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Nabil G, Ahmed YH, Ahmed O, Milad SS, Hisham M, Rafat M, Atia M, Shokry AA. Argel's stemmoside C as a novel natural remedy for mice with alcohol-induced gastric ulcer based on its molecular mechanistic pathways. JOURNAL OF ETHNOPHARMACOLOGY 2024; 327:117970. [PMID: 38428660 DOI: 10.1016/j.jep.2024.117970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 02/21/2024] [Accepted: 02/22/2024] [Indexed: 03/03/2024]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Solenostemma argel is widely distributed in Africa & Asia with traditional usage in alleviating abdominal colic, aches, & cramps. This plant is rich in phytochemicals, which must be explored for its pharmacological effects. PURPOSE Peptic Ulcer Disease (PUD) is the digestion of the digestive tube. PUD not only interferes with food digestion & nutrient absorption, damages one of the largest defensive barriers against pathogenic micro-organisms, but also impedes drug absorption & bioavailability, rendering the oral route, the most convenient way, ineffective. Omeprazole, one of the indispensable cost-effective proton-pump inhibitors (PPIs) extensively prescribed to control PUD, is showing growing apprehensions toward multiple drug interactions & side effects. Hence, finding a natural alternative with Omeprazole-like activity & limited side effects is a medical concern. STUDY DESIGN Therefore, we present Stemmoside C as a new gastroprotective phytochemical agent isolated from Solenostemma argel to be tested in upgrading doses against ethanol-induced gastric ulcers in mice compared to negative, positive, & reference Omeprazole groups. METHODS We carried out in-depth pharmacological & histopathological studies to determine the possible mechanistic pathway. RESULTS Our results showed that Stemmoside C protected the stomach against ethanol-induced gastric ulcers parallel to Omeprazole. Furthermore, the mechanistic studies revealed that Stemmoside C produced its effect using an orchestrated array of different mechanisms. Stemmoside C stimulates stomach defense by increasing COX-2, PGE-2, NO, & TFF-1 healing factors, IL-10 anti-inflammatory cytokine, & Nrf-2 & HO-1 anti-oxidant pathways. It also suppresses stomach ulceration by inhibiting leucocyte recruitment, especially neutrophils, leading to subsequent inhibition of NF-κBp65, TNF-α, IL-1β, & iNOS pro-inflammatory cytokines & JAK-1/STAT-3 inflammation-induced carcinogenicity cascade in addition to MMP-9 responsible for tissue degradation. CONCLUSION These findings cast light on Stemmoside C's clinical application against gastric ulcer progression, recurrence, & tumorigenicity & concurrently with chemotherapy.
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Affiliation(s)
- Ghazal Nabil
- Department of Pharmacology, Faculty of Veterinary Medicine, Cairo University, Giza, 12211, Egypt.
| | - Yasmine H Ahmed
- Department of Cytology & Histology, Faculty of Veterinary Medicine, Cairo University, Giza, 12211, Egypt
| | - Omaima Ahmed
- Department of Cytology & Histology, Faculty of Veterinary Medicine, Cairo University, Giza, 12211, Egypt
| | - Selvia S Milad
- Department of Physiology, Faculty of Veterinary Medicine, Cairo University, Giza, 12211, Egypt
| | - Mohamed Hisham
- Faculty of Veterinary Medicine, Cairo University, Giza, 12211, Egypt
| | - Mohamed Rafat
- Faculty of Veterinary Medicine, Cairo University, Giza, 12211, Egypt
| | - Mohamed Atia
- Faculty of Veterinary Medicine, Cairo University, Giza, 12211, Egypt
| | - Aya A Shokry
- Department of Pharmacology, Faculty of Veterinary Medicine, Cairo University, Giza, 12211, Egypt.
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Besson J, Brissot H, Azoulay F, Benzimra P, Fritz J. Spontaneous cecal perforation in a cat diagnosed with ultrasonography. Vet Radiol Ultrasound 2024; 65:275-278. [PMID: 38459956 DOI: 10.1111/vru.13355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 02/17/2024] [Accepted: 02/22/2024] [Indexed: 03/11/2024] Open
Abstract
An 8-year-old cat was presented for an acute history of anorexia, marked abdominal pain, and hyperthermia. Ultrasonography showed a cecal perforation with focal steatitis and adjacent free gas bubbles, consistent with focal peritonitis. Surgery confirmed the imaging findings. An enterectomy was performed with the removal of the cecum and ileocolic valve, and anastomosis between the ileum and colon was performed. Histology revealed transmural enteritis and chronic severe pyogranulomatous peritonitis with intralesional plant fragments.
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Affiliation(s)
- Julie Besson
- Department of Imaging, Azurvet Veterinary Specialists Centre, Saint-Laurent-du-Var, France
| | - Hervé Brissot
- Department of Soft Tissue Surgery, Azurvet Veterinary Specialists Centre, Saint-Laurent-du-Var, France
| | - Florian Azoulay
- Department of Imaging, Azurvet Veterinary Specialists Centre, Saint-Laurent-du-Var, France
| | | | - Julien Fritz
- Department of Imaging, Azurvet Veterinary Specialists Centre, Saint-Laurent-du-Var, France
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Sabetti MC, Cola V, Foglia A, Stanzani D, Galiazzo G, Perfetti S, Tagliavia C, Pisoni L, Pietra M. Endoscopic and surgical treatment of non-neoplastic proximal duodenal ulceration in dogs, and anatomical study of proximal duodenal vascularisation. J Small Anim Pract 2024; 65:113-122. [PMID: 37960926 DOI: 10.1111/jsap.13680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 09/13/2023] [Accepted: 10/01/2023] [Indexed: 11/15/2023]
Abstract
OBJECTIVES Proximal duodenal ulceration is often characterised by continuous bleeding, and treatment is challenging. The aims of this study were to investigate the role of vascularisation in proximal duodenal ulceration and describe clinical aspects, endoscopic features and treatment in dogs. MATERIAL AND METHODS Polyurethane foam casts of gastroduodenal vessels were obtained from five dogs which had died from disorders unrelated to the digestive system. In addition, 12 dogs having proximal duodenal ulcers diagnosed by endoscopic examination were enrolled in a treatment trial. After the endoscopic diagnosis of a duodenal ulcer, all the dogs were treated medically and, in the absence of resolution, were subsequently treated by endoscopic electrocauterisation or by surgery. RESULTS A submucosal vascular network was evident in all the casts, with a prominent venous plexus seen exclusively in the first half inch of the duodenum. In clinical cases, on endoscopic examination, the duodenal ulcer was located at the proximal part of the duodenum, involving the mesenteric portion of the wall. The dogs not responding to medical treatment (6/12) were treated with endoscopic electrocauterisation, surgical coagulation or resection of the proximal duodenal portion. All the dogs survived until discharge, and the median survival time following discharge was 107.5 days. CLINICAL SIGNIFICANCE Based on the anatomical details highlighted in this study, the continuous bleeding observed in our patients may have been due to the prominent venous plexus evidenced at the level of the proximal duodenum. Surgical and endoscopic treatments in six patients resolved the ulcer bleeding with no recurrences noted during follow-up.
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Affiliation(s)
- M C Sabetti
- Department of Veterinary Sciences, University of Parma, Via Taglio 8, 43100, Parma, Italy
| | - V Cola
- Department of Veterinary Medical Sciences, University of Bologna, via Tolara di Sopra 50, 40064 Ozzano Emilia (B0), Italy
| | - A Foglia
- Department of Veterinary Medical Sciences, University of Bologna, via Tolara di Sopra 50, 40064 Ozzano Emilia (B0), Italy
| | - D Stanzani
- Self Employed Veterinarian, 40050, Bologna, Italy
| | - G Galiazzo
- Self Employed Veterinarian, 45100, Rovigo, Italy
| | - S Perfetti
- Department of Veterinary Medical Sciences, University of Bologna, via Tolara di Sopra 50, 40064 Ozzano Emilia (B0), Italy
| | - C Tagliavia
- Department of Veterinary Medicine, University of Teramo, Località Piano D'Accio, 64100, Teramo, Italy
| | - L Pisoni
- Department of Veterinary Medical Sciences, University of Bologna, via Tolara di Sopra 50, 40064 Ozzano Emilia (B0), Italy
| | - M Pietra
- Department of Veterinary Medical Sciences, University of Bologna, via Tolara di Sopra 50, 40064 Ozzano Emilia (B0), Italy
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Traserra S, Cuerda H, Vallejo A, Segarra S, Sabata R, Jimenez M. Gastroprotective Effects of Oral Glycosaminoglycans with Sodium Alginate in an Indomethacin-Induced Gastric Injury Model in Rats. Vet Sci 2023; 10:667. [PMID: 38133218 PMCID: PMC10747959 DOI: 10.3390/vetsci10120667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 11/10/2023] [Accepted: 11/14/2023] [Indexed: 12/23/2023] Open
Abstract
The gastrointestinal (GI) mucosal barrier is often exposed to inflammatory and erosive insults, resulting in gastric lesions. Glycosaminoglycans (GAGs), such as hyaluronic acid (HA), chondroitin sulfate (CS), and N-acetylglucosamine (NAG) have shown potential beneficial effects as GI protectants. This study aimed to evaluate the gastroprotective effects of oral GAGs in rats with indomethacin-induced GI lesions. Forty-five Sprague-Dawley rats (8-9 weeks-old, 228 ± 7 g) were included in the study, divided into five study groups, and given, administered orally, either sucralfate (positive control group; PC), NAG (G group), sodium alginate plus HA and CS (AHC group), sodium alginate plus HA, CS, and NAG (AHCG group), or no treatment (negative control group; NC). Animals were administered 12.5 mg/kg indomethacin orally 15 min after receiving the assigned treatment. After 4 h, stomach samples were obtained and used to perform a macroscopic evaluation of gastric lesions and to allow histological assessment of the gastric wall (via H/E staining) and mucous (via PAS staining). The AHCG group showed significant gastroprotective improvements compared to the NC group, and a similar efficacy to the PC group. This combination of sodium alginate with GAGs might, therefore, become a safe and effective alternative to prescription drugs for gastric lesions, such as sucralfate, and have potential usefulness in companion animals.
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Affiliation(s)
- Sara Traserra
- Department of Cell Biology Physiology and Immunology, Universitat Autònoma de Barcelona, 08193 Cerdanyola del Vallès, Spain; (S.T.); (H.C.); (A.V.)
| | - Héctor Cuerda
- Department of Cell Biology Physiology and Immunology, Universitat Autònoma de Barcelona, 08193 Cerdanyola del Vallès, Spain; (S.T.); (H.C.); (A.V.)
| | - Adriana Vallejo
- Department of Cell Biology Physiology and Immunology, Universitat Autònoma de Barcelona, 08193 Cerdanyola del Vallès, Spain; (S.T.); (H.C.); (A.V.)
| | - Sergi Segarra
- R&D Bioiberica S.A.U., 08950 Esplugues de Llobregat, Spain; (S.S.); (R.S.)
| | - Roger Sabata
- R&D Bioiberica S.A.U., 08950 Esplugues de Llobregat, Spain; (S.S.); (R.S.)
| | - Marcel Jimenez
- Department of Cell Biology Physiology and Immunology, Universitat Autònoma de Barcelona, 08193 Cerdanyola del Vallès, Spain; (S.T.); (H.C.); (A.V.)
