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Int.J.Curr.Microbiol.App.Sci (2018) 7(3): 2475-2501
Review Article
Gastritis and Peptic Ulcer Diseases in Dogs: A Review
Pankaj Kumar Patel1, Sawita Kumari Patel2, S.K. Dixit1* and R.S. Rathore2
1Division of Medicine, 2Division of Veterinary Public Health, ICAR-Indian Veterinary
Research Institute, Izatnagar, UP-243122, India
*Corresponding author
Gastric diseases of dogs are usually gastric
mucosal inflammation, ulceration, obstruction
or neoplasia. Gastritis is the inflammation of
gastric mucosa and normally visualized by
vomiting. Categorization and gradation of
canine gastritis are based on the nature of the
predominant cellular infiltrate and the
presence of architectural abnormalities (Day
et al., 2008). Acute gastritis is clinically
characterized by the sudden onset of vomiting
(Ettinger and Feldman, 2005) whereas
chronic gastritis is clinically defined as
intermittent vomiting with duration of more
than 1-2 weeks (Day et al., 2008). It
occasionally coupled with the loss of body
weight, inappetence, and spells of abdominal
pain. In most patients the cause is secondary
from the history, such as dietary indiscretion;
the diagnosis is rarely confirmed by biopsy,
and treatment is symptomatic and supportive.
If the hyperplastic polyp (Gencosmanoglu et
al., 2003) or foreign body (Papazoglou et al.,
2003) obstructs the pyloric region of stomach
results onset of acute clinical signs, however
if foreign object stays on the body of the
stomach may lead to mucosal injury and acute
gastritis (Amorim et al., 2016). Fungal
infections and spirochetes also lead to
gastritis (Helman et al., 1999). Chronic
gastritis is defined as the presence of
International Journal of Current Microbiology and Applied Sciences
ISSN: 2319-7706 Volume 7 Number 03 (2018)
Journal homepage:
The most common clinical condition reported in dogs is acid related diseases in the
stomach like gastric disorders due to a structural and functional defect in gastric mucosa.
The most important factor for the development of gastritis, peptic ulcer disease and gastric
cancer in human is Helicobacter pylori. In the cases of gastric disorder lesions in canine
gastric mucosa is closely similar to their human counterparts. Many etiological factors are
responsible for oxidative stress due to excessive generation of reactive oxygen species as a
cause of gastric mucosal damage. The bacteria exist lifelong in the stomach of the
untreated patient. This article reviews the classification, some possible etiopathogenesis,
diagnosis and possible differential diagnosis and major strategies of therapy against acid
disorders (Fluid therapy, proton pump inhibitors, H-2 blocker, cytoprotective) with an
update on the management of oxidative stress with antioxidant therapy (Ascorbic acid, N-
acetyl cysteine, Vitamin E) and “Triple therapy” for management of Helicobacter pylori
induced gastric disorders.
Ke ywords
Antioxidant therapy,
Gastric mucosa,
Helicobacter pylori,
Oxidative stress, Triple
20 February 2018
Available Online:
10 March 2018
Article Info
Int.J.Curr.Microbiol.App.Sci (2018) 7(3): 2475-2501
intermittent vomiting for more than 1-2 weeks
(Dowdle et al., 2003).
The peptic ulcer is the imperfection in the
mucosal barrier that continues to the
muscularis mucosa of the stomach (Stanton
and Bright, 1989). The most common clinical
symptoms are sudden onset of acute vomiting
with or without blood, dehydration, anorexia,
weight loss and depression. Peptic ulcer most
commonly leads to the condition of GI
In dogs, non-steroidal anti-inflammatory
drugs (NSAIDs), hepatic and renal disease are
the most common predisposing factor for the
formation of peptic ulceration that leads to
anorexia, haematemesis, melena, dehydration,
anaemia and abdominal pain. Chronic ulcers
have varying size and are larger than normal
(Brown et al., 2007).
Chronic gastric ulcers and local ulcerative
neoplastic lesions are macroscopically
relatively similar; they can be differentiated
through histopathological examination
(Stanton and Bright, 1989). Based on
histological examination (relative control of
the reparative processes and the severity of
ulceration), the gastric ulcers are classified as
acute or chronic.
