CPD ARTICLE
pump inhibitors on calcium metabolism and bone
remodelling in dogs and cats suffering from chronic
kidney disease may further increase the risk of
osteoporosis and pathologic bone fractures in this
population.
Early studies in cats did not show overt changes in
serum cobalamin levels but did raise concerns for
changes in bone mineral density. For these reasons
antacids should be used judiciously in dogs and cats,
especially when suffering from renal disease, and its
use should be limited to patients with clear risk factors
or overt evidence of gastrointestinal ulceration or
gastrointestinal haemorrhage.
SUMMARY
To summarise, our understanding of antiemetics and
antacids have improved significantly over the last few
years and is likely to continue to change and improve
in the near future with new research. Maropitant
has largely replaced many of the older antiemetics
as an empirical choice and can often be used in
combination with older antiemetics in refractory
cases with even greater success.
Proton pump inhibitors such as omeprazole and
sucralfate form the cornerstones for the management
of gastrointestinal ulcerations and there is little
evidence for the use of older alternatives such as
histamine receptor blockers. Omeprazole is the most
readily available proton pump inhibitor to practice and
has been shown to have a superior effect on gastric
acid suppression when used twice daily instead of
once daily as previously advised. Finally, these drugs
are not without complications and side effects and
should be used prudently.
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Dr. Wilco Botha,
BSc BVSc (Hons)
MMedVet (Med)
Section of Small Animal Medicine, Department of
Companion Animal Clinical Studies,
Faculty of Veterinary Science, University of Pretoria.
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