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, 28029 Madrid, Spain
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Grady K, Ernst E, Secoura PL, Price J, Birkenheuer A, Vaden SL, Lidbury J, Gould E, Steiner JM, Tolbert MK. Gastric pH and serum gastrin concentration in age-matched healthy dogs and dogs with chronic kidney disease. J Vet Intern Med 2023; 37:2119-2124. [PMID: 37874019 PMCID: PMC10658589 DOI: 10.1111/jvim.16907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 10/06/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND Gastric hyperacidity and hypergastrinemia are purported to cause gastric ulceration in dogs with chronic kidney disease (CKD); however, no published studies have evaluated gastric pH with serum gastrin concentrations in dogs with CKD. HYPOTHESIS To compare mean intragastric pH, mean percent pH distribution, and serum gastrin concentrations in dogs with CKD to age-matched, healthy dogs. We hypothesized there would be no difference in mean gastric pH or serum gastrin between groups. ANIMALS Thirteen dogs with CKD; 10 aged-matched healthy dogs. METHODS Prospective, case-control study. Serum chemistry, complete blood count, urinalysis, and serum gastrin concentrations were evaluated in all dogs before radiographic-assisted gastric placement of a pH capsule. Forty-eight-hour continuous gastric pH monitoring was performed in all dogs. Serum gastrin concentration, mean pH, and mean percentage time that gastric pH was strongly acidic (pH <1 and pH <2) were compared between groups using a repeated measures mixed-model ANOVA. RESULTS No significant differences were observed between groups for any pH measurements, including mean ± SD gastric pH (CKD, 2.37 ± 0.87; healthy, 2.39 ± 0.99; P > .05). Serum gastrin concentrations were not significantly different between groups (median [range]: CKD, 10.5 ng/dL [<10-17.1]; healthy, 10.9 ng/dL [<10-15]; P > .05). CONCLUSIONS AND CLINICAL IMPORTANCE Our client-owned dogs with CKD did not have lower gastric pH or higher serum gastrin concentrations compared to healthy dogs. Our results suggest that prophylactic gastric acid suppression in dogs with CKD is not warranted unless other clinical indications for use are present.
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Affiliation(s)
- Kylie Grady
- Department of Molecular Biomedical SciencesCollege of Veterinary Medicine, North Carolina State UniversityRaleighNorth CarolinaUSA
| | - Eli Ernst
- Department of Molecular Biomedical SciencesCollege of Veterinary Medicine, North Carolina State UniversityRaleighNorth CarolinaUSA
- Present address:
Care CenterDaytonOhioUSA
| | - Patricia L. Secoura
- Department of Molecular Biomedical SciencesCollege of Veterinary Medicine, North Carolina State UniversityRaleighNorth CarolinaUSA
| | - Josh Price
- Department of Small Animal Clinical Sciences, College of Veterinary MedicineUniversity of TennesseeKnoxvilleTennesseeUSA
| | - Adam Birkenheuer
- Department of Molecular Biomedical SciencesCollege of Veterinary Medicine, North Carolina State UniversityRaleighNorth CarolinaUSA
| | - Shelly L. Vaden
- Department of Molecular Biomedical SciencesCollege of Veterinary Medicine, North Carolina State UniversityRaleighNorth CarolinaUSA
| | - Jonathan Lidbury
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical SciencesTexas A&M UniversityCollege StationTexasUSA
| | - Emily Gould
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical SciencesTexas A&M UniversityCollege StationTexasUSA
| | - Joerg M. Steiner
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical SciencesTexas A&M UniversityCollege StationTexasUSA
| | - M. Katherine Tolbert
- Department of Molecular Biomedical SciencesCollege of Veterinary Medicine, North Carolina State UniversityRaleighNorth CarolinaUSA
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical SciencesTexas A&M UniversityCollege StationTexasUSA
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Van Vertloo LR, Terhaar HM, Viall AK, Allbaugh RA. Retrospective evaluation of the incidence of gastrointestinal bleeding in dogs receiving ophthalmic nonsteroidal anti-inflammatory drugs. Vet Ophthalmol 2023; 26:560-564. [PMID: 37659073 DOI: 10.1111/vop.13145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 08/25/2023] [Accepted: 08/27/2023] [Indexed: 09/04/2023]
Abstract
OBJECTIVES To report the incidence of gastrointestinal (GI) bleeding and associated risk factors in a population of dogs receiving ophthalmic nonsteroidal anti-inflammatory drugs (NSAIDs). ANIMAL STUDIED Medical records of dogs prescribed ophthalmic NSAIDs (cases), dogs receiving systemic NSAIDs alone and dogs receiving systemic prednisone alone (controls). PROCEDURES Data were collected retrospectively from the medical records of 204 dogs prescribed ophthalmic NSAIDs (diclofenac, ketorolac, or flurbiprofen), which were subdivided based on if they received any concurrent systemic NSAIDs or glucocorticoids, 136 dogs receiving a systemic NSAID (carprofen or meloxicam) alone, and 151 dogs receiving a systemic glucocorticoid (prednisone) alone at a referral hospital from 2015 to 2019. RESULTS Gastrointestinal bleeds developed in 8/79 (10.1%) of topical NSAID-only cases, 10/136 (7.4%) of systemic NSAID controls, and 14/151 (9.3%) of systemic glucocorticoid controls, with no significant difference between the three groups (p = .6103). There were no significant differences in GI bleed rates between cases treated with ketorolac, diclofenac, or flurbiprofen (p = .160), although severe GI bleeding was only seen in ketorolac-treated dogs. Presence of a known concurrent risk factor for GI bleeding was significantly associated with the development of GI bleed in dogs on ophthalmic NSAIDs (p = .032). CONCLUSIONS Dogs treated with ophthalmic NSAIDs developed GI bleeding at a frequency comparable to dogs receiving systemic NSAIDs or systemic glucocorticoids alone, suggesting that dogs receiving ophthalmic NSAIDs may be at increased risk of GI bleeding.
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Affiliation(s)
- Laura R Van Vertloo
- Department of Veterinary Clinical Sciences, Iowa State University, Ames, Iowa, USA
| | - Hannah M Terhaar
- Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Austin K Viall
- Department of Pathology, Microbiology, and Immunology, University of California, Davis, California, USA
| | - Rachel A Allbaugh
- Department of Veterinary Clinical Sciences, Iowa State University, Ames, Iowa, USA
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Dobberstein REA, Oblak ML, Brisson BA, Singh A, Moens NMM, Ayoub S. Primary repair of nonsteroidal anti-inflammatory drug-associated full thickness gastrointestinal ulcers in 11 dogs. Vet Surg 2022; 51:1096-1105. [PMID: 35866930 DOI: 10.1111/vsu.13853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 05/01/2022] [Accepted: 06/16/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To report the outcomes of dogs that underwent primary repair of gastroduodenal perforations associated with the administration of nonsteroidal anti-inflammatory drugs (NSAID). A secondary objective was to identify clinicopathological findings that predisposed dogs to postoperative death. STUDY DESIGN Retrospective study. ANIMALS Eleven dogs with complete gastric or duodenal perforation related to administration of an NSAID that underwent primary surgical repair. METHODS Medical records were reviewed for dogs that presented with peritonitis due to a complete gastroduodenal perforation while receiving NSAIDs between November, 2011 and January, 2021. Data collected included patient characteristics, clinical signs, clinicopathological results, surgical details, and postoperative management and outcome. RESULTS All dogs were large breeds (mean weight 42 kg; range 22-75 kg), with a mean age of 7.35 years. Nine dogs from a total of 11 (82 %) received a concurrent corticosteroid and NSAID, or a higher dose/frequency/length of NSAID administration than recommended by the manufacturer. All gastroduodenal perforations were found in the upper gastrointestinal tract. Eight of 11 (73%) dogs survived to discharge. The median postoperative duration of follow up was 444 days (range 2-1460 days). No association was detected between ulcer size or location and mortality. CONCLUSION Most dogs who underwent primary repair of complete gastroduodenal ulcers survived. Gastroduodenal perforations were generally due to the administration of higher or longer doses of NSAIDs, or concurrent administration of another NSAID or corticosteroid. CLINICAL SIGNIFICANCE Primary closure may be associated with a high success rate in dogs with full thickness gastroduodenal ulcers.
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Affiliation(s)
- Rachel E A Dobberstein
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Michelle L Oblak
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Brigitte A Brisson
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Ameet Singh
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Noel M M Moens
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Sabrina Ayoub
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
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Pfeifer JM, Levy NA, Carter DL, Beal MW. Gastric or duodenal perforation and secondary septic peritonitis following therapeutic nonsteroidal anti-inflammatory drug administration. J Vet Emerg Crit Care (San Antonio) 2022; 32:764-768. [PMID: 35708902 DOI: 10.1111/vec.13217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 03/05/2021] [Accepted: 04/16/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To report which nonsteroidal anti-inflammatory drugs (NSAIDs) were associated with gastric or duodenal perforation (GDP) in dogs presented to a university teaching hospital and to report the frequency of prescription of NSAIDs by the corresponding referring veterinary community during the same time period. DESIGN Retrospective cohort study of dogs from January 2007 to March 2020. SETTING Single university teaching hospital. ANIMALS A total of 30 dogs met inclusion criteria. MEASUREMENTS AND MAIN RESULTS Four dogs were administered more than 1 NSAID within 7 days of GDP, 3 dogs received a combination of an NSAID and a corticosteroid, and 1 dog received 2 NSAIDs and a corticosteroid. Four dogs received an overdose of an NSAID. One dog received an overdose of 1 NSAID and received an additional NSAID at the labeled dose within 7 days of GDP. Eighteen dogs received only 1 NSAID at the labeled dose. In these 18 dogs, meloxicam was administered in 44.4% (8/18), firocoxib in 27.8% (5/18), deracoxib in 16.7% (3/18), and piroxicam in 11.1% (2/18). One hundred and sixty surveys on NSAID prescribing practice were returned. Carprofen was the most commonly prescribed NSAID (70.6%), followed by meloxicam (10.6%), deracoxib (8.4%), firocoxib (7.8%), aspirin (1.5%), and other (0.9%). CONCLUSIONS NSAID administration, even at labeled doses, appears to be a precipitating factor for GDP. Despite carprofen being the most frequently prescribed NSAID over the study period, no case of GDP received it as a single therapeutic agent. Further prospective evaluation is needed to verify these findings.
