Vetnuus | December 2025 45 Diagnosis: Tools and Techniques • Imaging: Abdominal radiographs are useful for ruling out obstruction or peritonitis but are not sensitive for nonperforating ulcers. Ultrasonography can detect mural lesions or masses but has limited sensitivity for nonperforated ulcers. Detection of free peritoneal fluid or gas suggests perforation. • Endoscopy: GI endoscopy is the gold standard for diagnosing mucosal ulcers, allowing direct visualisation and targeted biopsy. Capsule endoscopy offers a non-invasive alternative for visualising mucosal lesions5. • Laboratory Testing: A minimum database (CBC, serum biochemistry, urinalysis) helps differentiate primary GI from systemic disease and identifies metabolic derangements. Additional tests (e.g., liver function, ACTH stimulation) may be warranted based on clinical suspicion. Treatment: Addressing the Cause and Supporting Healing The cornerstone of therapy is identifying and removing the underlying cause—discontinuing NSAIDs, treating neoplasia, or managing systemic disease. Supportive care, including fluid therapy, may be necessary to correct metabolic imbalances. • Acid Suppression: Proton pump inhibitors (PPIs) such as omeprazole and pantoprazole are the most effective agents, providing more complete acid suppression than H2-receptor antagonists (e.g., famotidine). Combination therapy with both classes is not recommended and may reduce PPI efficacy. Tapering is advised after prolonged use to avoid rebound hyperacidity2,3,4. • Cytoprotective Agents: Sucralfate can bind to ulcerated mucosa and promote healing, but offers no additional benefit when used with PPIs. Misoprostol, a prostaglandin analogue, may be helpful in NSAID-induced ulcers, though evidence is limited. • Antimicrobials: Considered in cases of severe mucosal disruption or when bacterial translocation is a concern. • Surgery: Required for perforated ulcers or when medical management fails. Prognosis: Variable Outcomes Prognosis depends on the underlying cause, severity, and timeliness of intervention. Mild, promptly treated ulcers have a favourable outlook, while those associated with severe systemic disease, neoplasia, or perforation carry a guarded to poor prognosis. Surgical intervention for perforation is associated with a high mortality rate (approximately 60%). Key Takeaways • NSAIDs, neoplasia, and liver disease are major risk factors for GI ulceration in small animals. • PPIs are superior to H2-receptor antagonists for acid suppression. • Early recognition and intervention are critical, as perforated ulcers have a significantly worse prognosis. By understanding the complex interplay of factors leading to GI ulceration and applying a systematic approach to diagnosis and management, veterinarians can improve outcomes for affected dogs and cats. Nutritional Management of Gastrointestinal Disease in Small Animals Vomiting is the most prevalent clinical sign of gastric disease in companion animals. Effective dietary management aims to minimise gastric irritation, promote gastric emptying, normalise motility, and prevent gastroesophageal reflux. Key nutritional strategies include selecting lower-fat, low-residue diets to reduce delayed gastric emptying and reflux. In cases of acute, frequent vomiting, some publications advise fasting for 24 hours; however, the latest school of thought is to begin feeding or re-feeding as soon as possible. This is usually accomplished by offering small, frequent meals (3–6 per day) to facilitate gastric transit. Veterinary therapeutic gastrointestinal diets are specifically formulated for cats and dogs experiencing GI upset. Highly digestible diets maximise nutrient absorption and minimise gastrointestinal workload. For patients with chronic GI diseases, lowfat formulations are better tolerated and may be indicated for long-term use6,7. Energy-dense diets are available for animals with reduced appetites, allowing them to meet caloric needs with smaller food volumes6,7. Additional benefits of these diets include being complete and balanced, appropriate for both adults and growing animals, and undergoing clinical and palatability testing to ensure efficacy and acceptance. Many therapeutic GI diets come with a palatability guarantee, providing a practical solution for pets with selective appetites6,7. Royal Canin® ICU liquid diets, such as GI LOW FAT LIQUID and RECOVERY LIQUID, meet several of the above-mentioned criteria, making them outstanding options when selecting an appropriate diet, ensuring prudent nutritional management of small animal patients with gastrointestinal disease. References 1. MSD Veterinary Manual. (n.d.). Gastrointestinal ulcers in small animals. Retrieved October 24, 2025, from https:// www.msdvetmanual.com/digestive-system/diseases-of-thestomach-in-small-animals/gastrointestinal-ulcers-in-smallanimals 2. Marks SL, Kook PH, Papich MG, Tolbert MK, Willard MD. ACVIM consensus statement: Support for rational administration of gastrointestinal protectants to dogs and cats. J Vet Intern Med. 2018;32(6):1823-1840. 3. Daure E, Ross L, Webster CR. Gastroduodenal ulceration in small animals: part 1. Pathophysiology and epidemiology. J Am Anim Hosp Assoc. 2017;53(1):1-10. 4. Daure E, Ross L, Webster CR. Gastroduodenal ulceration in small animals: part 2. Proton pump inhibitors and histamine-2 receptor antagonists. J Am Anim Hosp Assoc. 2017;53(1):11-23. 5. Bottero E, Pierini A, Ruggiero P, Cattaneo D, Campanile A, Benvenuti E. Gastroduodenal ulceration detected endoscopically in cats: retrospective study of 61 patients. J Feline Med Surg. 2022;24(10):e347-e352. 6. VCA Animal Hospitals (n.d.) Blah, Blah, and More Blah! Bland Diet Instructions for Dogs and Cats. Available at: https://vcahospitals. com/know-your-pet/blah-blah-and-more-blah-bland-dietinstructions-for-dogs-and-cats (Accessed: 5 November 2025). 7. Nutritional Management for Gastrointestinal Disease in Dogs and Cats (2017) Today’s Veterinary Practice, January/February 2018 issue, 8 December. Available at: https://todaysveterinarypractice. com/nutritional-management-for-gastrointestinal-disease-indogs-and-cats/ (Accessed: 5 November 2025). Royal Canin I Column
RkJQdWJsaXNoZXIy OTc5MDU=