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

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.

Water requirements of canine athletes during multi-day exercise

BACKGROUND

Exercise increases water requirements, but there is little information regarding water loss in dogs performing multi-day exercise OBJECTIVES: Quantify the daily water turnover of working dogs during multi-day exercise and establish the suitability of SC administration of tracer to determine water turnover.

ANIMALS

Fifteen privately owned Labrador retrievers trained for explosive detection duties and 16 privately owned Alaskan Huskies conditioned for mid-distance racing.

METHODS

All dogs received 0.3 g D₂ O/kg body weight by IV infusion, gavage, or SC injection before the start of a multi-day exercise challenge. Explosive detection dogs conducted 5 days of simulated off-leash explosive detection activity. Alaskan sled dogs completed a mid-distance stage race totaling 222 km in 2 days. Total body water (TBW) and daily water turnover were calculated using both indicator dilution and elimination regression techniques.

RESULTS

Total body water (% of body weight) varied from 60% ± 8.6% in minimally conditioned Labrador retrievers to 74% ± 4.5% in highly conditioned Labrador retrievers. Daily water turnover was as high as 45% of TBW during exercise in cold conditions. There was no effect of sex or speed on daily water turnover. There was good agreement between results calculated using the indicator dilution approach and those calculated using a semilog linear regression approach when indicator isotope was administered IV or SC.

CONCLUSIONS AND CLINICAL IMPORTANCE

Water requirements are influenced primarily by the amount of work done. SC administration of isotope-labeled water offers a simple and accurate alternative method for metabolic studies.

Gastritis and Gastric Ulcers in Working Dogs

Gastritis and gastric ulcers are an important cause of morbidity and mortality in canine athletes. Although the majority of scientific work on this condition has been performed in ultraendurance racing sled dogs, this condition has been identified in other canine athletes, including sled dogs competing in shorter events and dogs performing off-leash explosive detection duties. The cause of the syndrome is unknown, but current hypotheses propose a link between exercise-induced hyperthermia and loss of gastric mucosal barrier function as an early event in the pathogenesis. Treatment is focused on prevention of clinical disease using acid secretion inhibitors, such as omeprazole, which has excellent efficacy in controlled clinical studies.

Effect of exercise on gastric health in field retrievers

Exercise-induced gastrointestinal disease (EIGD) has been reported in all domestic athletes. In dogs and humans, EIGD is most commonly associated with ultra-endurance racing sled dogs and marathon/triathlon competitors, respectively, suggesting that the syndrome is specifically a function of prolonged exercise. However, EIGD is also common in horses that exercise for brief periods, and more recently, EIGD has been identified in Labrador retrievers that perform off-leash explosive detection patrols. In this study, we tested the hypothesis that EIGD could be induced in retrievers performing competition-style retrieves. Gastric endoscopy and histopathological examination of gastric biopsies were performed on 10 healthy retrievers before and 24 h after a series of multi-set retrieves totalling over 5 km. Although the exercise challenge resulted in a small but statistically significant increase in gastric endoscopy severity score, it did not result in a higher prevalence of clinically-significant gastric disease or changes in gastric histopathology. We conclude that competitive retrieving is unlikely to induce clinically-significant gastric disease in healthy dogs.