Microscopically, subacute to chronic ulcers
have granulation tissue of uneven thickness
and ripeness, infiltrated by a mixed
inflammatory cell population and covered by
a thin layer of necrotic debris at the bottom
and boundaries along with superficial
regenerative epithelial hyperplasia (Brown et
al., 2007).
Review of literature
Gastric disorders are common finding which
35 percent cases look into chronic vomiting
and 26-48 percent of dogs are
asymptomatically affected (Wiinberg et al.,
2005). Although there is a high prevalence of
gastritis in dogs, an underlying cause is rarely
identified. In Madras veterinary college
teaching hospital (two semesters), out of the
total reported canine patients, 16.8 % dogs
were suffering from gastrointestinal disorders
and 0.19 % was reported from duodenal
ulcers (Saravanan et al., 2012). In Mekelle
veterinary clinic Ethiopia, out of the total 109
reported canine patients, 36 (33.0%) were
suffered from gastrointestinal tract disorders
and 15 (41.7%) dogs have been shown
vomiting (Atsbaha et al., 2014). It is the
condition which can be diagnosed on the basis
of clinical signs, laboratory findings, and
results of imaging techniques such as
radiography, ultrasonography, and endoscopy.
The most important diagnostic technique for
gastritis is the endoscopic examination. In the
case of gastritis mostly Helicobacter Spp.
organisms are isolated from gastric mucosal
biopsies of dogs (Wiinberg et al., 2005).
Endoscopic reports show that the chances of
formation of gastric mucosa ulcer are 48.5
percent in canines (Parrah et al., 2013).
Classification of gastritis
Gastritis in dogs classified into acute or
chronic which caused by multiple etiological
agencies such as dietary carelessness,
ingestion of coarse foreign bodies, plant
materials, irritant chemicals, drugs (NSAIDs,
glucocorticoids), viral diseases (e.g. canine
parvovirus, canine distemper) and bacterial
infections e.g. Helicobacter spp.). Metabolic
disorders frequently present with
haematemesis, melena, concurrent diarrhoea
and other signs of systemic illness. Acute
gastritis is the inflammation of the mucosal
layer of the stomach which is characterised by
sudden onset of vomiting and suspected to be
related to gastric mucosal injury or
inflammation (Amorim et al., 2016). Only
some reports showed the role of an infectious
Int.J.Curr.Microbiol.App.Sci (2018) 7(3): 2475-2501
agent in acute gastritis (Brown et al., 2007;
Simpson, 2013). Chronic gastritis classify
based on nature of the leading cellular
infiltrates (eosinophilic, lymphoplasmacytic,
granulomatous or lymphoid follicular), the
presence of architectural abnormalities
(atrophy, hypertrophy, fibrosis, oedema,
ulceration or metaplasia), severity (mild,
moderate or severe) (Wilcock, 2013). It can
also be subclassified on the basis of distinct
histological classification, Chronic superficial
gastritis (CSG) is the most common form of
chronic gastritis that no have understandable
changes in mucosal thickening always
associated with excessive but uneven
inflammatory components (Plasma cells,
neutrophils, lymphocytes) infiltrate and
fibrosis of mucosa and submucosa. Clinical
importance of chronic atrophic gastritis
(CAG) has occasionally reported (Simpson,
2013) which is characterised by diffuse
lesions in fundus and body of the stomach and
reduced mucosal layer thickening as well as
hypochlorhydria, achlorhydria and
proportionally increased of the number of
mucus-producing cells within the gland
(Wilcock, 2013).
Loss of gastric glands due to atrophy of the
gastric mucosa and combines with
mononuclear infiltration, glandular atrophy,
regenerative glandular nesting and mucosal
fibrosis and loss of feedback mechanism leads
increased serum gastrin level causes gastric
ulceration (Ditchfield et al., 1960; Rugge et
al., 2002; Amorim et al., 2016).
