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Omeprazole versus ranitidine in resolving gastric ulceration in dogs

Clinical Scenario

Fred, a 6 year old male neutered Golden Retriever, has been vomiting intermittently for a couple of weeks. His owners say the vomit now contains something that looks a bit like coffee, so you advise that he needs further investigation. As part of this, you decide to perform gastroduodenoscopy to take endoscopic biopsies. Using the scope, you see several patches of ulceration in his fundus and pylorus.

Whist waiting for the biopsy results, you decide to treat him with a gastroprotectant to help the ulcers heal. You think you remember hearing on a CPD course that either omeprazole or ranitidine was more effective at treating gastric ulcers but you can't remember which and it's not written in the notes. You wonder what the evidence says..... 

3-Part Question (PICO)

In [dogs with gastric ulceration] does [treatment with omeprazole compared to ranitidine] [lead to more rapid resolution of gastric ulceration]?

Search Strategy and Summary of Evidence

Search Strategy

MEDLINE(R) In-Process & Other Non-Indexed Citations and MEDLINE(R) 1946 to Present using the OVID interface

(dog.mp. OR dogs.mp. OR canine.mp. OR canines.mp. OR canis.mp. OR exp Dogs/)

AND

(gastric ulceration.mp. OR gastric ulcer.mp. OR gastric ulcers.mp. OR stomach ulceration.mp. OR stomach ulcer.mp. OR stomach ulcers.mp. OR gastrointestinal ulceration.mp. OR gastrointestinal ulcer.mp. OR gastrointestinal ulcers.mp. OR peptic ulcer.mp. OR peptic ulcers.mp. OR peptic ulceration.mp. OR exp stomach ulcer/)

AND

(ranitidine.mp. OR zantac.mp. OR histamine H2 antagonist.mp. OR Histamine H2 antagonists.mp. OR H2 blocker.mp. OR exp ranitidine/ OR exp Histamine H2 antagonists/ OR omeprazole.mp. OR Prilosec.mp. OR Losec.mp. OR Zegerid.mp. OR proton pump inhibitor.mp. OR proton pump inhibitors.mp. OR exp Omeprazole/ OR exp Proton Pump Inhibitors/)

CAB Abstracts 1910 to Present using the OVID interface

(dog.mp. OR dogs.mp. OR canine.mp. OR canines.mp. OR canis.mp. OR exp Dogs/ OR exp canis/)

AND

(gastric ulceration.mp. OR gastric ulcer.mp. OR gastric ulcers.mp. OR stomach ulceration.mp. OR stomach ulcer.mp. OR stomach ulcers.mp. OR gastrointestinal ulceration.mp. OR gastrointestinal ulcer.mp. OR gastrointestinal ulcers.mp. OR peptic ulcer.mp. OR peptic ulcers.mp. OR peptic ulceration.mp. OR exp stomach ulcers/)

AND

(ranitidine.mp. OR zantac.mp. OR histamine H2 antagonist.mp. OR Histamine H2 antagonists.mp. OR H2 blocker.mp. OR exp ranitidine bismuth citrate/ OR exp histamine receptor antagonists/ OR omeprazole.mp. OR Prilosec.mp. OR Losec.mp. OR Zegerid.mp. OR proton pump inhibitor.mp. OR proton pump inhibitors.mp. OR exp omeprazole/)

Search Outcome

MEDLINE

  • 101 papers found in MEDLINE search
  • 99 papers excluded as they don't meet the PICO question
  • 0 papers excluded as they are in a foreign language
  • 2 papers excluded as they are review articles/in vitro research/conference proceedings
  • 0 total relevant papers from MEDLINE

CAB Abstracts

  • 33 papers found in CAB search
  • 25 papers excluded as they don't meet the PICO question
  • 0 papers excluded as they are in a foreign language
  • 8 papers excluded as they are review articles/in vitro research/conference proceedings
  • 0 total relevant papers from CAB

Total relevant papers

0 relevant papers from both MEDLINE and CAB Abstracts

Comments

No citations have been included in this BET as no publications were found looking at the use of ranitidine versus omeprazole in treating canine gastric ulceration (ie. no peer-reviewed evidence to answer the PICO question). 

One paper was found comparing cimetidine with omeprazole in dogs with mechanically or asprin induced gastritis (Jenkins et al 1991), but cimeditine was considered to be sufficiently different to ranitidine for this publication to be included in the BET. Therefore, the table of evidence below has been left intentionally blank.

Summary of Evidence

No Summary of Evidence yet.

Comments

This search did not identify any relevant peer-reviewed evidence comparing the efficacy of omeprazole and ranitidine as treatments for gastric ulceration in dogs. This is despite both being anecdotally in common use for this indication in the United Kingdom.

Narrative reviews, conference proceedings and expert opinion pieces, along with other information sources such as textbooks and online resources, can be used when deciding which treatment(s) to use. However, an awareness of the strengths and limitations of these evidence sources in relation to decision-making is important.

Bottom line

At present there is no peer reviewed evidence comparing the efficacy of omeprazole and ranitidine for the treatment of canine gastic ulcers. Therefore, when deciding whether to use these treatments, practitioners should take into account other factors such as their own clinical experience and product licensing recommendations.

Disclaimer

The BETs on this website are a summary of the evidence found on a topic and are not clinical guidelines. It is the responsibility of the individual veterinary surgeon to ensure appropriate decisions are made based on the specific circumstances of patients under their care, taking into account other factors such as local licensing regulations. Read small print

References

Jenkins CC, DeNovo RC, Patton CS, Bright RM, Rorbach BW, (1991). Comparison of effects of cimetidine and omeprazole on mechanically created gastric ulceration and on aspirin-induced gastritis in dogs. American Journal of Veterinary Research 52: 658-661.

About this BET

First author:
Zoe Belshaw
Second author:
Marnie Brennan
Institution:

CEVM University of Nottingham

Search last performed:
2018-01-19 09:24:11
Original publication date:
2018-01-30 09:24:11
Last updated:
2018-01-30 09:24:11
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