scott@vtx-cpd.com

Replying to Ornella R. 27/03/2023 - 12:42

Thank you!

Let me know if you have any other questions!

Scott 🙂

Replying to Gisela T. 26/03/2023 - 16:37

Gisela.

I hope you are safe and well. Sorry for the delay in getting back to you.

Metoclopramide is definitely up for debate regarding how effective it is. I agree, cisapride is probably more effective in cats. Metoclopramide probably does still have some action in cats, so I would still consider using it in cats:

https://pubmed.ncbi.nlm.nih.gov/32515089/

I suppose the main benefit is it is injectable and we do not have injectable cisapride.

Hope that helps.

Scott

Replying to Magda Upton 23/03/2023 - 09:38

Hello Magda!

Lovely to hear from you. Great questions!!!! Generally, the use of enteric-coated human preparations is more unpredictable in cats and dogs as there are differences in the anatomy of the GI tract and pH between species. Having said that, most the dog studies use enteric-coated human tablets and they are demonstrated to be effective.

In human studies, the desired benefit of the drug therapy was not obtained because the tablet was crushed. Omeprazole is formulated as an enteric-coated tablet to avoid the inactivation of the drug by gastric acid. Crushing the tablet compromised the protective coating, which resulted in the loss of efficacy.

So generally I would not crush/remove the coating. But if there was no other option then I would!

Another thought might be the liquid omeprazole Bova re-formulate. We may even have an injectable form soon:

https://pubmed.ncbi.nlm.nih.gov/35546514/

I will check with BOVA where they are up to with that!

Hope that helps.

Scott 🙂

Replying to Emma Holt 23/03/2023 - 13:07

Hey Emma.

Thanks for your questions! Lovely to see you in person this week!

Scott 🙂

Replying to Vigre B. 24/03/2023 - 10:36

Hello Vigre.

Interesting case! You could indeed be dealing with an inherited cobalamin disorder!

Selective cobalamin malabsorption is a rare congenital disease. The first report about selective cobalamin malabsorption in dogs describes 2 related Giant Schnauzers that lacked the expression of the cobalamin-IF-receptor complex in the apical brush border of the ileal and renal epithelium. Classical clinical signs of IGS such as intermittent diarrhea, inappetence, poor body condition, and failure to grow typically manifest within the first year of age.

Several case reports and case series have described a selective cobalamin malabsorption in the Border Collie breed. Clinical manifestations in some cases are mild and the onset of clinical signs can be delayed into early adulthood compared to other breeds with selective cobalamin malabsorption. Also, juvenile cobalamin deficiency might not be routinely associated with hematologic changes in the Border Collie breed.

About 40% of healthy Border Collies have increased urine MMA levels, but none of the normocobalaminemic dogs in that study had increased plasma HCY concentrations compared to the Border Collies with cobalamin deficiency. It has been hypothesized that these dogs have a primary methylmalonic aciduria. Of note, hypocobalaminemia is also associated with an increased prevalence of EPI in Border Collies.

Would you be able to share the bloods? What was the cobalamin level? Did you check TLI and basal cortisol?

Interesting case!

Scott 🙂

Replying to Neus E. 22/03/2023 - 17:58

Thanks Neus.

This is a really interesting paper. We are chatting lots about omeprazole and the possible increase in bacterial load when dogs on omeprazole have an aspiration even due to the change in gastric pH and alteration to what swallowed bacteria survive!

I am sure you will not be surprised to hear there is omeprazole chat going on!

I will share this paper with the GI lot now!

Scott 🙂