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Antacid use and Gi disease in cats

Sutalo S, Ruetten M, et al. The effect of orally administered ranitidine and once-daily or twice-daily orally administered omeprazole on intragastric pH in cats. J Vet Intern Med. 2015 May;29(3):840-6.

Disorders related to gastric acid develop from an imbalance between the secretion of gastric acid and gastric acid mucosal defense mechanisms. While well studied in humans as gastric acidity has a significant role in gastric ulcer development, little is known in animals, especially cats, due to the invasive nature of viewing the stomach mucosal lining. Therefore, gastric acid suppressants, such as ranitidine and famotidine (histamine-2 receptor antagonists) and omeprazole (proton pump inhibitor), are commonly used empirically in cats for gastrointestinal disease.

A new system has been recently developed, the Bravo System, which allows noninvasive, continuous assessment of intragastric pH over longer time periods.  Another recent study used this monitoring system to evaluate the effects of twice daily omeprazole versus standard doses of famotidine on intragastric pH in cats. The current study’s aims were different where in this situation the authors examined the effects of orally administered ranitidine and omeprazole on intragastric pH and compared the efficacy of once-daily to twice-daily dosing of omeprazole in cats.

Additionally in this study, the authors used enteric coated omeprazole granules rather than splitting tablets due to the closer dosage approximation by administering 1 granule per kg body weight (1 granule =1.1mg omeprazole) administered in a gelatin capsule. A small amount of highly palatable canned cat food was fed immediately after administration here versus administration of a water chaser by syringe.

The results of the study showed twice-daily dosing of omeprazole significantly increased intragastric pH, but pH did not differ between once-daily dosing of omeprazole or ranitidine treatments compared to placebo-treated cats.  Therefore, twice-daily administration of omeprazole would be the preferred treatment for acid-related gastrointestinal disease in cats. (VT)

See also:

Parkinson S, Tolbert K, et al. Evaluation of the effect of orally administered acid suppressants on intragastric pH in cats. J Vet Intern Med.  2015 Jan;29(1):104-12.