Lymphoplasmacytic gastritis (LPG) with or
without coupled with hyperplasia of lymphoid
follicles, infiltration of lymphocytes and other
inflammatory cells, including Russell bodies
into the lamina propria layer of the stomach
and sometimes it may be associated with
Helicobacter spp. infection (Maxie, 2007;
Amorim et al., 2016). Eosinophilic gastritis
(EG) rarely reported by widespread
Alimentary tract hypersensitivity reaction
(eosinophilic gastroenteritis). Diffuse form of
EG has Scirrhous inflammatory thickening on
the gastric wall that resembles with gastric
neoplasia (Hayden and Fleischman, 1977;
Neiger, 2008; Lidbury et al., 2009). Genetic
predisposition and diet are noticed for
pathogenesis (Sattasathuchana and Steiner,
2014) but some factors like gastric parasitic
infestation by Physaloptera spp. (Neiger,
2008), Gnathostoma spp. (McCarthy et al.,
2000), Heterobilharzia americana (Rodriguez
et al., 2014) and mastocytoma along with
infiltration of eosinophils (Ozaki et al., 2002),
lesions are rarely observed in Toxocara canis
infestation (Chira et al., 2005). Focal type
chronic hypertrophy occurs as a result of
chronic administration of Aspirin. Focal
cystic hypertrophic gastropathy is
characterised by histopathologically elongated
and complexed mucous glands with the
recurrent formation of the mucosal cyst.
Hypertrophic glandular gastritis is frequently
associated with a diffused immune
proliferative enteropathy on basenji dogs and
this condition also occurs in many dogs due to
Hypergastrinemia (Breitschwerdt, 1992).
Chronic Giant hypertrophic gastritis (GHG) is
rarely found in dogs and characterized by
marked thickening on the gastric wall and
mucosal hypertrophy gives a cerebriform look
to the rugal folds which protrude into the
gastric lumen (Vaughn et al., 2014). Chronic
hypertrophic pyloric hypertrophy is
hypertrophy of mucosal layer of the antro-
pyloric stomach. Lesions are focal/multifocal,
polyploidy thickening / regionally generalised
rugal enlargement and these lesions are lead
to gastric outlet obstruction (Elwood et al.,
Patho-physiology of gastritis and peptic
ulcer disease
The gastric mucosal layer acts as a useful
protective wall against acidity, bacteria,
detergents and alteration in luminal
Int.J.Curr.Microbiol.App.Sci (2018) 7(3): 2475-2501
temperature. The first line of defence of
gastric wall is gastric secretion which
contains acid, mucus, bicarbonate and
antibacterial substances. Epithelial layer on
the wall of the gastric glands and gastric
mucosal layer prevents from reverse-diffusion
of acids and is rapidly repaired by restoration
after injury. The quick response showed
through gastric mucosa against stimulation of
neurohormonal and inflammatory signals to
the gastric microvasculature by increasing
blood supply for maintenance of gastric
mucosal integrity, removal of harmful
substances, and restoration of the gastric
epithelial layer (Abdel-Salam et al., 2001;
Kawano and Tsuji, 2000). Stimulation to the
gastric wall by foreign materials, chemical
injury, ischemia, infection, or antigens leads
to release of inflammatory components and
vasoactive substances from neutrophils, mast
cells, platelets, endothelial cells and neurons
(Wallace and Ma, 2001). Several pro-
inflammatory cytokines are released as a
response to the pathogenesis of peptic ulcer,
like interleukin (IL)- Ib, IL-2, IL-6, IL-8 and
tumour necrosis factor (TNF)-α. IL-I, lead to
reduce the severity of the gastroduodenal
injury and increase the resistance to gastric
injury (Wallace et al., 1990). These
inflammatory components stimulate acid
secretion and mucosal breakage increases the
permeability of epithelial layer and altered
blood flow that continues increase the risk of
gastritis, gastric erosion, ulceration, hypoxia,
haemorrhage, oedema and necrosis (Jacobson,
1992). Granuloma formation of gastric
mucosa is the end result of a response to
endogenous substances and foreign objects,
such as sewing needles and infectious
diseases (Pratt et al., 2014). Transient
ulceration commonly noticed due to direct
damage of gastric wall and mucosal barrier or
generally ingestion of a wide range of foreign
materials like coarse foods, chemicals, plants
materials, clothes etc. Gastric ulceration is
caused by the multi-etiological agent that
includes gastric mucosal damage by physical
agent, alterations in the chemical structure
and its renovate process (Parrah et al., 2013).
Mechanical scratch ulceration is generally
superficial and short-lived and superficial
lamina propria covered by fibrin, mucus and
scattered neutrophils (Wilcock, 2013).
