Canis ISSN: 2398-2942

Gastric ulceration

Contributor(s): Ken Harkin, James Simpson

Introduction

  • Superficial erosions - more common than deep ulceration.
  • Cause: drugs (especially corticosteroids, non-steroidal anti-inflammatory drugs), mast cell neoplasia, hepatic disease, renal disease, gastric neoplasia, chronic gastritis, gastroma,Helicobacter.
  • Signs: vomiting, hematemesis, melena and weight loss.
  • Diagnosis: gastroscopy.
  • Treatment: eliminate underlying cause, H2 antagonists, sucralfate.
  • Prognosis: may perforate → septic peritonitis and death.

Pathogenesis

Pathophysiology

  • Compromised blood supply → death of superficial gastric cells.
  • Excessive gastric acid production due to gastrinoma, high parasympathetic drive → mucosal damage and erosions.
  • Toxins directly damaging gastric mucosa and interfering with epithelial renewal, eg uremia → erosions in superficial cellular layer.
  • Toxins, drugs and spiral organisms directly damaging gastric mucosal barrier stimulating histamine release → gastric and production → more damage → vicious cycle established.

Timecourse

  • Variable depending on etiology.

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Boothe D M (1999) Gastrointestinal pharmacology. Vet Clin North Am Small Anim Pract 29 (2), 343-376 PubMed.
  • Penninck D & Tidwell A (1997) Ultrasonography of gastric ulceration in the dog. Vet Radiol 38, 308-312 PubMed.
  • Meddings J B et al (1995) Noninvasive detection of nonsteroidal anti-inflammatory drug-induced gastropathy in dogs. Am J Vet Res 56 (8), 977-981 PubMed.
  • Jenkins C C & DeNovo R C (1991) Omeprazole - a potent anti-ulcer drug. Comp Cont Ed Prac Vet 13, 1578-1583 AGRIS FAO.
  • Moreland K J (1988) Ulcer disease of the upper gastrointestinal tract in small animals: pathophysiology, diagnosis, and management. Comp Cont Ed 10 (11), 1256-1278 VetMedResource.


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