux disease, effective clinical dosages of antisecretory drugs have not been well established in the dog and cat to date. Similar to the situation in human medicine, practice of inappropriate prescription of acid suppressants is also commonplace in veterinary medicine. This report challenges the dogma and clinical practice of administering GI protectants for the routine management of gastritis, pancreatitis, hepatic disease, and renal disease in dogs and cats lacking additional risk factors for ulceration or concerns for GI bleeding. Judicious use of acid suppressants is warranted considering recent studies that have documented adverse effects of long-term supplementation of PPIs in people and animals.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/30378711/