Secretion of hydrochloric acid that creates
acidity catalyzes pepsinogen to the active
proteolytic enzyme pepsin (Chu and Schubert,
2012). Hamper integrity and protective
mechanism disturbance in mucosal layer
initially, increase rate of reverse diffusion of
gastric acid and pepsin lead to GI
inflammation and haemorrhages than
inflammatory components (e.g. endothelial
cells, neutrophils and mast cells) become
activated and release inflammatory mediators
(e.g. histamine, leukotrienes, platelet-
activating factor, proteolytic enzymes, and
free radicals) (Henderson and Webster, 2006).
Histamine promotes gastric acid secretion;
whereas another mediator promotes vascular
changes (e.g. vasodilation, vasoconstriction,
increased capillary permeability) lead to
oedema and translocation of inflammatory
cells that plugged the capillary lumen,
intensify initial gastric mucosal injury by
dropping blood flow, ischemia, disturbed
epithelial cell layer restoration, and reduced
secretion of mucus and PG-E (Sorjonen et al.,
1983; Guilford et al., 1996). Gastric ulcers
also have been reported in dogs, having
hepatic disease, renal disease, Addison's
disease; shock (Parrah et al., 2013). Dogs
having the severe head injury, numerous
trauma, cerebral injuries and diseases of
spinal cord leads to Gastroduodenal ulceration
(Neiger and Simpson, 2000; Dowdle et al.,
Etiopathogenesis of gastritis and peptic
ulcer diseases
Gastric foreign bodies are the most common
cause of gastric disorders in younger dogs
Int.J.Curr.Microbiol.App.Sci (2018) 7(3): 2475-2501
(Sullivan and Yool, 1998). Ingestion of
exogenous toxins like a household, cleaning
chemical, lead and various plants may directly
harm to the gastric mucosal barrier (Sass,
1970). In three dogs experimentally
administration of phenol (total dose of 2430
mg of phenol) leads severe oral and gastric
ulceration (Gieger et al., 2000). When orally
lead salt mixture (Chloride Br, Sulfate, 1:1:2)
give orally in nine dogs at diverse doses
(range 5-60 mg/kg body weight/day) for 14-
152 days gastric ulceration is induced (Hamir
et al.,1983). Systemic hypovolemia leads to
decrease blood flow to gastric mucosal layer,
there is the loss of the tolerable effects of
glucocorticoids in mucosal defense
mechanism and major electrolyte
abnormalities are leads to gastritis (Henderson
and Webster, 2006). Dogs with kidney failure
have infrequently shown gastric necrosis and
ulceration (Peters et al., 2005). Gastric ulcers
due to stress less commonly noticed in dogs,
regular and severe exercise have a higher risk
for occurrence of gastric ulcers in dogs and
during sled races mostly gastric disease has
known as a causative factor of sudden death
in the dog (Chatelain et al., 2014). The diet
containing a high amount of fat causes
delayed gastric emptying and hyperacidity in
the stomach, which in alone or associated
with the physiological reaction of stress
(increasing the level of serum cortisol level),
may influence to GI ulceration in animals
(Davis et al., 2003).
The aspirin-induced gastric disorders
maximally reported in antropyloric area
administrated dogs (Reimer et al., 1999;
Ulutas et al., 2006). Administrations of a
diversity of NSAID drugs piroxicam
including, aspirin, ibuprofen (Godshalk et al.,
1992; Lanza et al., 2009) naproxen and
flunixin meglumine or ibuprofen (Godshalk et
al., 1992; Dow et al., 1990), steroidal anti-
inflammatory drugs used for treatment of
spinal and vertebral diseases (Neiger, 2000)
are also reported as cause of gastric ulceration
(Gralnek et al., 2008). Some drug has been
damaged in the gastric mucosal layer of dogs
includes glucocorticoids (Valin and Allard,
2012) and various NSAIDs (Mathews et al.,
1996). Selective inhibitors of Cyclooxygenase
(COX)-2 (e.g. carprofen, etodolac, deracoxib,
meloxicam) are used to reducing the
ulcerogenic consequence of NSAIDs in the
GI tract. Even if they reduce the hazard but
they do not fully remove it and in many dogs
have reported that formation of gastric
ulceration subsequently the given of these
safer NSAIDs (Enberg et al., 2006). The
NSAIDs inhibits the enzyme COX which is
involved in the prostaglandin synthesis, and
inhibit the synthesis of prostacyclin and
prostaglandin E, resulting in the loss of the
gastric protective mechanism (Enberg et al.,
2006). If any change on the expression of
GKN gene leads to the deficiency of GKN1 &
