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Gastric cytoprotective agents

Mansfield, C.S. and Hyndman, T. (2013) Gastric cytoprotective agents. In: Washabau, R.J. and Day, M.J., (eds.) Canine and Feline Gastroenterology. Elsevier Saunders, St. Louis, Missouri, pp. 500-506.

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Gastric cytoprotective agents are used when normal gastric defense mechanisms are disrupted, thereby exposing submucosal layers to damage from gastric acid, or when there is another need for reducing gastric acidity, such as esophageal disease. Signs of significant gastric ulceration are hematemesis and melena. Hematemesis refers to the vomiting of blood, which, when digested, may have the appearance of coffee grounds. Gross melena (digested blood in the feces) only occurs after significant volumes of blood have been lost into the intestinal lumen.

The gastric mucosa has several intrinsic properties that protect it from autodigestion, including intact apical cell membranes, tight junctions, bicarbonate secretion, mucus production, rich blood supply, active cell renewal, surface active phospholipids, and endogenous prostaglandins. Gastric ulceration is believed to have its origins in the disruption of the mucosal barrier, or as a result of excessive acid secretion (Box 45-1), and is more commonly reported in dogs than in cats.1, 2, 3 and 4 History and physical examination, as well as full metabolic assessment, will help to rule out systemic disease and drug administration as the underlying cause. Strenuous exercise, particularly in sled dogs, is associated with increased intestinal permeability and gastrointestinal ulceration.5 and 6 The use of corticosteroids in dogs with intervertebral disk disease has been associated with severe gastrointestinal ulceration.7 If no underlying cause is identified abdominal ultrasound combined with further testing, such as endoscopy or gastric biopsy, may be required.

Publication Type: Book Chapter
Murdoch Affiliation: School of Veterinary and Life Sciences
Publisher: Elsevier Saunders
Copyright: © 2013 Elsevier Inc.
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