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Objective—To evaluate the use of sucrose permeability testing to detect ulcers in the gastric squamous mucosa of horses.
Animals—13 adult horses ranging from 5 to 19 years of age.
Procedure—Following induction of gastric ulcers by intermittent feed deprivation, horses underwent sucrose permeability testing (administration of sucrose by nasogastric intubation followed by collection of urine at 2 and 4 hours after intubation) and gastric endoscopy. Squamous ulcers were assigned a severity score (range, 0 to 3) by use of an established scoring system. Horses were subsequently administered omeprazole for 21 days, and sucrose testing and endoscopy were repeated. Pair-wise comparisons of urine sucrose concentration were made between horses with induced ulcers before and after omeprazole treatment. Urine sucrose concentrations also were compared on the basis of ulcer severity score.
Results—Urine sucrose concentrations and ulcer severity scores were significantly higher in horses with induced ulcers before omeprazole treatment than after treatment. Urine sucrose concentrations were significantly higher for horses with ulcer severity scores > 1. Use of a cut-point value of 0.7 mg/mL revealed that the apparent sensitivity and specificity of sucrose permeability testing to detect ulcers with severity scores > 1 was 83% and 90%, respectively. Results were similar after adjusting sucrose concentrations for urine osmolality.
Conclusions and Clinical Relevance—Urine sucrose concentration appears to be a reliable but imperfect indicator of gastric squamous ulcers in horses. Sucrose permeability testing may provide a simple, noninvasive test to detect and monitor gastric ulcers in horses. ( Am J Vet Res 2004;65:31–39)
Objective—To compare effects of a commercially available omeprazole paste and a compounded omeprazole suspension on healing of gastric ulcers in Thoroughbred racehorses in active training.
Design—Randomized controlled trial.
Animals—32 horses with gastric ulcers.
Procedure—Horses were assigned to 2 groups on the basis of endoscopic gastric ulcer severity. Group-1 horses were treated with omeprazole suspension for 30 days and with omeprazole paste for an additional 30 days. Group-2 horses were treated with omeprazole paste for 30 days and omeprazole suspension for an additional 30 days. Serum omeprazole concentrations were measured in 4 additional healthy horses after administration of a single dose of each formulation. In all instances, omeprazole was administered at a dose of 4 mg/kg (1.8 mg/lb), PO.
Results—Ulcer severity scores on day 0 were not significantly different between groups. On day 30, ulcer severity score was significantly decreased, compared with day-0 score, in group-2 but not in group-1 horses. On day 60, ulcer severity score was significantly decreased, compared with day-0 and day-30 scores, in group-1 horses. In group-2 horses, ulcer severity score on day 60 was significantly lower than the day-0 score but was not significantly different from the day-30 score. Maximum observed serum omeprazole concentration and area under the concentration-time curve were significantly higher after administration of the paste versus the suspension formulation.
Conclusions and Clinical Relevance—Results suggest that although administration of the commercially available paste omeprazole formulation was effective in promoting healing of gastric ulcers in these horses, administration of the compounded omeprazole suspension was ineffective. (J Am Vet Med Assoc 2002;221:1139–1143)
Objective—To determine the efficacy of long-term enalapril administration in delaying the onset of congestive heart failure (CHF).
Design—Placebo-controlled, double-blind, multicenter, randomized trial.
Animals—124 dogs with compensated mitral valve regurgitation (MR).
Procedures—Dogs randomly assigned to receive enalapril or placebo were monitored for the primary endpoint of onset of CHF for ≤ 58 months. Secondary endpoints included time from study entry to the combined endpoint of CHF-all-cause death; number of dogs free of CHF at 500, 1,000, and 1,500 days; and mean number of CHF-free days.
Results—Kaplan-Meier estimates of the effect of enalapril on the primary endpoint did not reveal a significant treatment benefit. Chronic enalapril administration did have a significant benefit on the combined endpoint of CHF-all-cause death (benefit was 317 days [10.6 months]). Dogs receiving enalapril remained free of CHF for a significantly longer time than those receiving placebo and were significantly more likely to be free of CHF at day 500 and at study end.
Conclusions and Clinical Relevance—Chronic enalapril treatment of dogs with naturally occurring, moderate to severe MR significantly delayed onset of CHF, compared with placebo, on the basis of number of CHF-free days, number of dogs free of CHF at days 500 and study end, and increased time to a combined secondary endpoint of CHF-all-cause death. Improvement in the primary endpoint, CHF-free survival, was not significant. Results suggest that enalapril modestly delays the onset of CHF in dogs with moderate to severe MR.
Objective—To determine the effect of long-term administration of enalapril on renal function in dogs with severe, compensated mitral regurgitation.
Design—Randomized controlled trial.
Animals—139 dogs with mitral regurgitation but without overt signs of heart failure.
Procedure—Dogs were randomly assigned to be treated with enalapril (0.5 mg/kg [0.23 mg/lb], PO, q 24 h) or placebo, and serum creatinine and urea nitrogen concentrations were measured at regular intervals for up to 26 months.
Results—Adequate information on renal function was obtained from 132 dogs; follow-up time ranged from 0.5 to 26 months (median, 12 months). Mean serum creatinine and urea nitrogen concentrations were not significantly different between dogs receiving enalapril and dogs receiving the placebo at any time, nor were concentrations significantly different from baseline concentrations. Proportions of dogs that developed azotemia or that had a ≥ 35% increase in serum creatinine or urea nitrogen concentration were also not significantly different between groups.
Conclusions and Clinical Relevance—Results suggest that administration of enalapril for up to 2 years did not have any demonstrable adverse effects on renal function in dogs with severe, compensated mitral regurgitation. (J Am Vet Med Assoc 2002;221: 654–658)