Forums » Internal Medicine - Small Animal

Gastroprotectants and Antacids

    • 272 posts
    December 5, 2018 1:19 PM EST

    In a VetVine Specialty Update on the topic of Use of Gastroprotectants and Antacids in Dogs and Cats (running time: 15 mins), Elisabeth Zenger, DVM, PhD, DACVIM (SAIM) summarizes 17 points of consideration as outlined in the most recent ACVIM Consensus Statement regarding the use of these drugs in dogs and cats.

    As an addendum, Dr. Zenger has also provided this information regarding the prescribing and dosing of a couple of the drugs discussed:

    1) PPI dosing (e.g. Omeprazole 10mg, 20mg, 40mg extended release capsules or Pantoprazole IV solution):

    1 mg/kg BID - always rounding up if there is a strong indication for the PPI (i.e. hematemesis).  

    If use is as an empirical treatment, you can round down if it's very close to the tablet size. 

    So, for a dog with hematemesis that weighs 11 kg I would give 20mg BID, whereas an 11 kg dog with IRIS stage 2 CKD and occasional vomiting 10mg BID might be okay to try. In the second example, if there was no difference after a week, then a short trial of 20mg BID could be tried. If there was still no difference, I would not continue.

     
    2) Sucralfate dosing is very empirical and case specific in my hands. I imagine the size of the tablet and how much surface area that would cover, and decide on what would be needed for the particular patient. So, a Chihuahua might get 1/4g once to twice daily whereas a big dog with hematemesis and melena after an NSAID might get a 10g load followed by 2g every 4 hours for 24 hours. Sucralfate should be given as a slurry separated from food and other medications by at least 1 hour.