GKN2, results have been reported as gastric
inflammation, non-steroidal anti-
inflammatory (NSAID) induced mucosal
injury and the development of neoplasia of
gastric mucosa (Martin et al., 2008; Nardone
et al., 2008). Another factor concerned with
the pathogenesis of NSAID-induced gastric
disorder is peroxidation of lipids of cell
membranes and damage to the cellular
proteins by the formation of oxidative free
radicals and proteases from activated
neutrophils (Biswas et al., 2003). NSAIDs
acts on mitochondria and uncoupling effect
on oxidative phosphorylation, disperse the
mitochondrial transmembrane potential and
induce mitochondrial permeability transition
pore (Yoshida et al., 1992; Tomoda et al.,
1994; Mahmud et al., 1996; Mingatto et al.,
2000; Davies et al., 2000; Ulutas et al., 2006)
leading to the release of cytochrome c from
mitochondrial intermembranous space into
cytosol. liberated cytochrome c generates
reactive oxygen species (ROS) like hydrogen
peroxide, thus activation of caspase 9 and
caspase 3 pathway and peroxidation of
Int.J.Curr.Microbiol.App.Sci (2018) 7(3): 2475-2501
cellular lipid membrane all resulting into
cellular apoptosis (Murphy et al., 2000).
Corticosteroid predisposes the GI tract to
damage by diminishing mucus production,
changing the biochemical composition of
mucus, declining restoration of epithelial cell
layer and intensifying acid production
(Sorjonen et al., 1983). It has been reported
that administration of prednisolone after 1 or
2 weeks of peptic ulcer formation leads to
decreased collagen-containing tissue in the
ulcer base and delayed healing (Luo et al.,
2004). Dexamethasone has been shown
inhibitory effects of angiogenesis at the ulcer
margins and baseline. Administration of
corticosteroids along with NSAIDs leads to
the formation of gastric mucosal lesions
(Boston et al., 2003). Some studies had been
shown that support the theory that
corticosteroids alone lead to GI mucosal
injury and hemorrhage (Rohrer et al., 1999).
The hepatic disease leads to portal
hypertension which causes distorted gastric
blood flow, delayed epithelial turnover,
gastric hyperacidity, and elevated serum bile
acid concentration stimulate to secretion of
Gastrin-17, results in apoptosis of gastric
epithelial cells (Henderson and Webster,
2006). Animals with mastocytosis may have
numerous all over gastric ulcers (Stanton and
Bright, 1989; Ozaki et al., 2002). The mast
cell tumor produces and releases histamine,
which binds to H2 receptors on gastric
parietal cells, gives a powerful stimulant to
acid secretion. In humans, peptic ulcer
formation as a result of excessive gastrin
production and hyperacidity caused by a
gastrinoma is known as the Zollinger Ellison
syndrome. This is a condition often
characterized by the triad of
hypergastrinemia, hypertrophic or CAG and
GI ulceration. Few cases of a canine homolog
of Zollinger Ellison syndrome associated with
gastric ulcer formation are reported (Gal et
al., 2011). Gastrin directly stimulates to
hydrochloric acid secretion from the parietal
cells, as well as indirectly stimulating acid
production by releasing histamine from fundic
enterochromaffin-like cells in response to
compromising the protective mechanisms and
reducing the epithelial cell turnover of the
gastric mucosa (Hughes, 2006). Gross and
histological appearances of gastric erosions
and ulcers are well documented, erosions
involve only surface epithelium with a
minimal inflammatory response but ulcers can
extend into the muscularis mucosae (Sullivan
and Yool, 1998).The chronic liver disease
leads to ischemia in GI mucosa that causes
portal hypertension and thrombus formation
into the gastric vessels (Stanton and Bright,
1989). The renal system has been involved in
the elimination of at least 40 % circulating
Gastrin-17, with up to 40 percent of
circulating Gastrin-17. Hence, in renal disease
hampered to clearance of Gastrin-17 lead to
hypergastrinemia which induced gastric acid
production. It is the principal factor for
vomiting and pathogenesis of gastric ulcer
formation in renal disease (Schulman and
Krawiec, 2000; Peters et al., 2005). Renal
failure leading to progressive uremia and urea
diffuses from interstitial fluids to stomach,
results in damage to epithelial cell layer of
gastric wall (Polzin and Osborne, 1995;
Guilford and Strombeck, 1996).
