PMID- 32697849
OWN - NLM
STAT- MEDLINE
DCOM- 20210209
LR  - 20220531
IS  - 2042-3306 (Electronic)
IS  - 0425-1644 (Linking)
VI  - 53
IP  - 2
DP  - 2021 Mar
TI  - Impact of concurrent treatment with omeprazole on phenylbutazone-induced equine 
      gastric ulcer syndrome (EGUS).
PG  - 356-363
LID - 10.1111/evj.13323 [doi]
AB  - BACKGROUND: Phenylbutazone is commonly prescribed for treatment of various 
      painful or inflammatory disorders in horses, but is associated with 
      gastrointestinal (GI) adverse effects. Anecdotally, many practitioners prescribe 
      omeprazole concurrently with phenylbutazone to reduce development of equine 
      gastric ulcer syndrome (EGUS), but the efficacy and safety of this practice 
      remains unknown. OBJECTIVES: To evaluate the effect of omeprazole on 
      phenylbutazone-induced equine glandular gastric disease (EGGD) and equine 
      squamous gastric disease (ESGD). STUDY DESIGN: Randomised block experimental 
      design. METHODS: Twenty-two horses with EGGD and ESGD scores </=2 were included. 
      Horses were assigned to treatment groups: phenylbutazone (4.4 mg/kg PO q 12 h; 
      PBZ), phenylbutazone plus omeprazole (4 mg/kg PO q. 24 h; PBZ/OME) or placebo 
      (CON) in a randomised block design based upon initial EGGD score. Horses were 
      treated for up to 14 days. Gastroscopy was performed weekly; CBC and biochemistry 
      were performed at Day 0 and study end. Horses were monitored for signs of colic 
      and/or diarrhoea. RESULTS: EGGD score increased in PBZ (median change 1, 
      inter-quartile range, [IQR], 0-2) compared to PBZ/OME (median change 0, IQR -1 to 
      0; P = .05). PBZ/OME (6/8) had more intestinal complications than CON (0/6; 
      difference between proportions = 75%; 95% CI, 23%-93%; P = .03). Plasma protein 
      concentrations decreased in PBZ, compared to CON (mean difference between groups, 
      14 g/L; 95% CI, 1.04-27; P = .03). Five horses were withdrawn from the study due 
      to intestinal complications (n = 3 PBZ/OME and n = 2 PBZ); one horse (PBZ) was 
      withdrawn due to severe grade 4 EGGD. MAIN LIMITATIONS: Small sample size and 
      changes in management for the 2-3 days prior to study initiation; variable 
      treatment duration among groups due to development of complications. CONCLUSIONS: 
      Administration of omeprazole ameliorated PBZ-induced EGGD, but was associated 
      with an increase in intestinal complications. Caution should be exercised when 
      co-prescribing NSAIDs and omeprazole in horses, particularly in association with 
      change in management.
CI  - (c) 2020 EVJ Ltd.
FAU - Ricord, Megan
AU  - Ricord M
AD  - Equine Health Studies Program, Department of Veterinary Clinical Sciences, School 
      of Veterinary Medicine, Louisiana State University, Baton Rouge, LA, USA.
FAU - Andrews, Frank M
AU  - Andrews FM
AUID- ORCID: 0000-0001-7930-6237
AD  - Equine Health Studies Program, Department of Veterinary Clinical Sciences, School 
      of Veterinary Medicine, Louisiana State University, Baton Rouge, LA, USA.
FAU - Yniguez, Francisco J M
AU  - Yniguez FJM
AD  - Equine Health Studies Program, Department of Veterinary Clinical Sciences, School 
      of Veterinary Medicine, Louisiana State University, Baton Rouge, LA, USA.
FAU - Keowen, Michael
AU  - Keowen M
AD  - Equine Health Studies Program, Department of Veterinary Clinical Sciences, School 
      of Veterinary Medicine, Louisiana State University, Baton Rouge, LA, USA.
FAU - Garza, Frank Jr
AU  - Garza F Jr
AD  - Equine Health Studies Program, Department of Veterinary Clinical Sciences, School 
      of Veterinary Medicine, Louisiana State University, Baton Rouge, LA, USA.
FAU - Paul, Linda
AU  - Paul L
AD  - Equine Health Studies Program, Department of Veterinary Clinical Sciences, School 
      of Veterinary Medicine, Louisiana State University, Baton Rouge, LA, USA.
FAU - Chapman, Ann
AU  - Chapman A
AD  - Equine Health Studies Program, Department of Veterinary Clinical Sciences, School 
      of Veterinary Medicine, Louisiana State University, Baton Rouge, LA, USA.
FAU - Banse, Heidi E
AU  - Banse HE
AUID- ORCID: 0000-0002-0120-0376
AD  - Equine Health Studies Program, Department of Veterinary Clinical Sciences, School 
      of Veterinary Medicine, Louisiana State University, Baton Rouge, LA, USA.
LA  - eng
GR  - Charles V. Cusimano Equine Health Studies Program/
PT  - Journal Article
PT  - Randomized Controlled Trial, Veterinary
DEP - 20200818
PL  - United States
TA  - Equine Vet J
JT  - Equine veterinary journal
JID - 0173320
RN  - 0 (Anti-Inflammatory Agents, Non-Steroidal)
RN  - GN5P7K3T8S (Phenylbutazone)
RN  - KG60484QX9 (Omeprazole)
SB  - IM
MH  - Animals
MH  - Anti-Inflammatory Agents, Non-Steroidal/adverse effects
MH  - *Horse Diseases/chemically induced/drug therapy
MH  - Horses
MH  - Omeprazole/adverse effects
MH  - Phenylbutazone/adverse effects
MH  - *Stomach Ulcer/chemically induced/drug therapy/veterinary
OTO - NOTNLM
OT  - dysbiosis
OT  - equine glandular gastric disease (EGGD)
OT  - horse
OT  - non-steroidal anti-inflammatory drug (NSAID)
OT  - proton pump inhibitor (PPI)
EDAT- 2020/07/23 06:00
MHDA- 2021/02/10 06:00
CRDT- 2020/07/23 06:00
PHST- 2020/04/07 00:00 [received]
PHST- 2020/07/02 00:00 [revised]
PHST- 2020/07/16 00:00 [accepted]
PHST- 2020/07/23 06:00 [pubmed]
PHST- 2021/02/10 06:00 [medline]
PHST- 2020/07/23 06:00 [entrez]
AID - 10.1111/evj.13323 [doi]
PST - ppublish
SO  - Equine Vet J. 2021 Mar;53(2):356-363. doi: 10.1111/evj.13323. Epub 2020 Aug 18.