Double‐blinded placebo‐controlled clinical trial of prophylactic omeprazole in dogs treated surgically for acute thoracolumbar intervertebral disc extrusion

Abstract Background Proton pump inhibitors are administered prophylactically in dogs treated surgically for acute thoracolumbar intervertebral disc extrusion (TL‐IVDE). However, their efficacy in decreasing gastrointestinal (GI) complications is unknown. Hypothesis Omeprazole does not decrease the frequency of GI complications compared to placebo in dogs treated surgically for acute TL‐IVDE. Animals Thirty‐seven client‐owned dogs undergoing hemilaminectomy for acute TL‐IVDE. Methods Randomized double‐blinded placebo‐controlled prospective clinical trial. Dogs received PO placebo or omeprazole at 1 mg/kg q12h for 5 days during hospitalization. Development of GI signs (e.g., diarrhea, vomiting, regurgitation, hematochezia, melena) was recorded daily. Clinicopathologic testing performed during hospitalization and at 2 and 4‐week re‐evaluations included: fecal occult blood, PCV, blood urea nitrogen/creatinine ratio, fecal calprotectin, canine pancreatic lipase immunoreactivity and fecal alpha‐1 proteinase inhibitor concentrations. Omeprazole and placebo groups were compared using chi‐squared or Fisher's exact tests. Results Gastrointestinal signs developed in 10/20 (50%) dogs in the omeprazole group and in 7/17 (41%) dogs in the placebo group (P = .59). Diarrhea was common (8/20 omeprazole, 5/17 placebo), hematochezia was rare (1/20 omeprazole, 1/17 placebo); melena was not observed. Clinicopathologic evidence suggestive of bleeding was present in 9/20 dogs treated with omeprazole and in 11/17 dogs that received placebo (P = .23). Fecal occult blood positivity was more common in dogs with GI signs (P = .03). Canine pancreatic lipase immunoreactivity was higher during hospitalization compared to re‐evaluations (P = .01). Conclusions and Clinical Importance Short‐term, prophylactic omeprazole treatment did not decrease clinically detectable GI complications in dogs with acute TL‐IVDE.