Here Comes the Season of Gastroenteritis: Choose Remedies Wisely.
As we enter into the fall and the winter holidays, we know that the incidence of gastroenteritis is going to increase. Soon we'll start getting the calls about the dog that ate all the Halloween candy, or the cat that stole some of the Thanksgiving turkey. To help these pets with their stomach upset, one of the drugs we typically prescribe is an antacid. But have you ever stopped to think about which one to use? Are you confused about whether you really can break the omeprazole tablet? A look at recent studies can help you make the best decision.
Two articles in the Journal of Veterinary Internal Medicinepublished in 2015 ( Parkinson , et al. and Sutalo, et al.) showed that omeprazole is far superior to the H-2 blockers famotidine and ranitidine for cats. There were similar results in the studies for dogs. If your goal is truly acid suppression, a proton-pump inhibitor is the way to go.
I think we have all had at least one experience where a well-meaning pharmacist caused a problem with a client because of a misunderstanding of veterinary pharmacology. A friendly pharmacist once stopped a client of mine while she was buying omeprazole for her dog, and told her I must not be a very smart vet, because "everyone knows you cannot break omeprazole tablets--they are ineffective once broken." The helpful pharmacist went on to suggest that my client have my credentials reviewed for such an error.
Thankfully, some of the same studies that guide us about using a proton-pump inhibitor for acid suppression in our patients also provide us with valuable information about the use of broken tablets. For a similar canine study, look to a 2011 article by Tolbert, et al. in the Journal of Veterinary Internal Medicine.
GI upset is a common problem for our patients, especially in the upcoming holiday seasons, when temptations will be everywhere. Make sure you choose wisely when selecting an acid suppressant, but know that you have the tools to help at your fingertips.
As always, at DVMS, we welcome your call to discuss a chronic, complex, or complicated internal medicine, cardiology, or radiology case. Please do not hesitate to contact us at 480.635.1110 EXT.7 if we may be of assistance.
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