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Affiliation(s)
- Julie M Pfeifer
- Department of Small Animal Clinical Sciences, Veterinary Medical Center, Michigan State University, East Lansing, Michigan, USA
| | - Nyssa A Levy
- Department of Small Animal Clinical Sciences, Veterinary Medical Center, Michigan State University, East Lansing, Michigan, USA
| | - Diana L Carter
- Department of Small Animal Clinical Sciences, Veterinary Medical Center, Michigan State University, East Lansing, Michigan, USA
| | - Matthew W Beal
- Department of Small Animal Clinical Sciences, Veterinary Medical Center, Michigan State University, East Lansing, Michigan, USA
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O'Kell AL, Gallagher AE, Cooke KL. Gastroduodenal ulceration in dogs with liver disease. J Vet Intern Med 2022; 36:986-992. [PMID: 35312117 PMCID: PMC9151467 DOI: 10.1111/jvim.16413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 03/07/2022] [Accepted: 03/09/2022] [Indexed: 12/05/2022] Open
Abstract
Background Liver disease is frequently cited as a cause of gastroduodenal ulceration (GDU) in dogs but studies regarding GDU and liver disease are limited. Objectives To document the presence of GDU in dogs with liver disease. Animals Forty dogs that underwent liver biopsy, computed tomographic (CT) angiography or both at the University of Florida Small Animal Hospital to diagnose congenital or acquired liver disease. Methods Cross‐sectional study. Dogs had gastroduodenoscopy performed with photographic and video documentation in a standardized fashion. Lesions (hemorrhage, erosions, ulcers) in the esophagus, stomach, and duodenum were scored based on a grading scale. Presence of esophageal varices was recorded. Dogs were categorized into 4 groups according to cause of liver disease (inflammatory disease, cirrhosis, congenital, other). Presence or absence of ulcers, erosions or both as well as total endoscopic scores were compared among groups. Results Forty dogs were enrolled with the following distribution: 13 congenital, 13 inflammatory, 3 cirrhosis, and 11 other. Four dogs had GDU (10%; 95% confidence interval [CI], 3%‐24%) and 6 dogs had erosions (15%; 95% CI, 6%‐30%). No difference was found in total endoscopic score (P = .21) or in the proportion of dogs with ulcers, erosions or both versus those without (P = .25) among the groups. Conclusions and Clinical Importance Gastroduodenal ulceration was found in 10% of dogs with liver disease in this population. Additional studies are warranted to confirm these findings in larger numbers of dogs with specific disease etiologies.
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Affiliation(s)
- Allison L. O'Kell
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine University of Florida Gainesville Florida USA
| | - Alexander E. Gallagher
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine University of Florida Gainesville Florida USA
| | - Kirsten L. Cooke
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine University of Florida Gainesville Florida USA
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Novel Multicentric Hepatic Lymphoma with Extrahepatic Biliary Obstruction Associated with Duodenal Perforation in a Cat. Case Rep Vet Med 2021; 2021:5808886. [PMID: 34925932 PMCID: PMC8677407 DOI: 10.1155/2021/5808886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 11/06/2021] [Indexed: 11/18/2022] Open
Abstract
An 11-year-old male castrated domestic shorthair cat was presented for evaluation due to clinical deterioration and potential extrahepatic biliary obstruction (EHBO). Further investigations confirmed EHBO and revealed severe and previously unreported comorbidities. On initial examination, the cat was markedly icteric with a poor body condition score and severe muscle wasting. Serum chemistry and complete blood count showed evidence of cholestasis and anemia. Primary diagnostics and therapeutics targeted these abnormalities. Abdominal ultrasound revealed peritoneal effusion, multifocal mixed echogenic hepatic and splenic foci, small intestinal thickening, cholelithiasis, choledocholithiasis, and common bile duct and pancreatic duct dilation with evidence of obstruction. Peritoneal effusion cytology confirmed septic peritonitis. Hepatic and splenic cytology was consistent with lymphoma. Based on these results, euthanasia was elected by the owners of the animal. Necropsy confirmed the ultrasound diagnoses, septic peritoneal effusion associated with a duodenal perforation, multiorgan lymphoma, and common bile duct carcinoma. Flow cytometry classified the lymphoma as a double-negative phenotype of T-cell lymphoma (CD3+ and CD5+, but CD4- and CD8-) present in the duodenum and liver and suspected in the spleen which has previously not been reported in cats. This case report documents a cat with EHBO caused by multiple disease processes including a novel T-cell lymphoma phenotype, biliary carcinoma, duodenal perforation and septic abdomen, and choleliths, as well as inflammatory hepatobiliary disease.
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Barandun MA, Mullins RA, Rytz U. Billroth II procedure for the treatment of spontaneous gastrointestinal perforation in two cats. J Am Vet Med Assoc 2021; 259:1325-1331. [PMID: 34727055 DOI: 10.2460/javma.20.04.0241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
CASE DESCRIPTION A 9-year-old castrated male domestic shorthair cat (cat 1) and a 10-year-old castrated male Maine Coon cat (cat 2) were presented for recurrent feline lower urinary tract disease after receiving outpatient care from their primary veterinarians. CLINICAL FINDINGS Physical examination findings for both cats were initially within reference limits. After a short period of hospitalization, both cats developed peritoneal effusion; results of cytologic analysis of a sample of the fluid were consistent with septic peritonitis. During exploratory laparotomy, perforation of the pylorus or proximal portion of the duodenum secondary to ulceration was identified. TREATMENT AND OUTCOME Both cats underwent partial duodenectomy, partial gastrectomy (pylorectomy), and gastrojejunostomy (Billroth II procedure). The cats recovered from surgery and returned to a normal quality of life; however, each had mild episodes of anorexia but maintained a stable body weight. Cat 2 required additional surgery for trichobezoar removal 7 weeks later but recovered quickly. At 7 months after trichobezoar removal, cat 2 developed intermittent vomiting, but clinicopathologic, abdominal ultrasonographic, and upper gastrointestinal tract endoscopic findings were within reference limits. At 9 (cat 2) and 13 (cat 1) months after the Billroth II procedure, both cats were reported to be in good general health and without gastrointestinal signs. CLINICAL RELEVANCE In both cats, the Billroth II procedure was technically straightforward and associated with a full recovery and good medium- to long-term quality of life. A Billroth II procedure could be considered for treatment of cats with large mural lesions in the pyloroduodenal region.
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Pavlova E, Gold RM, Tolbert MK, Lidbury JA. Medical conditions associated with gastroduodenal ulceration or erosion in 168 dogs: 2008-2018. J Vet Intern Med 2021; 35:2697-2704. [PMID: 34596276 PMCID: PMC8692196 DOI: 10.1111/jvim.16275] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 09/14/2021] [Accepted: 09/15/2021] [Indexed: 12/17/2022] Open
Abstract
Background Many medical conditions are thought to cause gastroduodenal ulceration or erosion (GUE) in dogs. However, evidence for the association between many of these conditions and GUE in dogs is lacking. Objective To identify medical conditions associated with GUE in dogs. Animals One hundred and sixty‐eight dogs with GUE and 168 randomly selected control dogs without evidence of GUE identified on necropsy between January 2008 and September 2018. Methods Patient signalment, blood urea nitrogen (BUN) and serum creatinine concentrations, recently administered ulcerogenic drugs, as well as necropsy findings were recorded. The association between these findings and presence of GUE was assessed by univariable and multivariable analysis. Results In the final multivariable model, the following factors were associated with GUE: Nonsteroidal anti‐inflammatory drug (NSAID) administration (odds ratio [OR], 6.3; 95% confidence interval [CI], 2.3‐17.4; P = .0004), glucocorticoid administration (OR, 3.0; 95% CI, 1.5‐5.9; P = .001), gastrointestinal neoplasia (OR, 13.5; 95% CI, 1.7‐108.0; P = .01) and gastrointestinal mechanical disease (foreign bodies, gastric dilatation, and volvulus; OR, 4.8; 95% CI, 1.2‐19.7; P = .03). Additionally, working dog breeds were predisposed to GUE compared to mixed breed dogs (OR, 2.8; 95% CI, 1.1‐7.4; P = .04). Insufficient clinical data was available to either support or refute a role of other putative risk factors evaluated. Conclusion and Clinical Importance Administration of NSAID or glucocorticoid and gastrointestinal neoplasia or mechanical disease were associated with GUE in dogs. The potential predisposition of working breed dogs for GUE requires further investigation.
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Affiliation(s)
- Elena Pavlova
- Department of Small Animal Clinical Sciences, Texas A&M University College of Veterinary Medicine and Biomedical Sciences, College Station, Texas, USA
| | - Randi M Gold
- Department of Small Animal Clinical Sciences, Texas A&M University College of Veterinary Medicine and Biomedical Sciences, College Station, Texas, USA
| | - M Katherine Tolbert
- Department of Small Animal Clinical Sciences, Texas A&M University College of Veterinary Medicine and Biomedical Sciences, College Station, Texas, USA
| | - Jonathan A Lidbury
- Department of Small Animal Clinical Sciences, Texas A&M University College of Veterinary Medicine and Biomedical Sciences, College Station, Texas, USA
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Elfadadny A, Mandour AS, Ragab RF, Alsharif KF, Batiha GES, Samir H, Beder NA. A comparative time-dependent study of hematology, serum gastrin concentrations, and gastroscopic assessment of meloxicam-induced gastric ulceration in dogs. J Vet Intern Med 2021; 35:2196-2204. [PMID: 34464464 PMCID: PMC8478067 DOI: 10.1111/jvim.16253] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 08/11/2021] [Accepted: 08/12/2021] [Indexed: 02/06/2023] Open
Abstract
Background Diagnosis of gastric ulcers by methods other than gastroscopy in dogs has been problematic for many years and biomarkers such as serum gastrin (SG) concentrations have been introduced as a noninvasive way to evaluate gastric diseases. Objectives To determine the time course changes in hematology, SG concentrations, and gastroscopic images of meloxicam‐induced gastric ulceration in dogs and identify a relationship between SG and gastroscopic image analysis in a clinical setting. Animals Fifteen crossbreed dogs. Methods Two groups: control (n = 5) and meloxicam‐treated (n = 10). The meloxicam‐treated group received meloxicam 0.2 mg/kg PO for 15 days. Clinical signs, hematology, SG, and image analysis (PI, pixel intensity; ID, integrated density; RA, relative area; and UI, ulcer index) of the gastroscopic examination were evaluated across time (T5, time 5 day; T10, time 10 day; and T15, time 15 day). Results Significant changes were observed among 3 time points and between the 2 groups in terms of SG, hematology, and gastroscopic image analysis. In the meloxicam‐treated group, decreases in hemoglobin concentration, red blood cell count and packed cell volume at T10 and T15 (P = .0001) were observed, whereas SG, ID, and UI increased over time (P < .0001). The PI decreased significantly (P = .0001) in the meloxicam‐treated group compared to controls. Significant correlations were found between SG and PI, and ID and ulcer area (r = −0.89, 0.81, 0.64), respectively. Conclusion and Clinical Importance Gastroscopy is the gold standard for early descriptive diagnosis of gastric ulcerations in dogs, and SG is a good indicator for meloxicam‐induced gastric ulcers in dogs and can predict the gastroscopic score of the lesion.
