From our Podcast Episode #112, with Prof. Caroline Mansfield.
I don’t know about you, but at some stage it felt like all of our vomiting patients were getting Proton Pump Inhibitors, ‘just in case’ it helped a bit. We’ve toned that down a lot in recent years after learning that PPI’s are not without consequence, specifically in their ability to mess with the microbiome. (We have a couple of discussions on the podcast about it.) But those are more long term consequences, and I certainly still use them for many hospitalised patients where I have reason to believe that may have damage to the integrity of the stomach wall. Which is why these bombshells about omeprazole from Prof. Caroline Mansfield from our discussion about haemorrhagic diarrhoea syndrome surprised me:
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Omeprazole can make animals feel sick. A yet-to-be published study by her resident that was investigating the effects of omeprazole on healthy dogs showed that it contributes to vomiting and diarrhoea, in addition to causing dysbiosis. (So much so that the study had to be stopped for ethical reasons!)
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It’s not a small effect either. Over 50% of dogs in the study developed diarrhoea, vomiting, or anorexia on 0.5 or 1mg/kg doses.
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“So I guess when you think about when we use omeprazole clinically, we often use it with dogs with GI disease. And so they already have vomiting or diarrhoea or anorexia and maybe we use the omeprazole and we go: “oh no, they've still got gut disease!’, and we just keep going with omeprazole. But maybe the omeprazole is contributing to that and making it worse. “
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