Protect the stomach during a disc episode
Stomach protection during disc episode is important. There are multiple factors that often cause extra stomach acids to form during the disc episode. Using an acid suppresser such as Pepcid AC makes sense!
- Stress can increase stomach acids. Dogs are creatures of routine. The change of needing to be in a recovery suite and suffering pain until pain meds can be prescribed are stressful to a dog.
- The use of any anti-inflammatory drug (steroid or NSAID) can increase stomach acids.
- Spinal cord damage can inhibit the autonomic function that normally protects the stomach lining.
William Thomas, DVM, MS, DACVIM (Neurology) and Luisa De Risio, ECVN (Neurology), RCVS, EBVS European Specialist in Veterinary Neurology explains to veterinarians:
“Gastrointestinal signs are of particular importance, so ask if the client has noticed decreased appetite, vomiting, diarrhea, or blood in the feces. Patients with spinal cord disease are at increased risk of these signs due to altered autonomic function affecting the gastrointestinal tract. Additionally, these patients may have been treated with corticosteroids and non-steroidal anti-inflammatory drugs that have gastrointestinal side effects.” — W.B. Thomas, L De Risio. (2015). “History, Neurologic Examination, and Neuroanatomic Localization for Spinal Cord and Nerve Root Disease.” In J.M. Fingeroth, W. B. Thomas. (Eds.). Advances in Intervertebral Disc Disease in Dogs and Cats. (p 93). © 2015 ACVS Foundation. Wiley & Sons 2015.
Dogs don’t speak up at first signs of trouble like a person would
By the time we notice black or red blood in the stools, things can quickly go from bleeding ulcers to a life-threatening perforated stomach. Your dog does not need another issue of bleeding ulcers on top of dealing with a disc episode. Stomach protection at the beginning of disc episode and during the time an anti-inflammatory is in use can avoid stomach lining damage.
Proactively start Pepcid AC (famotidine) when meds are first prescribed. This approach can typically avoid a dog having to deal with a GI problem on top of a disc problem.
A highly recommended reading:
6 things to know about anti-inflammatories: https://dodgerslist.com/2020/04/18/steroids-vs-nsaids/
Signs of GI tract damage
Early signs start with lip licking due to nausea, not eating, and vomiting. As damage increases, diarrhea occurs leading to serious bleeding ulcers and red or black blood in the stool. Bleeding ulcers not attended to can be life threatening.
Pepcid AC (famotidine) blocks the production of acid. The usual dose of Pepcid AC (famotidine) with a disc episode is 0.44 mg per pound every 12 hours. Pepcid AC has a very limited potential for side effects. However, do make it a point to ask if your dog has any health issues that prevent the use of Pepcid AC (famotidine). A vet needs to be fully informed about everything your dog takes.
HEALTH ISSUES- Mar Vista Vet reports: “Pepcid AC has a very limited potential for side effects, the reason of release to over-the-counter status. The dose of famotidine may require reduction in patients with liver or kidney disease as these diseases tend to prolong drug activities. There have been some reports of exacerbating heart rhythm problems in patients who already have heart rhythm problems so it may be prudent to choose another means of stomach acid control in heart patients.” http://marvistavet.com/famotidine.pml
“For symptomatic animals, GI protectants are very important…H2 blockers, sucralfate and omeprazole can also be used to manage and/or prevent gastric ulcers.” Sharon Gwaltney-Brant, DVM, PhD, DABVT, DABT. Toxicity of pain medications (Proceedings). 2010. veterinarycalendardvm360
- H2 blocker: FAMOTIDINE– Pepcid AC®, brand X products. Used at the start of any anti inflammatory drugs (non-steroidal or a steroid)
- OMEPRAZOLE– Prilosec®, Losec®, brand X products. Contact your vet for dosing info
- SUCRALFATE– Carafate®; a prescription product. Any sign of GI tract damage, advocate for this to be added to Pepcid AC.