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Affiliation(s)
- Ahmed Elfadadny
- Department of Animal Internal Medicine, Faculty of Veterinary Medicine, Damanhour University, Damanhour, El-Beheira, Egypt
| | - Ahmed S Mandour
- Department of Animal Medicine (Internal Medicine), Faculty of Veterinary Medicine, Suez Canal University, Ismailia, Egypt
| | - Rokaia F Ragab
- Department of Biochemistry, Faculty of Veterinary Medicine, Damanhour University, Damanhour, El-Beheira, Egypt
| | - Khalaf F Alsharif
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia
| | - Gaber El-Saber Batiha
- Department of Pharmacology and Therapeutics, Faculty of Veterinary Medicine, Damanhour University, Damanhour, El-Beheira, Egypt
| | - Haney Samir
- Department of Theriogenology, Faculty of Veterinary Medicine, Cairo University, Giza, Egypt
| | - Noha A Beder
- Department of Animal Internal Medicine, Faculty of Veterinary Medicine, Damanhour University, Damanhour, El-Beheira, Egypt
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14
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Stiller J, Defarges AM, Brisson BA, Bersenas AME, Pearl DL. Feasibility, complications, and quality of visualization using video capsule endoscopy in 40 dogs with overt or questionable gastrointestinal bleeding. J Vet Intern Med 2021; 35:1743-1753. [PMID: 33993552 PMCID: PMC8295713 DOI: 10.1111/jvim.16153] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 04/25/2021] [Accepted: 04/27/2021] [Indexed: 12/15/2022] Open
Abstract
Background Prospective studies describing video capsule endoscopy (VCE), its feasibility, and complications in dogs are limited. Objective To assess VCE, quality of visualization, complications, and risk factors for incomplete studies in dogs with overt or questionable gastrointestinal bleeding (GIB). Animals Forty dogs with overt or questionable GIB. Methods Prospective, multicenter, interventional study. From August 2017 to March 2020, dogs were examined by VCE (ALICAM) because of overt or questionable GIB. Reported outcomes included diagnostic results of VCE study, quality of visualization, and complications. Risk factors for incomplete studies were evaluated using logistic regression. Results In total, 40 dogs (13 overt, 27 questionable GIB) were included. The capsules were administered PO in 29 and endoscopically in 11 dogs (6 duodenum, 5 stomach). One capsule was not retrieved. In 24 of 39 recordings, bleeding lesions were identified (10 overt GIB, 14 questionable GIB). Overall, the quality of visualization was poor to limited in the stomach and colon, and adequate to good in the small intestine. The most common complication was an incomplete study in 15/39 studies, particularly after oral administration (13/28). Risk factors for incomplete study after oral administration included administration of simethicone or opioids, chronic enteropathy, and capsule gastric transit time >6 hours. Conclusions and Clinical Importance Video capsule endoscopy can be used to diagnose a variety of lesions causing bleeding in the gastrointestinal tract of dogs with questionable GIB. Incomplete studies are the most common complications in dogs after oral administration of capsules.
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Affiliation(s)
- Jenny Stiller
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada.,Small Animal Clinic, College of Veterinary Medicine, University of Leipzig, Leipzig, Saxony, Germany
| | - Alice M Defarges
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Brigitte A Brisson
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Alexa M E Bersenas
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - David L Pearl
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
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15
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Weston PJ, Maddox TW, Hõim SE, Griffin S, Mesquita L. Diagnostic utility of abdominal ultrasound for detecting non-perforated gastroduodenal ulcers in dogs. Vet Rec 2021; 190:e199. [PMID: 33899941 DOI: 10.1002/vetr.199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 01/05/2021] [Accepted: 02/06/2021] [Indexed: 11/05/2022]
Abstract
BACKGROUND Abdominal ultrasound is frequently used to detect non-perforated gastroduodenal ulcers in dogs. Studies assessing the diagnostic utility of abdominal ultrasound for the detection of non-perforated gastroduodenal ulcers have yielded mixed results. No studies to date have investigated the effects of patient bodyweight, breed, sex, age, ulcer aetiology (neoplastic or inflammatory) or location on the diagnostic accuracy of abdominal ultrasound. METHODS Retrospective, multicentre study to evaluate the diagnostic utility of abdominal ultrasonography for the diagnosis of non-perforated gastroduodenal ulceration in dogs. RESULTS Sixty-one dogs met the inclusion criteria. Ulcers were detected during ultrasound examination in 18 of 61 dogs, yielding a sensitivity of 29.5% (95% confidence interval 18.8%-42.7%). Ulcers in the pyloric region were detected more frequently than those in the duodenum; however, location was not significantly associated with the ability of ultrasound to detect lesions (p = 0.41). No associations were identified between the ability of ultrasound to detect an ulcer and patient bodyweight (p = 0.45), breed (p = 0.98), sex (p = 0.90), age (p = 0.94), and neoplastic versus inflammatory nature of ulcerative lesions (p = 0.93). CONCLUSION The diagnostic utility of ultrasound as the sole modality for the detection of non-perforated gastroduodenal mucosal ulceration is poor. The authors therefore recommend the use of additional modalities when ulcerative lesions are suspected.
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Affiliation(s)
| | - Thomas W Maddox
- Small Animal Teaching Hospital, University of Liverpool, Neston, UK
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16
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Stiller J, Defarges AM, Brisson BA, Bersenas AME, Pomrantz JS, Lang B, Pearl DL. Diagnostic evaluation of urea nitrogen/creatinine ratio in dogs with gastrointestinal bleeding. J Vet Intern Med 2021; 35:1427-1438. [PMID: 33728701 PMCID: PMC8162593 DOI: 10.1111/jvim.16101] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 02/24/2021] [Accepted: 02/24/2021] [Indexed: 12/25/2022] Open
Abstract
Background Urea nitrogen/creatinine ratio (UCR) is a marker for upper gastrointestinal bleeding (GIB) in people. Objectives To assess the usefulness of UCR to predict occult GIB and distinguish upper from lower GIB in dogs. Animals Eighty‐nine dogs with GIB and 65 clinically healthy dogs. Dogs were grouped according to 65 overt GIB and 24 occult GIB, and based on lesion localization (37 upper, 13 lower, and 8 both). Methods Seventy‐four dogs were included retrospectively and 15 dogs prospectively. Serum urea nitrogen and creatinine concentrations, UCR, hemoglobin concentration, hematocrit, mean corpuscular volume, and mean corpuscular hemoglobin concentration were compared between groups. Logistic regression models were fitted to assess if variables could distinguish occult GIB from being healthy and upper from lower GIB. Results The UCR was significantly higher in dogs with overt GIB compared to control dogs (P = .02) and dogs with occult GIB (P = .05). The UCR was not significantly associated with occult GIB vs being healthy, or upper vs lower GIB (P > .05 each). Dogs with higher hemoglobin concentration and hematocrit had significantly lower odds of having occult GIB than being healthy (P < .0001 each). Conclusions and Clinical Importance The UCR does not seem to be a clinically useful marker of occult GIB and appears to have poor discriminatory ability between upper and lower GIB. An increased UCR in a dog without signs of overt GIB, especially if its hematocrit is within the middle or upper reference interval, does not appear to warrant prompt prescription of gastrointestinal protectants.
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Affiliation(s)
- Jenny Stiller
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada.,Small Animal Clinic, College of Veterinary Medicine, University of Leipzig, Leipzig, Saxony, Germany
| | - Alice M Defarges
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Brigitte A Brisson
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Alexa M E Bersenas
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Jill S Pomrantz
- North America Medical Consulting Services, IDEXX Laboratories, Inc., Westbrook, Maine, USA
| | - Brittany Lang
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - David L Pearl
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
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17
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Mabry K, Hill T, Tolbert MK. Prevalence of gastrointestinal lesions in dogs chronically treated with nonsteroidal anti-inflammatory drugs. J Vet Intern Med 2021; 35:853-859. [PMID: 33534961 PMCID: PMC7995375 DOI: 10.1111/jvim.16057] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 01/21/2021] [Accepted: 01/22/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most common pharmaceutical associated with gastroduodenal ulceration and perforation. The prevalence of gastrointestinal (GI) injury associated with chronic use of NSAIDs in dogs is unknown. OBJECTIVE/HYPOTHESIS To determine the prevalence of GI mucosal erosions in dogs receiving chronic treatment with NSAIDs. We hypothesized that dogs receiving NSAIDs would have more GI mucosal erosions and longer GI transit time than a control population. ANIMALS Fourteen client-owned medium- and large-breed dogs receiving an NSAID for at least 30 days and 11 client-owned control dogs undergoing video capsule endoscopy (VCE) for evaluation of chronic GI disease. METHODS Dogs were prospectively recruited after determining no clinically relevant comorbidities were present and VCE was performed. The GI transit time and the presence of mucosal lesions were recorded. RESULTS Twelve dogs receiving NSAIDs and 11 retrospectively evaluated control dogs were included. The NSAIDs administered included carprofen (9 dogs), meloxicam (2 dogs), and firocoxib (1 dog) for a median of 6 months. Ten (83.3%; 95% confidence interval; 51.6%-97.9%) NSAID-treated dogs had GI erosions. Erosions were seen with all 3 NSAIDs in at least 1 dog. Three of 11 control dogs had gastric erosions. Dogs receiving NSAIDs had more erosions detected (P = .004). CONCLUSIONS AND CLINICAL RELEVANCE Subclinical GI erosions are more common in dogs receiving chronic treatment with NSAIDs than in control dogs with chronic GI disease, suggesting that NSAIDs be used with caution, particularly in dogs with comorbidities predisposing them to GI ulceration.
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Affiliation(s)
- Kasey Mabry
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, The University of Georgia, Athens, Georgia, USA
| | - Tracy Hill
- Department of Veterinary Clinical Services, College of Veterinary Medicine, University of Minnesota, St. Paul, Minnesota, USA
| | - Mary Katherine Tolbert
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A & M University, College Station, Texas, USA
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18
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Presumptive Lornoxicam Intoxication in Four Dogs. Top Companion Anim Med 2020; 42:100502. [PMID: 33249243 DOI: 10.1016/j.tcam.2020.100502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 11/09/2020] [Accepted: 11/23/2020] [Indexed: 11/22/2022]
Abstract
Lornoxicam is a nonsteroidal anti-inflammatory drug extensively used in human medicine, which is not approved for canine use. Lornoxicam intoxication has been rarely reported in dogs. Four dogs of various breeds, aged 7 months to 10 years, were admitted with a recent history of melena, anorexia and depression, occurring 1-4 days after the ingestion of lornoxicam (dose range: 0.53-2.7 [median 1.17] mg/kg). No clinically relevant comorbidities were documented, but low doses of prednisolone had been given in 3 of the dogs, in close temporal association with lornoxicam. Major clinical and clinicopathologic findings on admission included mucosal pallor, melena, depression, severe anemia, neutrophilic leucocytosis, and panhypoproteinemia. Perforated pyloric and duodenal ulcers were documented in 3 dogs by exploratory celiotomy or postmortem. Prolonged hospitalization (5-20 days) with extensive supportive care and multiple blood transfusions was required in 3 of the 4 dogs who survived to discharge. Lornoxicam ingestion may cause protracted and severe gastrointestinal tract injury and bleeding, blood loss anemia, panhypoproteinemia, and perforated gastrointestinal ulcers, associated with significant morbidity and mortality in dogs.
