You wake up in the morning to find that your dog has vomited and there are flecks of red blood within the vomit. You panic and try to figure out what could be wrong. After a few minutes of frantic googling, you come to the realization that your dog has stomach ulcers. You rush your dog to your veterinarian, and thankfully, with treatment, it makes a full recovery. Stomach ulcers in dogs are a common condition and can be caused by a number of different things. The good news is that stomach ulcers in dogs are often treatable, and most dogs make a full recovery with proper medical care.
What is the normal physiology of the stomach in dogs?
The stomach's mucosal barrier serves as a protective layer for the stomach from gastric acid, digestive enzymes, and food. The stomach epithelial cells secrete mucus that coats the stomach and provides additional protection. The stomach also has a layer of smooth muscle that contracts to help with the mixing and grinding of food. Additionally, various beneficial prostaglandins are present that provide protective mechanisms to the stomach.
The stomach mucosal barrier is made up of several different layers:
- The epithelial cell layer is the first layer of defence against stomach acids and other irritants. The stomach epithelial cells secrete mucus that coats the stomach and provides additional protection.
- The mucous layer is the second layer of defence against stomach acids and other irritants. The mucous layer is composed of mucus-secreting cells called goblet cells. This layer provides a barrier between the stomach lining and the stomach contents.
- The submucosal layer is the third layer of defence against stomach acids and other irritants. This layer is made up of connective tissue and blood vessels. The submucosal layer provides nutrients to the stomach lining and helps to repair any damage that may occur.
- The muscularis layer is the fourth layer of defence against stomach acids and other irritants. This layer is made up of smooth muscle tissue that contracts to mix and grind food.
What exactly are stomach ulcers in dogs?
Imagine you're a dog owner whose pet has been diagnosed with stomach ulcers. This can be a scary experience, but it's important to remember that most stomach ulcers are treatable. Your veterinarian will prescribe medications to help your dog heal. In the meantime, here's what you need to know about stomach ulcers in dogs.
Just like humans, stomach ulcers in dogs are open sores that develop on the lining of the stomach. These stomach ulcers can cause your dog a lot of pain and may even lead to more serious health problems if left untreated. Erosions and stomach ulcers occur when there is too much stomach acid produced, or when there are changes to the protective stomach mucosal barrier.
What causes stomach ulcers in dogs?
Increased stomach acid production or altered stomach mucosal barriers may cause stomach ulceration. Gastrinomas, renal disease, liver disease, and mast cell tumours are all associated with increased gastric acid production. Pancreatic islet cells produce excessive amounts of gastrin in mast cell tumours. Histamine is a mediator of gastric parietal cell acid secretion and can cause hyperacidity in the stomach.
The gastric or stomach mucosal barrier function can be altered by certain medical conditions, such as Addison's disease, inflammatory bowel disease, gastric foreign bodies, and liver disease, for example. Cachexia (poor body condition with marked muscle loss) and hypoproteinemia (low blood proteins), for example, can reduce cell turnover, weaken the mucosal barrier, and reduce healing. Shock and gastric dilatation-volvulus, for example, may result in ulceration because of reduced mucosal blood flow. Stomach ulcers in dogs can also be caused by various forms of stomach cancers (such as lymphoma or leiomyosarcoma) and infections (such as helicobacter infections).
An increased risk of gastric ulceration is seen with nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids, as they inhibit the production of protective prostaglandins. Prostaglandins play a crucial role in maintaining mucosal blood flow and epithelial healing, both of which are reduced by NSAIDs. Even topical NSAIDs may cause stomach ulcers in dogs, therefore it is important to be cautious. Concurrent utilization of NSAIDs and glucocorticoids may increase the risk of stomach ulcers in dogs and should not be used together.
What are the symptoms of stomach ulcers in dogs?
Physical symptoms and abnormalities can vary considerably, but common signs include:
- vomiting (most common symptom)
- blood in the vomit (fresh or old blood)
- weight loss
- melena (black, tarry stools)
- abdominal pain
- pale mucous membranes
How are stomach ulcers diagnosed in dogs?
A stomach ulcer is usually diagnosed based on the history and clinical signs, as well as results from a physical examination and diagnostic testing.
