Adopting Best Practices: Rational Therapy for Gastrointestinal Ulceration and Erosion

摘要

The gastric mucosa is repeatedly exposed to noxious substances including an acidic pH, mechanical and chemical irritants, and digestive enzymes. The gastric mucosal barrier (GMB) is comprised of defense mechanisms that protect the gastric mucosa against these noxious substances. The GMB is comprised of a single layer of highly resistant epithelial cells that repel gastric acid and are capable of rapid repair, a double mucus layer that is rich in bicarbonate ions, the local production of prostaglandins that serve to regulate blood flow and stimulate the secretion of mucus and bicarbonate ions, and a rich mucosal blood supply. Injury to the upper GI mucosa develops when there is an imbalance between injurious agents and protective mechanisms. Gastrichyperacidity disorders, such as mastocytosis and gastrinoma, and diseases exacerbated by exposure to gastric acid, such as peptic ulceration and stress-related mucosal bleeding, are increasingly identified in canine and feline patients. The rational andappropriate use of gastroprotectants for the prevention and treatment of upper GI ulceration and erosion (GUE) is a matter of great concern. Herein, the objective of these proceedings is to review the evidence for the use of gastroprotectants as prophylaxis and treatment for GUE in dogs and cats.