Double-blinded placebo-controlled clinical trial of prophylactic omeprazole in dogs treated surgically for acute thoracolumbar intervertebral disc extrusion

J Vet Intern Med, 2023 · DOI: 10.1111/jvim.16642 · Published: March 1, 2023

Neurology Veterinary Medicine Gastroenterology

Simple Explanation

This study investigates whether omeprazole, a drug that reduces stomach acid, can prevent gastrointestinal (GI) issues in dogs undergoing surgery for a slipped disc in their back (TL-IVDE). The study compared dogs that received omeprazole to those who received a placebo. The researchers looked for signs of GI problems like vomiting, diarrhea, and blood in the stool. They also ran lab tests to check for signs of GI bleeding or inflammation. The study found that omeprazole did not significantly reduce the occurrence of GI problems in these dogs. This suggests that giving omeprazole preventatively may not be necessary for all dogs undergoing this type of surgery.

Study Duration

18 Months

Participants

37 client-owned dogs undergoing hemilaminectomy for acute TL-IVDE

Evidence Level

Level 1, Randomized double-blinded placebo-controlled prospective clinical trial

Key Findings

1
The frequency of GI signs was not significantly different between the omeprazole and placebo groups (P = .59).
2
Abnormal cPLI during hospitalization was the only clinicopathologic difference identified between the omeprazole and placebo groups (P = .02).
3
A positive FOB test was more common in dogs with GI signs during hospitalization (P = .03).

Research Summary

This study evaluated the efficacy of prophylactic omeprazole in preventing gastrointestinal (GI) complications in dogs undergoing surgery for acute thoracolumbar intervertebral disc extrusion (TL-IVDE). The study found no significant difference in the frequency of GI signs between the omeprazole and placebo groups, suggesting that prophylactic omeprazole treatment does not decrease clinically detectable GI complications in these dogs. Clinicopathologic evidence suggestive of GI bleeding was present in approximately half of the dogs, but was not significantly different between the two groups. Abnormal cPLI was more frequent in the omeprazole group while FOB positivity was more common in dogs with GI signs.

Practical Implications

Re-evaluate Prophylactic Use of Omeprazole

The study suggests that routine prophylactic use of omeprazole may not be necessary in all dogs undergoing surgery for TL-IVDE.

Consider Individual Risk Factors

Clinicians should consider individual risk factors for GI complications before prescribing prophylactic gastroprotectants.

Further Research Needed

Further research is needed to determine the optimal use of gastroprotectants in dogs with TL-IVDE, particularly in those with specific risk factors or existing GI disease.

Study Limitations

1
The generalizability of the results is limited as the study excluded dogs with additional risk factors for GI bleeding.
2
The study did not evaluate the potential risk associated with short-term, concurrent administration of PPIs and NSAIDs in dogs with TL-IVDE.
3
The severity of neurological dysfunction also might influence the development of GI signs which could not be fully evaluated.

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