The chief gastric pathogenic Helicobacter
spp. in dogs are H. felis, H.bizzozeronii and
H. heilmanniisensustricto (s.s.), while H.
salomonis is least reported and the prevalence
of H. cynogastricus and H. baculiformis has
not yet been studied (Amorim et al., 2016).
However, H. pylori have been rarely
identified in the canine stomach (Chung et al.,
2014). There is also evidence of mixed
infections of different species (Ekman et al.,
2013). Helicobacter spp. populations are
mostly found in the fundus and body of the
stomach (Anacleto et al., 2011). Gastrokines
Int.J.Curr.Microbiol.App.Sci (2018) 7(3): 2475-2501
(GKNs) are bioactive molecules that contain
BRICHOS domain and secreted from a
specific cell of gastric mucosa (Menheniott et
al., 2013). GKN1 connected with decreasing
the formation of colonies and proliferation by
an atypical glandular cell of gastric mucosa
and reducing of cellular viability,
proliferation, and colony (Yoon et al., 2013).
GKNs and trefoil factors (TFFs) both are
together lead to enhance cellular
differentiation, cytoprotective role and
working on NF-κβ signalling pathways that
result anti-inflammatory effects, therefore it
promotes restoration of gastric epithelial cells
(Rippa et al., 2011). If any change on the
expression of GKN gene cause deficiency of
GKN1 & GKN2, results from gastric
inflammation, non-steroidal anti-
inflammatory (NSAID) induced mucosal
injury and the development of neoplasia of
gastric mucosa (Martin et al., 2008; Nardone
et al., 2008).
Gastric disease caused by H. pylori suppress
to GKNs gene expression by methylation of
trefoil factor 2 (Peterson et al., 2010), lead to
Gkn1 and Gkn2 deficiency (Menheniott et al.,
2013). Progressive loss of expression GKN
gene lead to progression of different phases of
disease development, started from chronic
gastritis to gastric mucosal atrophy followed
by a neoplasm of intestine due to complete
loss of GKN gene expression (Sharman et al.,
2017; Menheniott et al., 2013). Electron
microscopic examination of gastric mucosa
showed spiral-shaped organisms in the lumen
of stomach and canaliculi of parietal cells
(Lee et al., 1992). Pathogenic viral infections
in dogs include parvovirus; distemper virus,
rotavirus, and coronavirus rarely causes
gastritis with intestinal or systemic
involvement being most responsible for
patient morbidity and mortality.
Parasitic infestation is least commonly
reported. The larvae of Spirocerca lupi pierce
the gastric mucosal barrier than severe mixed
inflammatory/neoplastic-like reaction and
forms nodular foci, these are generally known
as granulomas (van der Merwe et al., 2008).
The initial stage of inflammation, larvae
encircled by loose connective tissue that are
extremely vascularised and containing fibrin-
rich fluid, neutrophils, and foci of necrosis.
Later stage, these connective tissues are
composed mostly of actively dividing
fibroblasts which like embryonic appearance,
sometimes similar to sarcoma (Bailey, 1963).
In Gnathostoma spinigerum infestation, adult
parasite formed solid nodules in the gastric
submucosa and they stick out into the lumen
and parasite eggs trapped by connective tissue
lead to the formation of center portion
granuloma (Maleewong et al., 1992). The
Hetero bilharzia mericanais trematode
parasite leads to gastric granulomatous
inflammation with circumscribing trapped
eggs (Rodriguez et al., 2014). Gastric
nematode infestation by Ollulanus tricuspis,
which was commonly observed in cats
(Cecchi et al., 2006) also has been reported in
dogs with the sign of chronic vomiting and
granulomatous gastritis (Kato et al., 2015).
Nematodes, Physaloptera rara, and
Physaloptera canis, an uncommon source of
gastric ulceration related to chronic vomiting
(Burrows, 1983). These parasites are free
moving in lumen cause a minimal
inflammatory reaction, but mostly they
attached with the gastric mucosa lead to
inflammation due to the formation of
numerous minute hemorrhages (Clark, 1990).