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Tolbert MK, Spencer A, Lynch AM, Papich MG, Lidbury JA. Capsule endoscopy detects insufficient treatment of gastric bleeding in a dog with chronic hepatitis. VETERINARY RECORD CASE REPORTS 2020. [DOI: 10.1136/vetreccr-2020-001238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
| | - Ashley Spencer
- Department of Clinical SciencesNorth Carolina State University College of Veterinary MedicineRaleighNorth CarolinaUSA
| | - Alex M Lynch
- Department of Clinical SciencesNorth Carolina State University College of Veterinary MedicineRaleighNorth CarolinaUSA
| | - Mark G Papich
- College of Veterinary MedicineNorth Carolina State UniversityRaleighNorth CarolinaUSA
| | - Jonathan A Lidbury
- Small Animal Clinical SciencesTexas A&M UniversityCollege StationTexasUSA
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20
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McCormack R, Olley L, Glanemann B, Swann JW. Prospective observational study of the use of omeprazole and maropitant citrate in veterinary specialist care. Sci Rep 2020; 10:15727. [PMID: 32978503 PMCID: PMC7519060 DOI: 10.1038/s41598-020-72950-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 09/08/2020] [Indexed: 12/17/2022] Open
Abstract
The proton pump inhibitor omeprazole is administered to dogs with gastroduodenal ulceration or oesophagitis, whereas the neurokinin-1 receptor antagonist maropitant citrate is licensed as an antiemetic drug. In people, omeprazole is overprescribed in hospitals, increasing the risk of adverse effects and imposing unnecessary costs in healthcare. To investigate the use of omeprazole and maropitant in our veterinary specialist hospital, we conducted a prospective observational study in its Medicine and Surgery wards, recording patient data and obtaining contemporaneous information from clinicians about their reasons for administering either drug. In doing so, we find omeprazole and maropitant are administered to a large proportion of dogs, including to many of those with no presenting signs suggestive of gastrointestinal disease. We find prescribing clinicians consider both drugs safe but often underestimate their financial cost. We find the stated reasons and objective predictors of administration of both drugs vary according to clinical setting but that these modalities yield concordant results. Reviewing the manner of administration and stated indications for use of both drugs, we find omeprazole is often administered outside dosing recommendations, and both drugs are frequently administered for aims that are unlikely to be achieved when considering their known biological effects in dogs. In conclusion, our work reveals probable overprescribing of omeprazole and maropitant citrate in hospitalised dogs, highlighting a need for initiatives to decrease inappropriate prescribing.
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Affiliation(s)
- Rachel McCormack
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, UK
| | - Louise Olley
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, UK
| | - Barbara Glanemann
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, UK
| | - James W Swann
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, UK. .,Kennedy Institute of Rheumatology, University of Oxford, Roosevelt Drive, Oxford, OX3 7FY, UK.
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21
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Lawson A, Walton B. Monitoring side effects of long‐term NSAID use in dogs with chronic osteoarthritis. IN PRACTICE 2019. [DOI: 10.1136/inp.l1506] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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22
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Hill TL. Gastrointestinal Tract Dysfunction With Critical Illness: Clinical Assessment and Management. Top Companion Anim Med 2019; 35:47-52. [PMID: 31122688 DOI: 10.1053/j.tcam.2019.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 04/08/2019] [Accepted: 04/09/2019] [Indexed: 12/29/2022]
Abstract
The gut is the site of digestion and absorption as well as serving as an endocrine and immune organ. All of these functions may be affected by critical illness. This review will discuss secondary effects of critical illness on the gut in terms of gastrointestinal function that is clinically observable and discuss consequences of gut dysfunction with critical illness to patient outcome. Because there is little evidence-based medicine in the veterinary field, much of our understanding of gut dysfunction with critical illness comes from animal models or from the human medical field. We can extrapolate some of these conclusions and recommendations to companion animals, particularly in dogs, who have similar gastrointestinal physiology to people. Additionally, the evidence regarding gut dysfunction in veterinary patients will be explored. By recognizing signs of dysfunction early and taking preventative measures, we may be able to increase success with treatment of critical illnesses.
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Affiliation(s)
- Tracy L Hill
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, The University of Georgia, Athens, GA, USA.
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23
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Putterman AB, Trumpatori B, Mathews KG. Successful vascularized jejunal patch graft to treat severe orad duodenal injury secondary to foreign body obstruction in a dog. Vet Surg 2019; 48:1338-1343. [PMID: 30737813 DOI: 10.1111/vsu.13174] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 12/17/2018] [Accepted: 01/17/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To report the surgical treatment and outcome of an adult dog with a duodenal perforation treated with a vascularized jejunal patch graft. STUDY DESIGN Case report. ANIMAL A 1-year-old castrated male boxer dog. METHODS Damage to a duodenal segment containing the major and minor papillae was repaired with a vascularized jejunal graft. A segment of healthy jejunum was mobilized maintaining the jejunal vessels, and a donor site anastomosis was performed. The vascularized jejunal graft was incised on the antimesenteric border creating a rectangular segment, which was trimmed and sutured to the duodenal recipient site as a patch graft to repair the defect. RESULTS The dog recovered well without major complications. Within 2 weeks, appetite and bowel movements were normal, with no episodes of vomiting. Infrequent regurgitation resolved without medical therapy. CONCLUSION A vascularized jejunal patch graft is a feasible option for successful surgical repair of duodenal injury in the dog. CLINICAL SIGNIFICANCE This report describes a novel surgical repair technique for treatment of gastrointestinal injuries.
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Affiliation(s)
- Allison B Putterman
- Department of Veterinary Clinical Medicine, University of Illinois College of Veterinary Medicine, Urbana, Illinois
| | - Brian Trumpatori
- Department of Surgery, Veterinary Specialty Hospital of the Carolinas, Cary, North Carolina
| | - Kyle G Mathews
- Department of Clinical Sciences, North Carolina State University College of Veterinary Medicine, Raleigh, North Carolina
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24
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Marks SL, Kook PH, Papich MG, Tolbert MK, Willard MD. ACVIM consensus statement: Support for rational administration of gastrointestinal protectants to dogs and cats. J Vet Intern Med 2018; 32:1823-1840. [PMID: 30378711 PMCID: PMC6271318 DOI: 10.1111/jvim.15337] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 08/24/2018] [Accepted: 09/05/2018] [Indexed: 12/12/2022] Open
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 (H2 RAs), 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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Affiliation(s)
- Stanley L. Marks
- Department of Medicine & EpidemiologySchool of Veterinary Medicine, University of California, DavisDavisCalifornia
| | - Peter H. Kook
- Vetsuisse Faculty, Clinic for Small Animal Internal Medicine, Vetsuisse FacultyUniversity of ZurichZurichSwitzerland
| | - Mark G. Papich
- Department of Molecular Biomedical SciencesNorth Carolina State University, College of Veterinary MedicineRaleighNorth Carolina
| | - M. K. Tolbert
- Department of Small Animal Clinical SciencesCollege of Veterinary Medicine, Texas A & M UniversityCollege StationTexas
| | - Michael D. Willard
- Department of Small Animal Clinical SciencesCollege of Veterinary Medicine, Texas A & M UniversityCollege StationTexas
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25
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Hill TL, Lascelles BDX, Blikslager AT. Effect of sucralfate on gastric permeability in an ex vivo model of stress-related mucosal disease in dogs. J Vet Intern Med 2018; 32:670-678. [PMID: 29460464 PMCID: PMC5866966 DOI: 10.1111/jvim.15076] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 11/19/2017] [Accepted: 01/22/2018] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Sucralfate is a gastroprotectant with no known systemic effects. The efficacy of sucralfate for prevention and treatment of stress-related mucosal diseases (SRMD) in dogs is unknown. HYPOTHESIS/OBJECTIVES To develop a canine ex vivo model of SRMD and to determine the effect of sucralfate on mucosal barrier function in this model. ANIMALS Gastric antral mucosa was collected immediately postmortem from 29 random-source apparently healthy dogs euthanized at a local animal control facility. METHODS Randomized experimental trial. Sucralfate (100 mg/mL) was applied to ex vivo canine gastric mucosa concurrent with and after acid injury. Barrier function was assessed by measurement of transepithelial electrical resistance (TER) and radiolabeled mannitol flux. RESULTS Application of acidified Ringers solution to the mucosal side of gastric antrum caused a reduction in gastric barrier function, and washout of acidified Ringers solution allowed recovery of barrier function (TER: 34.0 ± 2.8% of control at maximum injury, 71.3 ± 5.5% at recovery, P < .001). Sucralfate application at the time of injury or after injury significantly hastened recovery of barrier function (TER: 118.0 ± 15.2% of control at maximum injury, P < .001 and 111.0 ± 15.5% at recovery, P = .35). CONCLUSIONS AND CLINICAL IMPORTANCE Sucralfate appeared effective at restoring defects in gastric barrier function induced by acid and accelerating repair of tissues subjected to acid in this model, suggesting that sucralfate could have utility for the treatment and prevention of SRMD in dogs.
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Affiliation(s)
- Tracy L. Hill
- Department of Small Animal Medicine and Surgery, College of Veterinary MedicineUniversity of GeorgiaAthensGeorgia
| | - B. Duncan X. Lascelles
- Department of Clinical Sciences, College of Veterinary MedicineNorth Carolina State UniversityRaleighNorth Carolina
- Center for Pain Research and InnovationUNC School of DentistryChapel HillNorth Carolina
- Department of Anesthesiology, Center for Translational Pain ResearchDuke UniversityDurhamNorth Carolina
| | - Anthony T. Blikslager
- Department of Clinical Sciences, College of Veterinary MedicineNorth Carolina State UniversityRaleighNorth Carolina
- Center for Gastrointestinal Biology and Disease, Large Animal Models CoreNorth Carolina State UniversityRaleighNorth Carolina
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26
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Eulenberg VM, Lidbury JA. Hepatic Fibrosis in Dogs. J Vet Intern Med 2017; 32:26-41. [PMID: 29194760 PMCID: PMC5787209 DOI: 10.1111/jvim.14891] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 10/17/2017] [Accepted: 10/31/2017] [Indexed: 12/19/2022] Open
Abstract
Hepatic fibrosis is commonly diagnosed in dogs, often as a sequela to chronic hepatitis (CH). The development of fibrosis is a crucial event in the progression of hepatic disease that is of prognostic value. The pathophysiology of hepatic fibrosis in human patients and rodent models has been studied extensively. Although less is known about this process in dogs, evidence suggests that fibrogenic mechanisms are similar between species and that activation of hepatic stellate cells is a key step. Diagnosis and staging of hepatic fibrosis in dogs requires histopathological examination of a liver biopsy specimen. However, performing a liver biopsy is invasive and assessment of fibrotic stage is complicated by the absence of a universally accepted staging scheme in veterinary medicine. Serum biomarkers that can discriminate among different fibrosis stages are used in human patients, but such markers must be more completely evaluated in dogs before clinical use. When successful treatment of its underlying cause is feasible, reversal of hepatic fibrosis has been shown to be possible in rodent models and human patients. Reversal of fibrosis has not been well documented in dogs, but successful treatment of CH is possible. In human medicine, better understanding of the pathomechanisms of hepatic fibrosis is leading to the development of novel treatment strategies. In time, these may be applied to dogs. This article comparatively reviews the pathogenesis of hepatic fibrosis, its diagnosis, and its treatment in dogs.
