ACVIM consensus statement: Support for rational administration of gastrointestinal protectants to dogs and cats

10 de fevereiro de 2020

Consenso ACVIM: Suporte para a administração racional de protetores gastrointestinais em cães e gatos

Autores

Stanley L. Marks, Peter H. Kook, Mark G. Papich, M. K. Tolbert, Michael D. Willard

Abstract

The gastrointestinal (GI) mucosal barrier is continuously exposed to noxious toxins, reactive oxy-gen species, microbes, and drugs, leading to the development of inflammatory, erosive, and ulti-mately ulcerative lesions. This report offers a consensus opinion on the rational administrationof GI protectants to dogs and cats, with an emphasis on proton pump inhibitors (PPIs), histaminetype-2 receptor antagonists (H2RAs), misoprostol, and sucralfate. These medications decreasegastric acidity or promote mucosal protective mechanisms, transforming the management ofdyspepsia, peptic ulceration, and gastroesophageal reflux disease. In contrast to guidelines thathave been established in people for the optimal treatment of gastroduodenal ulcers and gastro-esophageal reflux disease, effective clinical dosages of antisecretory drugs have not been wellestablished in the dog and cat to date. Similar to the situation in human medicine, practice ofinappropriate prescription of acid suppressants is also commonplace in veterinary medicine. Thisreport challenges the dogma and clinical practice of administering GI protectants for the routinemanagement of gastritis, pancreatitis, hepatic disease, and renal disease in dogs and cats lackingadditional risk factors for ulceration or concerns for GI bleeding. Judicious use of acid suppres-sants is warranted considering recent studies that have documented adverse effects of long-term supplementation of PPIs in people and animals

Keywords

Acid, canine, feline, gastroesophageal reflux, histamine type-2 receptor antagonist, misoprostol, proton pump inhibitor, sucralfate, ulcer

Palavras-chave

Acido gástrico, sucralfato, ulcera, refluxo, misoprostol, inibidores da bomba de protons, antagonistas do receptor de histamina tipo 2

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