Efficacy of misoprostol in prevention of gastric hemorrhage in dogs treated with high doses of methylprednisolone sodium succinate

Cécile R. Rohrer From the Departments of Small Animal Clinical Sciences (Rohrer, Hill, Fischer, Fox, Schaer, Preast, Burrows) and Pathobiology (Ginn), College of Veterinary Medicine, University of Florida, Gainesville, FL 32610-0126.

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Richard C. Hill From the Departments of Small Animal Clinical Sciences (Rohrer, Hill, Fischer, Fox, Schaer, Preast, Burrows) and Pathobiology (Ginn), College of Veterinary Medicine, University of Florida, Gainesville, FL 32610-0126.

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Andrea Fischer From the Departments of Small Animal Clinical Sciences (Rohrer, Hill, Fischer, Fox, Schaer, Preast, Burrows) and Pathobiology (Ginn), College of Veterinary Medicine, University of Florida, Gainesville, FL 32610-0126.

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Leslie E. Fox From the Departments of Small Animal Clinical Sciences (Rohrer, Hill, Fischer, Fox, Schaer, Preast, Burrows) and Pathobiology (Ginn), College of Veterinary Medicine, University of Florida, Gainesville, FL 32610-0126.

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Michael Schaer From the Departments of Small Animal Clinical Sciences (Rohrer, Hill, Fischer, Fox, Schaer, Preast, Burrows) and Pathobiology (Ginn), College of Veterinary Medicine, University of Florida, Gainesville, FL 32610-0126.

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Pamela E. Ginn From the Departments of Small Animal Clinical Sciences (Rohrer, Hill, Fischer, Fox, Schaer, Preast, Burrows) and Pathobiology (Ginn), College of Veterinary Medicine, University of Florida, Gainesville, FL 32610-0126.

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Vanessa A. Preast From the Departments of Small Animal Clinical Sciences (Rohrer, Hill, Fischer, Fox, Schaer, Preast, Burrows) and Pathobiology (Ginn), College of Veterinary Medicine, University of Florida, Gainesville, FL 32610-0126.

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Colin F. Burrows From the Departments of Small Animal Clinical Sciences (Rohrer, Hill, Fischer, Fox, Schaer, Preast, Burrows) and Pathobiology (Ginn), College of Veterinary Medicine, University of Florida, Gainesville, FL 32610-0126.

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Abstract

Objective

To determine whether administration of misoprostol prevents gastric hemorrhage in healthy dogs treated with high doses of methylprednisolone sodium succinate (MPSS).

Animals

18 healthy hound-type dogs of both sexes.

Procedure

All dogs were given high doses of MPSS (30 mg/kg of body weight, initially, then 15 mg/kg 2 and 6 hours later, and, subsequently, q 6 h for a total of 48 hours) IV. Dogs were assigned randomly to receive concurrent treatment with misoprostol (4 to 6 μg/kg, PO, q 8 h; n = 9) or an empty gelatin capsule (9). Gastroduodenoscopy was performed before and after treatment. Hemorrhage was graded from none (0) to severe (3) for each cardia, fundus, antrum, and duodenum. A total stomach score was calculated as the sum of the regional stomach scores. Food retention was recorded, and pH of gastric fluid was determined. Gastric and fecal occult blood was measured.

Results

Gastric hemorrhage was evident in all dogs after MPSS administration, and its severity was similar in both groups. Median total stomach score was 6 for misoprostol-treated dogs and 5.5 for dogs given the gelatin capsule. Difference in gastric acidity, frequency of food retention, and incidence of occult blood in gastric fluid and feces was not apparent between the 2 groups.

Conclusions and Clinical Relevance

Administration of misoprostol (4 to 6 μg/kg, PO, q 8 h) does not prevent gastric hemorrhage caused by high doses of MPSS. Alternative prophylactic treatment should be considered. (Am J Vet Res 1999;60:982–985)

Abstract

Objective

To determine whether administration of misoprostol prevents gastric hemorrhage in healthy dogs treated with high doses of methylprednisolone sodium succinate (MPSS).

Animals

18 healthy hound-type dogs of both sexes.

Procedure

All dogs were given high doses of MPSS (30 mg/kg of body weight, initially, then 15 mg/kg 2 and 6 hours later, and, subsequently, q 6 h for a total of 48 hours) IV. Dogs were assigned randomly to receive concurrent treatment with misoprostol (4 to 6 μg/kg, PO, q 8 h; n = 9) or an empty gelatin capsule (9). Gastroduodenoscopy was performed before and after treatment. Hemorrhage was graded from none (0) to severe (3) for each cardia, fundus, antrum, and duodenum. A total stomach score was calculated as the sum of the regional stomach scores. Food retention was recorded, and pH of gastric fluid was determined. Gastric and fecal occult blood was measured.

Results

Gastric hemorrhage was evident in all dogs after MPSS administration, and its severity was similar in both groups. Median total stomach score was 6 for misoprostol-treated dogs and 5.5 for dogs given the gelatin capsule. Difference in gastric acidity, frequency of food retention, and incidence of occult blood in gastric fluid and feces was not apparent between the 2 groups.

Conclusions and Clinical Relevance

Administration of misoprostol (4 to 6 μg/kg, PO, q 8 h) does not prevent gastric hemorrhage caused by high doses of MPSS. Alternative prophylactic treatment should be considered. (Am J Vet Res 1999;60:982–985)

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