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Affiliation(s)
- V M Eulenberg
- Gastrointestinal Laboratory, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, TX
| | - J A Lidbury
- Gastrointestinal Laboratory, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, TX
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Tivers MS, Lipscomb VJ, Bristow P, Brockman DJ. Intrahepatic congenital portosystemic shunts in dogs: short- and long-term outcome of suture attenuation. J Small Anim Pract 2017; 59:201-210. [DOI: 10.1111/jsap.12788] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 09/29/2017] [Accepted: 10/06/2017] [Indexed: 10/18/2022]
Affiliation(s)
- M. S. Tivers
- Department of Clinical Sciences and Services; Royal Veterinary College; Hatfield Hertfordshire AL9 7TA UK
- Bristol Veterinary School; University of Bristol; Langford Bristol BS40 5DU UK
| | - V. J. Lipscomb
- Department of Clinical Sciences and Services; Royal Veterinary College; Hatfield Hertfordshire AL9 7TA UK
| | - P. Bristow
- Department of Clinical Sciences and Services; Royal Veterinary College; Hatfield Hertfordshire AL9 7TA UK
| | - D. J. Brockman
- Department of Clinical Sciences and Services; Royal Veterinary College; Hatfield Hertfordshire AL9 7TA UK
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Hardy BT, Gentile-Solomon J, Solomon JA. Multiple gastric erosions diagnosed by means of capsule endoscopy in a dog. J Am Vet Med Assoc 2017; 249:926-930. [PMID: 27700263 DOI: 10.2460/javma.249.8.926] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
CASE DESCRIPTION A 6-year-old spayed female Golden Retriever was evaluated for a 2-week history of progressive hyporexia, signs of abdominal pain, and weight loss. CLINICAL FINDINGS Physical examination findings included mild signs of pain on palpation of the cranial part of the abdomen and a body condition score of 4 (scale, 1 to 9). A CBC revealed mild microcytosis and hypochromasia; results of serum biochemical analysis were within the respective reference ranges, and abdominal ultrasonography revealed no abnormalities. Capsule endoscopy was performed, and numerous gastric erosions and hemorrhages were detected, with rare dilated lacteals in the proximal aspect of the small intestine. TREATMENT AND OUTCOME Treatment was initiated with omeprazole and sucralfate for 6 weeks, and the dog was transitioned to a novel protein diet. Capsule endoscopy was repeated at the end of the initial treatment course and revealed overall improvement, with a few small erosions remaining; medical treatment was continued for an additional 2 weeks. At last follow-up 9 months after treatment ended, the dog was clinically normal. CLINICAL RELEVANCE Capsule endoscopy was useful for initial detection and subsequent reevaluation of gastrointestinal lesions in this patient without a need for sedation or anesthesia. Information obtained in the follow-up evaluation was valuable in identifying a need to extend the duration of medical treatment.
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Fitzgerald E, Barfield D, Lee KCL, Lamb CR. Clinical findings and results of diagnostic imaging in 82 dogs with gastrointestinal ulceration. J Small Anim Pract 2017; 58:211-218. [DOI: 10.1111/jsap.12631] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 11/04/2016] [Accepted: 11/25/2016] [Indexed: 12/29/2022]
Affiliation(s)
- E. Fitzgerald
- Department of Clinical Science and Services, The Royal Veterinary College; University of London; North Mymms Hertfordshire AL9 7TA UK
| | - D. Barfield
- Department of Clinical Science and Services, The Royal Veterinary College; University of London; North Mymms Hertfordshire AL9 7TA UK
| | - K. C. L. Lee
- Department of Clinical Science and Services, The Royal Veterinary College; University of London; North Mymms Hertfordshire AL9 7TA UK
| | - C. R. Lamb
- Department of Clinical Science and Services, The Royal Veterinary College; University of London; North Mymms Hertfordshire AL9 7TA UK
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Abstract
Acute liver injury and acute liver failure are syndromes characterized by a rapid loss of functional hepatocytes in a patient with no evidence of pre-existing liver disease. A variety of inciting causes have been identified, including toxic, infectious, neoplastic, and drug-induced causes. This article reviews the pathophysiology and clinical approach to the acute liver injury/acute liver failure patient, with a particular emphasis on the diagnostic evaluation and care in the acute setting.
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Affiliation(s)
- Vincent Thawley
- Emergency and Critical Care Medicine, Department of Clinical Studies, Matthew J. Ryan Veterinary Hospital of the University of Pennsylvania, 3900 Delancey Street, Philadelphia, PA 19104, USA.
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Daure E, Ross L, Webster CRL. Gastroduodenal Ulceration in Small Animals: Part 1. Pathophysiology and Epidemiology. J Am Anim Hosp Assoc 2017; 53:1-10. [DOI: 10.5326/jaaha-ms-6635] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
ABSTRACT
Gastroduodenal ulceration in small animals is a complex and important comorbidity that occurs when the physiological homeostasis of the gastrointestinal tract is disrupted secondary to administration of medications or the presence of local or systemic diseases. The aim of this article is to provide a comprehensive review of the veterinary literature regarding the pathophysiology, epidemiology, and risk factors associated with gastroduodenal ulceration in small animals. Pertinent concepts from the human literature will be integrated into the discussion. This article serves as an introduction to the second part of this series, which will review current evidence regarding the use of H2-receptor antagonists and proton pump inhibitors in small animals.
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Affiliation(s)
- Evence Daure
- From the Centre Vétérinaire Daubigny, Quebec, Canada (E.D.); and the Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, Massachusetts (L.R., C.R.L.W.)
| | - Linda Ross
- From the Centre Vétérinaire Daubigny, Quebec, Canada (E.D.); and the Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, Massachusetts (L.R., C.R.L.W.)
| | - Cynthia R. L. Webster
- From the Centre Vétérinaire Daubigny, Quebec, Canada (E.D.); and the Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, Massachusetts (L.R., C.R.L.W.)
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Daure E, Ross L, Webster CRL. Gastroduodenal Ulceration in Small Animals: Part 2. Proton Pump Inhibitors and Histamine-2 Receptor Antagonists. J Am Anim Hosp Assoc 2016; 53:11-23. [PMID: 27841679 DOI: 10.5326/jaaha-ms-6634] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
In the first part of this review, we discussed the pathophysiology and epidemiology of gastric acid secretion and the epidemiology of gastroduodenal ulceration in dogs and cats. In this section, we discuss the pharmacology and evidence-based clinical use of histamine-2 receptor antagonists and proton pump inhibitors.
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Affiliation(s)
- Evence Daure
- From the Centre Vétérinaire Daubigny, Quebec, Canada (E.D.); and the Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, Massachusetts (L.R., C.R.L.W.)
| | - Linda Ross
- From the Centre Vétérinaire Daubigny, Quebec, Canada (E.D.); and the Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, Massachusetts (L.R., C.R.L.W.)
| | - Cynthia R L Webster
- From the Centre Vétérinaire Daubigny, Quebec, Canada (E.D.); and the Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, Massachusetts (L.R., C.R.L.W.)
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Cook EK, Satake N, Sykes BW, Bennett EL, Mills PC. Pharmacokinetics of esomeprazole following intravenous and oral administration in healthy dogs. VETERINARY MEDICINE-RESEARCH AND REPORTS 2016; 7:123-131. [PMID: 30050845 PMCID: PMC6044797 DOI: 10.2147/vmrr.s112643] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Investigation into the pharmacokinetic profile of esomeprazole was conducted using eight healthy dogs after intravenous (IV) and oral (po) administration in a two-part randomized crossover study. The dogs were fasted for a minimum of 12 hours and then received esomeprazole either intravenously (dose range 0.93–1.48 mg/kg) or orally using an enteric-coated formulation (dose range 0.95–1.50 mg/kg). After a 1-week washout period, the dogs received an alternative treatment. Serial blood samples were collected at predetermined time points, and plasma esomeprazole concentrations were determined by using ultra-high-performance liquid chromatography–mass spectrometry. Noncompartmental pharmacokinetic analyses were performed. Then, the area under the plasma concentration/time curve (AUC) and maximal plasma concentration (Cmax) values were normalized to a 1.0 mg/kg dose of esomeprazole, that is, AUC/dose. Median (range) dose-normalized peak plasma concentration (Cmax) values for the IV and po formulations were 4.06 µg/mL (2.47–4.57 µg/mL) and 1.04 µg/mL (0.31–1.91 µg/mL), respectively. The median (range) time-to-peak concentration (Tmax) for the po formulation was 105 minutes (45–360 minutes). Median (range) plasma terminal half-life (t½) was 45.56 minutes (39.43–64.20 minutes) for the IV formulation and 63.97 minutes (44.02–109.94 minutes) for the enteric-coated po formulation. The median (range) po bioavailability was 63.33% (32.26%–79.77%). Clinically, both po and IV formulations were well tolerated with minimal side effects observed.
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Affiliation(s)
- Emily K Cook
- School of Veterinary Sciences, The University of Queensland, Gatton, Queensland, Australia,
| | - Nana Satake
- School of Veterinary Sciences, The University of Queensland, Gatton, Queensland, Australia,
| | - Ben W Sykes
- School of Veterinary Sciences, The University of Queensland, Gatton, Queensland, Australia,
| | - Emma L Bennett
- School of Veterinary Sciences, The University of Queensland, Gatton, Queensland, Australia,
| | - Paul C Mills
- School of Veterinary Sciences, The University of Queensland, Gatton, Queensland, Australia,
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Irom S, Sherding R, Johnson S, Stromberg P. Gastrointestinal perforation associated with endoscopy in cats and dogs. J Am Anim Hosp Assoc 2016; 50:322-9. [PMID: 25028434 DOI: 10.5326/jaaha-ms-5727] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Gastrointestinal endoscopy is a minimally invasive diagnostic tool for cats and dogs with signs of gastrointestinal disease. This retrospective study examined the case records of six cats and one dog diagnosed with perforation secondary to gastrointestinal endoscopy. Gastrointestinal perforation occurred in 1.6% of cats and 0.1% of dogs that underwent endoscopy during the 17 yr study period (from 1993 to 2010). It can be difficult to predict what animals are at risk for gastrointestinal perforation but possible risk factors suggested by this study include small intestinal infiltrative disease in cats and preexisting gastrointestinal ulceration in both cats and dogs. Overall, gastrointestinal endoscopy is associated with a low rate of gastrointestinal perforation.
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Affiliation(s)
- Sara Irom
- Great Lakes Veterinary Specialists, Cleveland, OH (S.I.); and Department of Veterinary Clinical Sciences (R.S., S.J.) and Department of Veterinary Biosciences (P.S.), The Ohio State University, Columbus, OH
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Lidbury JA, Cook AK, Steiner JM. Hepatic encephalopathy in dogs and cats. J Vet Emerg Crit Care (San Antonio) 2016; 26:471-87. [PMID: 27060899 DOI: 10.1111/vec.12473] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Revised: 11/04/2014] [Accepted: 11/07/2014] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To comparatively review the pathogenesis, clinical presentation, diagnosis, and management of hepatic encephalopathy (HE) in dogs and cats. DATA SOURCES The Medline database was searched for articles related to HE in people, dogs, and cats. Articles published within the last 5 years were given special importance. HUMAN DATA SYNTHESIS The pathogenesis of HE is complex and incompletely understood, but ammonia appears to play a central role. Hyperammonemia leads to accumulation of glutamine in astrocytes, with subsequent astrocyte swelling and neurological dysfunction. The development of HE in patients with hepatic cirrhosis is a poor prognostic indicator. The fermentable disaccharide lactulose and the antimicrobial rifaximin are US Food and Drug Administration approved treatments for human HE. Severe protein restriction is no longer recommended for patients with this condition. VETERINARY DATA SYNTHESIS HE is often associated with portosystemic shunting in dogs and cats. Ammonia plays a central role in the pathogenesis of HE in dogs and cats, but other factors such as manganese and endogenous benzodiazepines may also contribute. Recently, a soy protein-based diet was found to be beneficial in treating canine HE. Severe dietary protein restriction is likely to be detrimental in affected animals. There have been no clinical trials of drugs routinely used in the management HE in veterinary medicine, but lactulose and antimicrobials such as metronidazole are well-established treatments. CONCLUSIONS HE is a potentially life-threatening condition that is probably underdiagnosed in companion animals. Although various treatment recommendations have been proposed, there is a lack of evidence in the veterinary literature regarding optimal strategies for the management of this condition. As our understanding of the pathogenesis of HE in dogs and cats evolves, novel diagnostic tests and therapeutic agents may become available.
