Alimentary - Gastric ulceration

Question 1

What causes ulcers?

Answer 1

Use of NSAIDS e.g. meloxicam e.g. metacam/loxicom

Question 2

How do NSAIDs cause ulcers?

Answer 2

They work by blocking the precursors to prostaglandins, PGE2.

By inhibiting COX-1, decreases protective mucosal barrier and blood flow in stomach and leading to acidic damage.

Also increases H+ cells pumped out, as the ATPase is regulated by prostaglandins.

Question 3

What are the clinical signs of ulceration?

Answer 3

Uncomfortable upon abdominal palpation
Vomiting up coffee ground looking substance
Endoscopic assessment can see it

Question 4

How far can the ulcer progress?

Answer 4

Through all 4 walls.

It will always affect the epidermis and if goes through all 4 will be fatal

Question 5

What can be done to continue the NSAIDs but manage the ulcer?

Answer 5

Ranitidine - a H2 antagonist so competes with H2/Histamine for HCl secretion from parietal cells

Omeprazole - reduces HCl in stomach as a proton pump inhibitor

Question 6

What can the owner do to help manage?

Answer 6

Feed proper amounts in regular meals
Administer NSAIDs with food
Avoid fatty foods
Weight management
Regular vet checks