Effect of gastric acid-suppressive therapy and biological variation of serum gastrin concentrations in dogs with chronic enteropathies

Abstract

BackgroundSerum gastrin concentration can help diagnose gastrinomas in dogs if >3–10× the upper reference limit (URL), but antisecretory therapy and other conditions can also cause hypergastrinemia. Effects of antisecretory therapy (famotidine or ranitidine, omeprazole) on serum gastrin concentration in dogs with chronic enteropathy (CE) and its biological variation (BV) are unknown. Aim of the study was to evaluate serum gastrin in acid-suppressant-treated or -naïve CE dogs; test the association between serum gastrin and histopathologic findings in acid-suppressant-naïve CE dogs; and evaluate the BV of serum gastrin in dogs not receiving any gastric acid suppressive therapy. Samples from 231 dogs were used and serum gastrin was measured by chemiluminescence assay. Gastric and duodenal histologic lesions were evaluated and graded. BV of serum gastrin was evaluated in serial samples.ResultsSerum gastrin concentrations were significantly higher in acid-suppressant-treated than acid-suppressant-naïve dogs (P = 0.0245), with significantly higher concentrations in proton pump inhibitor (PPI)- than H2-antihistamine-treated patients (P = 0.0053). More PPI- than H2-antihistamine-treated dogs had gastrin concentrations above URL (P = 0.0205), but not >3× nor >10× the URL. Serum gastrin concentrations correlated with the severity of gastric antral epithelial injury (P = 0.0069) but not with any other lesions or the presence/numbers of spiral bacteria in gastric biopsies. Intra- and inter-individual BV were 43.4 and 21.6%, respectively, in acid-suppressant-naïve dogs, with a reciprocal individuality index of 0.49 and a critical difference of ≥29.5 ng/L.ConclusionsAntisecretory (particularly PPI) treatment leads to hypergastrinemia in CE dogs, but the concentrations seen in this study are unlikely to compromise a diagnosis of gastrinoma. Use of a population-based URL for canine serum gastrin and a URL of ≤27.8 ng/L are appropriate.

Aloe vera gel confers therapeutic effect by reducing pyroptosis in ethanol-induced gastric ulcer rat model: Role of NLRP3/GSDMD signaling pathway

“…Higher pH inhibits somatostatin release, which increases gastrin release, causing hypergastrinemia [ 52 ]. These findings agreed with these studies [ 53 , 54 ]. Prolonged hypergastrinemia due to chronic PPI use exerts tropic effects in the stomach, which increases the risk of gastric cancer [ 52 ].…”

Prospective Randomized Controlled Clinical Trial of the Long-Term Effects of Omeprazole on Healthy Dogs

“…A study involving 231 dogs with chronic enteropathy receiving antisecretory therapy demonstrated higher levels of serum gastrin in dogs treated with omeprazole. However, serum gastrin levels in these dogs did not exceed 3 times the upper reference limit (URL), excluding the diagnosis of gastrinoma [13]. Notably, the omeprazole group in the present study exhibited mean gastrin levels four times higher than the control group.…”

“…Studies in dogs determined that serum gastric levels were significantly higher in patients treated with PPIs compared to a control group. However, the administration time of the antacids was not standardized [13]. Currently, there have been no long-term studies on the use of PPIs in dogs similar to those conducted in cats.…”

Clinical utility of currently available biomarkers in inflammatory enteropathies of dogs

“…32 Serum gastrin concentrations may indicate a gastrinoma if increased >10 times above the normal reference interval. 33 Despite the importance of the minimum database comprised of routine clinicopathologic tests, these diagnostic tests usually are not specific for CIE in dogs, and additional biomarkers that are more disease-specific, organ-specific, or both appear to be a very useful additional tool for the management of dogs with CIE.…”