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Affiliation(s)
- Jonathan A Lidbury
- Department of Veterinary Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, 77843
| | - Audrey K Cook
- Department of Veterinary Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, 77843
| | - Jörg M Steiner
- Department of Veterinary Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, 77843
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36
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Amorim I, Taulescu MA, Day MJ, Catoi C, Reis CA, Carneiro F, Gärtner F. Canine Gastric Pathology: A Review. J Comp Pathol 2016; 154:9-37. [PMID: 26774560 DOI: 10.1016/j.jcpa.2015.10.181] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2015] [Revised: 10/28/2015] [Accepted: 10/30/2015] [Indexed: 12/14/2022]
Abstract
Gastric disorders are common in dogs and are a major reason for veterinary consultation. In human medicine, the classification of gastric diseases based on histological features, genotypes and molecular phenotypes helps to better understand the characteristics of each subtype, and to improve early diagnosis, prevention and treatment. Canine gastric lesions often show strong histological similarities to their human counterparts. However, such conditions in the canine stomach are poorly studied and their cellular and molecular features are largely unknown. This article reviews the histopathological classification of inflammatory and neoplastic lesions of the canine stomach and provides an update on the application of molecular techniques within the field of canine gastric pathology. The canine disorders are compared with current knowledge of the equivalent human diseases.
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Affiliation(s)
- I Amorim
- Instituto de Investigação e Inovação em Saúde, Universidadedo Porto, Porto, Portugal; IPATIMUP - Institute of Molecular Pathology and Immunology of the University of Porto, Rua Rua Júlio Amaral de Carvalho nr. 45, Porto, Portugal; Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Rua Jorge Viterbo Ferreira nr. 228, Porto, Portugal
| | - M A Taulescu
- Pathology Department, Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine, Cluj-Napoca, Romania.
| | - M J Day
- School of Veterinary Sciences, University of Bristol, Langford, Bristol, UK
| | - C Catoi
- Pathology Department, Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine, Cluj-Napoca, Romania
| | - C A Reis
- Instituto de Investigação e Inovação em Saúde, Universidadedo Porto, Porto, Portugal; IPATIMUP - Institute of Molecular Pathology and Immunology of the University of Porto, Rua Rua Júlio Amaral de Carvalho nr. 45, Porto, Portugal; Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Rua Jorge Viterbo Ferreira nr. 228, Porto, Portugal; Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, Porto, Portugal
| | - F Carneiro
- Instituto de Investigação e Inovação em Saúde, Universidadedo Porto, Porto, Portugal; Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Rua Jorge Viterbo Ferreira nr. 228, Porto, Portugal; Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, Porto, Portugal; Department of Pathology, Centro Hospitalar de São João, Porto, Portugal
| | - F Gärtner
- Instituto de Investigação e Inovação em Saúde, Universidadedo Porto, Porto, Portugal; IPATIMUP - Institute of Molecular Pathology and Immunology of the University of Porto, Rua Rua Júlio Amaral de Carvalho nr. 45, Porto, Portugal; Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Rua Jorge Viterbo Ferreira nr. 228, Porto, Portugal
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Nel JJ, du Plessis CJ, Coetzee GL. Gastrojejunostomy without partial gastrectomy to manage duodenal stenosis in a dog. J S Afr Vet Assoc 2015; 86:1285. [PMID: 26824343 PMCID: PMC6138148 DOI: 10.4102/jsava.v86i1.1285] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Revised: 06/05/2015] [Accepted: 07/20/2015] [Indexed: 11/02/2022] Open
Abstract
A nine-year-old female Rottweiler with a history of repeated gastrointestinal ulcerations and three previous surgical interventions related to gastrointestinal ulceration presented with symptoms of anorexia and intermittent vomiting. Benign gastric outflow obstruction was diagnosed in the proximal duodenal area. The initial surgical plan was to perform a pylorectomy with gastroduodenostomy (Billroth I procedure), but owing to substantial scar tissue and adhesions in the area a palliative gastrojejunostomy was performed. This procedure provided a bypass for the gastric contents into the proximal jejunum via the new stoma, yet still allowed bile and pancreatic secretions to flow normally via the patent duodenum. The gastrojejunostomy technique was successful in the surgical management of this case, which involved proximal duodenal stricture in the absence of neoplasia. Regular telephonic followup over the next 12 months confirmed that the patient was doing well.
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Affiliation(s)
- Johannes J Nel
- Department of Companion Animal Clinical Studies, University of Pretoria.
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38
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Swann JW, Maunder CL, Roberts E, McLauchlan G, Adamantos S. Prevalence and risk factors for development of hemorrhagic gastro-intestinal disease in veterinary intensive care units in the United Kingdom. J Vet Emerg Crit Care (San Antonio) 2015; 26:419-27. [PMID: 26641416 DOI: 10.1111/vec.12434] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Revised: 06/21/2014] [Accepted: 05/30/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To determine the prevalence of hemorrhagic gastro-intestinal (GI) disease developing in dogs and cats admitted for management of non-GI disease in veterinary intensive care units (ICUs). DESIGN Retrospective study of animals presented between October 2012 and July 2013. SETTING Three ICUs located in veterinary teaching hospitals in the United Kingdom. ANIMALS Dogs (n = 272) and cats (n = 94) were consecutively enrolled from 3 ICUs if they were hospitalized in the unit for at least 24 hours. Cases were excluded if they had hemorrhagic GI disease in the 48-hour period before presentation or in the 24-hour period after admission. Cases were also excluded if they suffered skull fracture, epistaxis, or hemoptysis, if they underwent surgical procedures of the GI or upper respiratory tracts, or if they were presented for management of GI disease. MEASUREMENTS AND MAIN RESULTS Hemorrhagic GI disease was observed in dogs at all 3 units, but at different rates (Center 1: 10.3%, Center 2: 4.8%, Center 3: 2.2%). Hemorrhagic GI disease was not observed in cats at any of the participating centers. Construction of a multivariable logistic regression model revealed that serum albumin concentration, administration of prophylactic gastro-protectant drugs, and institution were significantly associated with the development of hemorrhagic GI disease in dogs. Development of hemorrhagic GI disease and placement of a feeding tube were significantly associated with mortality during the period of hospitalization in dogs. Thirty-seven (13.6%) dogs and 12 (12.8%) cats died or were euthanized while hospitalized, with a higher mortality rate (42.1%) in dogs with hemorrhagic GI disease. CONCLUSIONS Hemorrhagic GI disease does develop in dogs hospitalized for management of non-GI disease, but this phenomenon was not observed in cats. Development of hemorrhagic GI disease appeared to have a significant impact on survival in veterinary ICUs.
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Affiliation(s)
- James W Swann
- Department of Clinical Science and Services, Royal Veterinary College, University of London, London
| | | | - Emma Roberts
- School of Veterinary Medicine, University of Glasgow, Glasgow, UK
| | | | - Sophie Adamantos
- The School of Veterinary Sciences, University of Bristol, Bristol
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Bernardin F, Martinez Rivera L, Ragetly G, Gomes E, Hernandez J. Spontaneous gastrointestinal perforation in cats: a retrospective study of 13 cases. J Feline Med Surg 2015; 17:873-9. [PMID: 25406178 PMCID: PMC11112198 DOI: 10.1177/1098612x14558894] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
OBJECTIVES The aim of this study was to describe the clinical characteristics and the frequency of malignant vs non-malignant causes for spontaneous gastrointestinal perforation in cats. METHODS The medical records of cats diagnosed as having gastrointestinal perforation between August 2010 and July 2013 were reviewed. Diagnosis was confirmed by exploratory surgery. Patients with incomplete records, perforation due to external trauma, leakage at previous enterotomy or anastomotic sites, or foreign bodies were excluded. Each record was examined for different information pertaining to signalment, medical history, clinical and clinicopathological data, imaging findings, abdominal fluid examination, surgical findings, histopathological examination, treatment received after surgery and outcome. RESULTS Thirteen cats were included. Five of these cats had concurrent illnesses, including viral upper respiratory tract disease, pancreatitis and chronic kidney disease. Two cats had previously received non-steroidal anti-inflammatory drugs and four had received corticosteroids. Clinical signs and clinicopathological abnormalities were not specific. Six of 13 patients were diagnosed during surgery with gastric perforations, four patients with duodenal perforations and three patients with jejunal perforations. Histopathological examination of the ulcerated wall was performed in 11/13 cats. Alimentary lymphoma was diagnosed in six cats. Non-neoplastic lesions (lymphocytic- plasmacytic inflammatory bowel disease, necrotic suppurative enteritis) were observed in the other five cats. The major limitation of the study was the small sample size. CONCLUSIONS AND RELEVANCE Lymphoma may be a frequent cause of spontaneous perforation in cats. Therefore, histological examination of ulceration is essential in all cases. The direct and sole implication of anti-inflammatory administration in a gastrointestinal perforation is not clearly established in this study.
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Affiliation(s)
- Fanny Bernardin
- Internal Medicine Department, Centre Hospitalier Vétérinaire Frégis, Arcueil, France
| | - Laura Martinez Rivera
- Internal Medicine Department, Centre Hospitalier Vétérinaire Frégis, Arcueil, France
| | - Guillaume Ragetly
- Internal Medicine Department, Centre Hospitalier Vétérinaire Frégis, Arcueil, France
| | - Eymeric Gomes
- Internal Medicine Department, Centre Hospitalier Vétérinaire Frégis, Arcueil, France
| | - Juan Hernandez
- Internal Medicine Department, Centre Hospitalier Vétérinaire Frégis, Arcueil, France
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40
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Epstein M, Rodan I, Griffenhagen G, Kadrlik J, Petty M, Robertson S, Simpson W. 2015 AAHA/AAFP Pain Management Guidelines for Dogs and Cats*. J Am Anim Hosp Assoc 2015; 51:67-84. [DOI: 10.5326/jaaha-ms-7331] [Citation(s) in RCA: 104] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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41
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Epstein ME, Rodanm I, Griffenhagen G, Kadrlik J, Petty MC, Robertson SA, Simpson W. 2015 AAHA/AAFP pain management guidelines for dogs and cats. J Feline Med Surg 2015; 17:251-72. [PMID: 25701863 PMCID: PMC11148887 DOI: 10.1177/1098612x15572062] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
RATIONALE The robust advances in pain management for companion animals underlie the decision of the American Animal Hospital Association (AAHA) and American Association of Feline Practitioners (AAFP) to expand on the information provided in the 2007 AAHA/AAFP Pain Management Guidelines. The 2015 Guidelines summarize and offer a discriminating review of much of this new knowledge. RELEVANCE Pain management is central to veterinary practice, alleviating pain, improving patient outcomes, and enhancing both quality of life and the veterinarian-client-patient relationship. These Guidelines support veterinarians in incorporating pain management into practice, improving patient care. APPROACHES The management of pain requires a continuum of care that includes anticipation, early intervention, and evaluation of response on an individual patient basis. A team-oriented approach, including the owner, is essential for maximizing the recognition, prevention and treatment of pain in animals. EVIDENCE BASE The Guidelines include both pharmacologic and non-pharmacologic modalities to manage pain; they are evidence-based insofar as possible and otherwise represent a consensus of expert opinion. Behavioral changes are currently the principal indicator of pain and its course of improvement or progression, and the basis for recently validated pain scores. Post-surgical pain is eminently predictable but a strong body of evidence exists supporting strategies to mitigate adaptive as well as maladaptive forms. Chronic pain is dominated by degenerative joint disease (DJD), which is one of the most significant and under-diagnosed diseases of cats and dogs. DJD is ubiquitous, found in pets of all ages, and inevitably progresses over time; evidence-based strategies for management are established in dogs, and emerging in cats.
