Long term use of omeprazole in dogs

Re: Long term use of omeprazole in dogs

Hannah Wynne Richards — Mon, 12 May 2014 12:08:41 GMT

How on earth did that happen?

Wynne

Re: Long term use of omeprazole in dogs

Tim Charlesworth — Fri, 09 May 2014 14:12:27 GMT

I saw a dog once who had been on losec for 3 years without anyone noticing (they kept getting repeat prescriptions from different vets) who ended up with a fungal gastritis. Did fine once we stopped the losec. He actually had a hiatal hernia so came off meds altogether once that was fixed,

Tim

Re: Long term use of omeprazole in dogs

Martin Atkinson — Fri, 09 May 2014 10:08:42 GMT

[quote user="John Ellis"]...he said that there is a small risk of focal gastric lymphoma in people, but its ok because they can just cut it out![/quote] Personally I would have thought there was a greater risk of dying from a perforated gastro/duodenal ulcer than focal gastric lymphoma so I'd take the chance! Plus the chronic inflammation from an untreated gastric ulcer is as likely to be a predisposer to neoplasia as the drugs used to treat it.

Re: Long term use of omeprazole in dogs

Anthony Dennison — Fri, 09 May 2014 09:57:55 GMT

We have a dog that is on long term omeprazole, has been for years. The owner refuses to stop as the dog 'will be immediately sick'.

Anecdote alert:

My best mate at uni used to suffer terribly with heartburn, and had a really strong gag reflex (much entertainment when presented with a dirty pint). He went on treatment for helicobacter, and was diagnosed with a hiatal hernia. He's on omeprazole for life, if he's going out drinking he'll take a double dose! Fine now.

Re: Long term use of omeprazole in dogs

Mark Hedberg — Fri, 09 May 2014 08:42:38 GMT

[quote user="Arlo Guthrie"]

[quote user="John Ellis"]One of my colleagues asked her doctor about this, and he said that there is a small risk of focal gastric lymphoma in people, but its ok because they can just cut it out!! She has been on omeprazole for years now, and no problems so far. Obviously she isn't a dog, but thought it was interesting![/quote]

Very.

I've just been prescribed it, and it's changed my life - though I'm not sure I want to swap heartburn for a focal gastric lymphoma

[/quote]

Interestingly, before you do that, you may want to ask about helicobacter - the 'ulcer bacteria' is massively underdiagnosed, and i had chronic severe heartburn that resolved nicely once they put me on a helicobacter cocktail for 2 weeks.

Cheers,

Mark

Re: Long term use of omeprazole in dogs

Stephen Courtney — Thu, 08 May 2014 22:37:48 GMT

I had a dog on it for about 18 months. he did fine, till he died from multicentric lymphoma, which was on the cards anyway as he had adult onset demodex. among other things, includiung the problem we needed the omeprazole for.

I have another dog on it long term as well, she constantly regurgitates and coughs, has aspirated twice, and been worked up to the nth degree with no answer. Omeprazole is part of her cocktail, and she is doing OK, certainly no signs attributable to the omeprazole.

If you are really worried, you could switch to famotidine? but I agree that if it was solely nsaid related, it should have resolved a lot quicker. there is something else going on there.

Re: Long term use of omeprazole in dogs

Andrew Kent — Thu, 08 May 2014 18:36:41 GMT

[quote user="John Ellis"]One of my colleagues asked her doctor about this, and he said that there is a small risk of focal gastric lymphoma in people[/quote]

I think that's a typical GP making something up. The association was thought to be with carcinoids or carcinomas but there are multiple long term studies in people that say omeprazole is very safe. The main problem is that if you have gastric cancer it may mask the signs and make diagnosis more difficult.

Andy

Re: Long term use of omeprazole in dogs

Arlo Guthrie — Thu, 08 May 2014 17:18:57 GMT

Very.

I've just been prescribed it, and it's changed my life - though I'm not sure I want to swap heartburn for a focal gastric lymphoma

Re: Long term use of omeprazole in dogs

Kate Richardson — Thu, 08 May 2014 12:14:44 GMT

I have used omeprazole long term in dogs with no apparent side effects. I would be more concerned in this dog about the underlying cause of the melaena- if it was entirely due to NSAIDs then it should be resolved by now. So I would suspect they just tipped a sub clinical problem into a clinical one.

Re: Long term use of omeprazole in dogs

No Name — Thu, 08 May 2014 12:04:25 GMT

[quote user="Martin Atkinson"]

May be worth treating with a course of antibiotics as gastro-duodenal ulceration has if I recall correctly been associated with Helicobactor in dogs as well as humans. In humans they give amoxycillin plus metronidazole along with omeprazole and it can cure them

[/quote]

I remember looking into this but I couldn't find any evidence that dogs were infected with H. pylori but that they were often infected with other helicobacter spp. I believe it is mainly H. pylori which is associated with gastric ulceration in humans (although a lot of people will have the infection but never develop ulcers) and that others species are less pathogenic in humans.

Another anecdote - my mum was treated with antibiotics (not sure which ones) and omeperazole. Gastroscopy showed the ulcers healed following antibiotic treatment but my mum remains on omeperazole because if she doesn't take it for a while then she develops clinical signs again. She's been prescribed it indefinitely and has probably been on it for a good part of a decade now - her GP doesn't seem too worried.

Re: Long term use of omeprazole in dogs

Martin Atkinson — Thu, 08 May 2014 09:39:05 GMT

Re: Long term use of omeprazole in dogs

Stuart Fitzgerald — Thu, 08 May 2014 09:39:03 GMT

That's great, nice to get a bit of reasurance as I don't really think I have a whole lot of options with this case anyway. Thanks everyone.

Re: Long term use of omeprazole in dogs

Joyce Whitehead — Wed, 07 May 2014 21:13:53 GMT

We had an old lab some years ago with confirmed gastric ulceration on gastroscopy, no nasties on biopsy. He didn't respond to anything but omeprazole, and in the end must have been on it for 3-4 years till his legs gave out. We tried stopping a few times but he relapsed so we gave in. The owner was a human nurse and she said loads of people are on it long term. Certainly my dad had it for years.

Re: Long term use of omeprazole in dogs

John Ellis — Wed, 07 May 2014 20:49:12 GMT

One of my colleagues asked her doctor about this, and he said that there is a small risk of focal gastric lymphoma in people, but its ok because they can just cut it out!! She has been on omeprazole for years now, and no problems so far. Obviously she isn't a dog, but thought it was interesting!

John

Re: Long term use of omeprazole in dogs

Andrew Kent — Wed, 07 May 2014 20:20:17 GMT

Hi Stuart,

The concern with long term omeprazole is that is has experimentally been associated with causing carcinoids in rats with long term use. However that hasn't really been shown clinically and in people it is often used for years and years. We have seen dogs develop fungal gastritis with long term omeprazole but its unusual.

If nothing else controls the signs then go for it. If ranitidine or famotidine is as good it would be preferable. And as you say investigation would be the best!

The owner just needs to accept that there can be long term complications.

Andy