During the physical examination, your veterinarian will feel your dog's abdomen for any pain or abnormalities. A rectal examination may also be performed. Diagnostic tests that may be recommended include:
- Complete blood count (CBC) - changes in the CBC can reveal blood loss or the underlying cause and can also reveal an anemia
- Biochemical blood profile - to evaluate the major organs and metabolic system
- Stool sample analysis - to measure any evidence of blood in the stool
- Abdominal radiographs (X-rays) or ultrasonography - may reveal changes to the stomach wall and are important to perform to help diagnose the cause of vomiting
- Barium contrast study (upper gastrointestinal series) - filling defects from the barium series can suggest severe stomach ulcers
- Endoscopy - is often diagnostic as the endoscopy camera can visualize the stomach ulcers
What are the treatment options for stomach ulcers in dogs?
The specific therapy for a gastric ulcer involves reducing the amount of stomach acid that is secreted and providing protection for the mucosal lining of the stomach. Whenever possible, it is also important to treat any underlying causes of the ulcer.
H2 (Histamine) Receptor Antagonists
H2 receptor antagonists work by blocking histamine receptors on the cells that line the stomach, which decreases the amount of acid produced. Common examples of H2 receptor antagonists include famotidine, cimetidine and ranitidine.
Proton Pump Inhibitors
Proton pump inhibitors are more effective than other gastro protectants for acid-related gastric ulceration. Proton pump inhibitors work by inhibiting the enzyme, hydrogen-potassium ATPase, which prevents hydrogen ions from being secreted into the stomach, therefore reducing stomach acid production. Omeprazole is commonly used to treat stomach ulcers in dogs and should be dosed twice daily for maximum benefit.
Prostaglandin E Analogs
The synthetic prostaglandin analogs work by increasing stomach mucosal protection. At higher doses, these drugs can decrease gastric acid secretion and increase mucosal healing rates. Misoprostol is most commonly used to treat gastric ulcers caused by NSAIDs and can be given to patients who are taking chronic NSAIDs.
Sucralfate is a white liquid that treats and protects ulcers by coating them and promoting healing. It does this by stimulating the production of prostaglandins, encouraging cell growth, and making mucus more protective. Chronic use of sucralfate in dogs can cause constipation.
What is the prognosis for dogs with stomach ulcers?
The prognosis for dogs with stomach ulcers is generally good if the ulcer is caught early and treated appropriately. However, stomach ulcers can lead to serious complications such as stomach perforation, which can be life-threatening. If your dog is showing any signs of gastric ulceration, you should take them to see a veterinarian as soon as possible.
FAQs about stomach ulcers in dogs
How can stomach ulcers in dogs be prevented?
As the leading cause of stomach ulcers in dogs is the use of non-steroidal anti-inflammatory drugs (NSAIDs), careful monitoring needs to be done when giving these drugs. The lowest effective dose should be given for dogs that require NSAIDs long term. If your dog needs to take an NSAID, your veterinarian will likely prescribe a proton pump inhibitor or misoprostol to help protect the stomach.
Are stomach ulcers in dogs painful?
Yes, stomach ulcers can be painful for dogs. If your dog is showing signs of stomach pain, such as lethargy, crouching or arched back, or guarding their stomach, you should take them to see your veterinarian as soon as possible.
How long does it take for stomach ulcers in dogs to heal?
The healing time for stomach ulcers in dogs depends on the severity of the ulcer and the treatment used. Mild stomach ulcers may heal within a few days, while more severe stomach ulcers can take weeks or even months to heal. If your dog has a stomach ulcer, it is important to follow your veterinarian's instructions for treatment and monitoring closely.
How do I know if my dog has a stomach ulcer?
The most common signs of stomach ulcers in dogs are vomiting and appetite loss. If your dog is showing these signs, you should take them to see a veterinarian as soon as possible. Diagnosis can be made through barium contrast studies, endoscopy, and biopsy. Treatment involves reducing stomach acid production and protecting the stomach lining. In some cases, ulcers can lead to serious complications such as stomach perforation, which can be life-threatening.
Stomach ulcers in dogs are a common problem that can be caused by a variety of things, including specific diseases, increased stomach acid production, and medications such as NSAIDs and corticosteroids. Treatment options include reducing stomach acid, coating the stomach ulcer with a protective agent, and increasing stomach mucosal protection. Most dogs with stomach ulcers recover well when treated appropriately. If you are concerned that your dog may have a stomach ulcer, please contact your veterinarian for further advice.