Clinicopathologic and gastrointestinal effects of administration of prednisone, prednisone with omeprazole, or prednisone with probiotics to dogs: A double-blind randomized trial.

Abstract

BACKGROUND: The efffect of administering of probiotics or twice-daily omeprazole on glucocorticoid-induced gastric bleeding in dogs is unknown. HYPOTHESIS: Compare gastrointestinal bleeding among dogs administered placebo, prednisone (2&#xa0;mg/kg q24h), prednisone with omeprazole (1&#xa0;mg/kg q12h), or prednisone with probiotics (Visbiome, 11.2-22.5 billion CFU/kg q24h) for 28&#x2009;days. ANIMALS: Twenty-four healthy research dogs. METHODS: Double-blinded, placebo-controlled randomized trial. Clinical signs and endoscopic gastrointestinal mucosal lesion scores at baseline (t), day 14 (t), and day 28 (t) were compared using split-plot repeated-measures mixed-model ANOVAs. RESULTS: Fecal score differed by treatment-by-time (F[6,40] =&#x2009;2.65, P&#x2009;<&#x2009;.03), with higher scores in groups receiving prednisone at tthan t. Nineteen of thirty-three episodes of diarrhea occurred in the prednisone with omeprazole group. Gastric mucosal lesion scores differed by treatment-by-time (F[6,60] =&#x2009;2.86, P&#xa0;=&#xa0;.05), among treatment groups (F[3,60] =&#x2009;4.9, P&#xa0;=&#xa0;.004), and over time (F[2,60] =&#x2009;16.5, P&#x2009;<&#x2009;.001). Post hoc analysis revealed lesion scores increased over time for all groups receiving prednisone. At t, scores for the prednisone (8.7&#x2009;&#xb1;&#x2009;4.9) and prednisone with probiotics (8.7&#x2009;&#xb1;&#x2009;4.9) groups differed significantly from placebo (1.8&#x2009;&#xb1;&#x2009;1.8; P&#x2009;&#x2264;&#x2009;.04), whereas scores for the prednisone with omeprazole (6.5&#x2009;&#xb1;&#x2009;5.5) group did not differ from placebo (P&#xa0;=&#xa0;.7). Ulcers occurred only in dogs receiving prednisone. CONCLUSIONS AND CLINICAL IMPORTANCE: Prednisone-induced gastric bleeding. Co-administration of omeprazole partially mitigated bleeding, but a similar protective benefit was not demonstrated by co-administration of the evaluated probiotic.