title: A Prospective, Placebo-Controlled Pilot Evaluation of the Effect of Omeprazole on Serum Calcium, Magnesium, Cobalamin, Gastrin Concentrations, and Bone in Cats.
abstract: BACKGROUND
  Chronic proton pump inhibitor administration has been associated with electrolyte and cobalamin deficiency, disrupted bone homeostasis, hypergastrinemia, and rebound acid hypersecretion in humans. It is unknown if this occurs in cats.
  
  
  OBJECTIVE
  Prolonged oral omeprazole results in altered bone mineral density or content, serum calcium, magnesium, cobalamin, and gastrin concentrations in healthy cats.
  
  
  METHODS
  Six healthy adult DSH cats.
  
  
  METHODS
  In a within subjects, before and after design, cats received placebo followed by omeprazole (0.83-1.6 mg/kg PO q12h) for 60 days each. Analysis of serum calcium, magnesium, cobalamin, and gastrin concentrations was performed on days 0, 30, and 60. Bone density and content were evaluated on days 0 and 60 of each intervention. Continuous data were analyzed using a two-way ANOVA (α = 0.006). On day 60 of omeprazole administration, continuous intragastric pH monitoring was performed in 2 cats to evaluate the effects of abrupt withdrawal of omeprazole.
  
  
  RESULTS
  No significant changes were detected between treatments for any variables, except serum gastrin, which was significantly higher during omeprazole treatment in comparison to placebo (P = 0.002). Evidence of gastric hyperacidity was seen in both cats in which intragastric pH monitoring was performed following cessation of omeprazole.
  
  
  CONCLUSIONS
  Although further studies with larger populations of cats will be needed to draw any definitive conclusions, these preliminary results suggest that prolonged PPI treatment results in hypergastrinemia and abrupt PPI withdrawal might result in RAH in cats.
authors.affiliation: Department of Small Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, TN.
authors.forename: E
authors.initials: E
authors.lastname: Gould
authors.affiliation: Department of Small Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, TN.
authors.forename: C
authors.initials: C
authors.lastname: Clements
authors.affiliation: Department of Small Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, TN.
authors.forename: A
authors.initials: A
authors.lastname: Reed
authors.affiliation: Department of Small Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, TN.
authors.forename: L
authors.identifier: http://orcid.org/0000-0002-7329-683X
authors.initials: L
authors.lastname: Giori
authors.affiliation: Texas A&M University, Gastrointestinal Laboratory, College Station, TX.
authors.forename: J M
authors.initials: JM
authors.lastname: Steiner
authors.affiliation: Texas A&M University, Gastrointestinal Laboratory, College Station, TX.
authors.forename: J A
authors.initials: JA
authors.lastname: Lidbury
authors.affiliation: Texas A&M University, Gastrointestinal Laboratory, College Station, TX.
authors.forename: J S
authors.initials: JS
authors.lastname: Suchodolski
authors.affiliation: Department of Small Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, TN.
authors.forename: M
authors.initials: M
authors.lastname: Brand
authors.affiliation: Department of Small Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, TN.
authors.forename: T
authors.initials: T
authors.lastname: Moyers
authors.affiliation: Department of Small Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, TN.
authors.forename: L
authors.initials: L
authors.lastname: Emery
authors.affiliation: Department of Small Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, TN.
authors.forename: M K
authors.initials: MK
authors.lastname: Tolbert
mesh_terms: D000818:Animals; D015519:Bone Density / Q000187:drug effects*; D002118:Calcium / Q000097:blood; D002415:Cats; D065187:Controlled Before-After Studies; D005260:Female; D005745:Gastric Acidity Determination / Q000662:veterinary; D005755:Gastrins / Q000097:blood; D008274:Magnesium / Q000097:blood; D008297:Male; D009853:Omeprazole / Q000009:adverse effects*; D010865:Pilot Projects; D054328:Proton Pump Inhibitors / Q000009:adverse effects*; D014805:Vitamin B 12 / Q000097:blood
chemical_list: D005755:Gastrins; D054328:Proton Pump Inhibitors; D008274:Magnesium; D009853:Omeprazole; D014805:Vitamin B 12; D002118:Calcium
keywords: DEXA; Feline; Intragastric pH; Rebound acid hypersecretion