Top Tip 12 - Medicine - Which anti-ulcer medication to choose?

Inhibiting gastric acid secretion is of fundamental importance in the treatment of gastritis and gastric ulceration whether it is secondary to gastrointestinal or metabolic causes or a consequence of steroid or NSAID therapy. Commonly used drugs include H2 receptors blockers (eg ranitidine, famotidine, cimetidine) or proton pump inhibitors (eg omeprazole). But which is the best “anti-ulcer” medication?

New research in dogs indicates that proton pump inhibitors are likely superior to H2 receptors blockers in the management of gastric ulceration. A prospective, placebo controlled study was performed by Tolbert and others from North Carolina State University and presented in abstract form at this year’s American College of Veterinary Internal Medicine meeting (ACVIM). The study compared oral famotidine (1-1.3mg/kg) and omeprazole (1.5-2.6mg/kg q24) for the control of intragastric pH in dogs. We know from studies in people that healing of gastric ulcers likely requires a gastric pH >3. In this study, omeprazole maintained a gastric pH > 3 for a greater percentage of the day compared with famotidine treated dogs (54.1-62.5% compared with 21.5).

Matt Reeves is a small animal medicine specialist at SARC. Matt is most happy to discuss diagnostic and treatment queries with referring vets at any time. If you have a question, please feel welcome to call Matt on (03) 9532 5261.

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