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Affiliation(s)
- Mark E Epstein
- TotalBond Veterinary Hospitals PC, 3200 Union Road, Gastonia, NC 28056, USA
| | - Ilona Rodanm
- Cat Care Clinic and Feline-Friendly Consultations, 322 Junction Road, Madison, WI 53717, USA
| | - Gregg Griffenhagen
- Colorado State University School of Veterinary Medicine, 300 West Drake Road, Fort Collins, CO 80523, USA
| | - Jamie Kadrlik
- Pet Crossing Animal Hospital and Dental Clinic, 10861 Bloomington Ferry Road, Bloomington, MN 55438, USA
| | - Michael C Petty
- Arbor Pointe Veterinary Hospital/Animal Pain Center, 42043 Ford Road, Canton, MI 48187, USA
| | - Sheilah A Robertson
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824, USA
| | - Wendy Simpson
- Morrisville Cat Hospital, 100 Keybridge Drive, Suite A, Morrisville, NC 27560, USA
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Boysen SR. Gastrointestinal Hemorrhage. SMALL ANIMAL CRITICAL CARE MEDICINE 2015. [PMCID: PMC7152172 DOI: 10.1016/b978-1-4557-0306-7.00119-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Parente NL, Bari Olivier N, Refsal KR, Johnson CA. Serum concentrations of gastrin after famotidine and omeprazole administration to dogs. J Vet Intern Med 2014; 28:1465-70. [PMID: 25056694 PMCID: PMC4895597 DOI: 10.1111/jvim.12408] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Revised: 05/14/2014] [Accepted: 06/11/2014] [Indexed: 11/26/2022] Open
Abstract
Background The duration of antacid‐induced hypergastrinemia after cessation of administration of omeprazole and famotidine apparently has not been determined in dogs. Hypothesis That serum gastrin will return to basal concentrations by 7 days after cessation of famotidine or omeprazole administration. Animals Nine healthy, adult, male, research colony dogs. Methods Randomized, cross‐over design. Serum gastrin was determined daily for 7 days to establish baseline concentrations. Famotidine (1.0 mg/kg q24h) or omeprazole (1.0 mg/kg q24h) was administered PO for 7 days followed by a 14‐day washout. Serum concentrations of gastrin were determined daily during 7 days of administration and daily for 7 days after cessation of administration. Each drug was evaluated in 8 of the 9 dogs. Results Omeprazole caused a significant increase in serum gastrin concentration (37.2 ± 7.3 to 71.3 ± 19.0 ng/L; P = .006). Famotidine induced a transient increase in serum gastrin (37.2 ± 7.3 to 65.5 ± 38.5 ng/L; P = .02) that peaked at administration day 3 and declined thereafter. By day 7 after cessation of both drugs, there was no difference in serum gastrin concentrations compared to those before administration (famotidine P = .99; omeprazole P = .99). During or after administration, gastrin concentrations above 3 times the upper reference range were rare (12 of 224 samples). Conclusions and Clinical Importance A 7‐day withdrawal from short‐term administration of famotidine or omeprazole is sufficient for serum gastrin to return to baseline concentrations. Withholding famotidine or omeprazole for longer before investigating pathologic causes of hypergastrinemia is unnecessary.
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Affiliation(s)
- N L Parente
- Department of Small Animal Clinical Sciences, Michigan State University College of Veterinary Medicine, East Lansing, MI
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Dayer T, Howard J, Spreng D. Septic peritonitis from pyloric and non-pyloric gastrointestinal perforation: prognostic factors in 44 dogs and 11 cats. J Small Anim Pract 2013; 54:625-9. [DOI: 10.1111/jsap.12151] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- T. Dayer
- Department of Small Animal Surgery, Vetsuisse Faculty; University of Bern; Bern Switzerland
| | - J. Howard
- Department of Clinical Pathology, Vetsuisse Faculty; University of Bern; Bern Switzerland
| | - D. Spreng
- Department of Small Animal Surgery, Vetsuisse Faculty; University of Bern; Bern Switzerland
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Monteiro-Steagall BP, Steagall PVM, Lascelles BDX. Systematic review of nonsteroidal anti-inflammatory drug-induced adverse effects in dogs. J Vet Intern Med 2013; 27:1011-9. [PMID: 23782347 DOI: 10.1111/jvim.12127] [Citation(s) in RCA: 116] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Revised: 04/08/2013] [Accepted: 05/14/2013] [Indexed: 12/01/2022] Open
Abstract
The aim of this systematic review was to identify, assess, and critically evaluate the quality of evidence of nonsteroidal anti-inflammatory drug (NSAID)-induced adverse effects in dogs. Original prospective studies published in peer-reviewed journals in English (1990-2012) that reported data on the safety of NSAIDs administration in dogs were searched. For each study, design type (I, II, III, or IV) and assessment of quality (+, Ø, -) were rated. For each drug, quantity and consistency rating (***, **, *) and strength of evidence (high, moderate, low, or extremely low) were identified and evaluated. The strength of evidence was defined in terms of how applicable and relevant the conclusions were to the target population. Sixty-four studies met the inclusion criteria. Thirty-five (55%) research studies and 29 (45%) clinical trials were identified. A high strength of evidence existed for carprofen, firocoxib, and meloxicam; moderate for deracoxib, ketoprofen, and robenacoxib; and low for etodolac. Quality and consistency rating were as follows: carprofen (***/***), deracoxib (**/***), etodolac (*/unable to rate), firocoxib (***/**), ketoprofen (**/***), meloxicam (***/***), and robenacoxib (**/**), respectively. Adverse effects were detected in 35 studies (55%) and commonly included vomiting, diarrhea, and anorexia. Three studies (5%) reported a power analysis related to adverse effects of ≥80%. In randomized, placebo-controlled, blinded studies (n = 25, 39%), the incidence of adverse effects was not statistically different between treated and control dogs. Finally, most studies were not appropriately designed to determine the safety of NSAIDs, and involved a healthy nongeriatric population of research dogs.
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Affiliation(s)
- B P Monteiro-Steagall
- Veterinary Anesthesia Consultancy Services, Rua Cel. Mello de Oliveira, Sao Paulo, Brazil
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Liver. CANINE AND FELINE GASTROENTEROLOGY 2013. [PMCID: PMC7161409 DOI: 10.1016/b978-1-4160-3661-6.00061-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
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Lin LS, Kayasuga Y, Shimohata N, Kamata H, Suzuki S, Echigo R, Mochizuki M, Chung UI, Sasaki N. Lyophilized aspirin with trehalose may decrease the incidence of gastric injuries in healthy dogs. J Vet Med Sci 2012; 74:1511-6. [PMID: 22785245 DOI: 10.1292/jvms.12-0109] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Trehalose has several novel anti-inflammatory and cell-protective functions. We hypothesized that lyophilized aspirin/trehalose could decrease the severity of aspirin-induced gastropathy. Thirteen dogs were assigned into aspirin, lyophilized aspirin/trehalose, and control groups, and the gastric lesions were assessed on gastroscopy with the modified Lanza scale. Another 6 dogs were used to measure the plasma aspirin concentration by high-performance liquid chromatography after aspirin or lyophilized aspirin/trehalose administration. The results indicated that lyophilized aspirin/trehalose induced less gastric ulceration than aspirin despite maintaining therapeutic concentrations of plasma aspirin in both the groups. Lyophilized aspirin/trehalose might be a solution to decrease aspirin-induced gastropathy.
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Affiliation(s)
- Lee-Shuan Lin
- Department of Veterinary Surgery, Graduate School of Agriculture and Life Science, The University of Tokyo, Tokyo, Japan
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KuKanich B, Bidgood T, Knesl O. Clinical pharmacology of nonsteroidal anti-inflammatory drugs in dogs. Vet Anaesth Analg 2012; 39:69-90. [PMID: 22151877 DOI: 10.1111/j.1467-2995.2011.00675.x] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
OBJECTIVES To discuss the clinical pharmacology of currently licensed veterinary NSAIDs and to review gastrointestinal and renal adverse effects as well as drug-drug interactions that have been reported with these drugs. To review the use of NSAIDs in the peri-operative setting and their use in patients with osteoarthritis. To further review the reported effects of NSAIDs on canine articular cartilage and liver as well as the clinical relevance of a washout period. DATABASES USED PubMed, CAB abstracts and Google Scholar using dog, dogs, nonsteroidal anti-inflammatory drugs and NSAID(s) as keywords. CONCLUSIONS A good understanding of the mechanisms by which NSAIDs elicit their analgesic effect is essential in order to minimize adverse effects and drug-drug interactions. Cyclooxygenase (COX) is present in at least two active isoforms in the body and is the primary pharmacologic target of NSAIDs. Inhibition of COX is associated with the analgesic effects of NSAIDs. COX is present in the gastrointestinal tract and kidneys, along with other areas of the body, and is also the likely reason for many adverse effects including gastrointestinal and renal adverse effects. The newer veterinary approved NSAIDs have a lower frequency of gastrointestinal adverse effects in dogs compared to drugs such as aspirin, ketoprofen and flunixin, which may be due to differential effects on the COX isoforms. There are currently no published reports demonstrating that the newer NSAIDs are associated with fewer renal or hepatic adverse effects in dogs. NSAIDs remain the cornerstone of oral therapy for osteoarthritis unless contraindicated by intolerance, concurrent therapies or underlying medical conditions. NSAIDs are also effective and frequently used for the management of post-operative pain.
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Affiliation(s)
- Butch KuKanich
- Kansas State University College of Veterinary Medicine, Manhattan, KS, USA
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Buob S, Johnston AN, Webster CRL. Portal hypertension: pathophysiology, diagnosis, and treatment. J Vet Intern Med 2011; 25:169-86. [PMID: 21382073 DOI: 10.1111/j.1939-1676.2011.00691.x] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Portal hypertension (PH) is the result of increased vascular resistance in the portal circulation, increased portal venous blood flow, or both. In veterinary medicine, where portal pressure is seldom measured directly, the diagnosis of PH often is inferred from identification of associated complications including multiple acquired portosystemic shunts, ascites, and hepatic encephalopathy. Likewise, treatment of PH primarily is aimed at controlling these complications. The goal of this review is to provide an update on the pathophysiology, diagnosis, and treatment of PH. The review draws from information in the veterinary hepatology literature, reviews, and consensus statements in human hepatology and the literature on experimental models of PH.
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Affiliation(s)
- S Buob
- Department of Clinical Sciences, Tufts Cummings School of Veterinary Medicine, North Grafton, MA, USA
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