Gastric phycomycosis characterized by
minute non-specific changes to thickening
mucosal folds of gastric wall with outlet
hindrance. Granulomatous lesions have
typical nodular, circumscribed collections of
macrophages along with uneven lymphocytes,
eosinophils, multinucleated giant cells, and
neutrophils, with or without central necrosis
and a peripheral lymphoid cuff (Ectors et al.,
1993). Histoplasmosis caused by the fungus
Int.J.Curr.Microbiol.App.Sci (2018) 7(3): 2475-2501
Histoplasma capsulatum infected by spores
via inhalation or ingestion route. These spores
are phagocytized by macrophages and
dispersed through the bloodstream or
lymphatic channel to the organ systems and
formation of subclinical or clinical
granulomatous condition amongst other
organs including the GI tract (LinBlache et
al., 2011). In young aged, large-breed, male
dogs Pythiuminsidiosum may produce
pyogenic granulomas in mucosa and
submucosa of stomach and different places of
the GI tract (Grooters and Gee, 2002).
Cryptococcus neoformans cause
granulomatous gastritis mimicking carcinoma
which is a factor of gastric outlet obstruction
(Van der Gaag et al., 1991).
Different cellular defense mechanisms
involve for protection against the free radical
damage (Lewin et al., 1997). Enzymes (e.g.
catalase, glutathione peroxidase complex and
superoxide dismutase) and transition-metal
binding proteins (e.g. transferrin, ferritin, and
ceruloplasmin) production and action of free
radicals. Scavengers (e.g. albumin, bilirubin,
ascorbic acid, urates, and thiols, or
liposoluble, such as vitamin E and coenzyme
Q10) stop and discontinue radical chain by
increase peroxidation chain of lipid molecules
by a react and neutralize free radicals and
convert them into more stable molecules. The
peroxidized fatty acids are removed by
specific phospholipases, making possible the
re-acylation of the damaged molecule by an
acetyl-CoA and the respective enzyme lead
reconstitution of normal structures. The
overproduction of ROS leads to the imbalance
between oxidants and antioxidants at cellular
as well as systemic level. Reactive oxygen
species (ROS) are major molecules of
oxidative stress in exceeds the threshold level
which is generated as primary part of
metabolism that lead to trigger progressive
destruction of polyunsaturated fatty acids
(PUFA) and membrane destruction
(Halliwell, 1990). In acute events of
inflammation free radicals may play a major
role in gastric mucosal barrier dysfunction. In
humans oxidative stress occurs during
exercise leads to decrease gastric and
mesenteric blood flow (Qamar et al., 1987;
Mastaloudis et al., 1994; Hinchcliff et al.,
2000; Otte et al., 2001; Radak et al., 2003)
along with mitochondrial electron transport
chain inefficiency during respiration leading
reperfusion injury mediated by ROS. In the
disease condition, exercise has been activated
to pro-inflammatory cascades which are able
to trigger the leukocytes (Cooper et al., 2007).
Exercise leads to neuroendocrine changes,
like increases release of growth hormone may
also play a major role in the trigger to the
neutrophils (Smith et al., 1996). Neutrophil
penetrates into inflammatory sites and then
release superoxide anions generated by
myeloperoxidase and NADPH oxidase
activities. By the help of superoxide
dismutase activity and highly reactive
hydroxyl radical catalyzed by oxido-reductive
active metal ion converts Superoxide to
hydrogen peroxide. In rats experimentally
feeding of Lipid peroxides lead to change the
oxido-reductive mechanism status in gastric
mucosal cells and can suppress apoptosis and
turnover of epithelial cells (Tsunada et al.,
2003). Lipid peroxidation mediated by
reactive oxygen species (ROS) is considered
as an important cause of oxidative damage
and destruction to the cell membrane,
changing the structural integrity and
biochemical functions of the lipid membrane
(Fridovich et al., 1978; Niki et al., 1987).
Plasma MDA concentration denotes tissue
lipid peroxidation marker (Galunska et al.,
2002). Gastrointestinal mucosa detoxifies to
the dietary lipid peroxides (Miyamoto et al.,
2003) and antioxidant systems may be
relatively exhausted by the peroxide intake,
consequently changing the cellular redox
mechanism. In peripheral tissue, glutathione
Int.J.Curr.Microbiol.App.Sci (2018) 7(3): 2475-2501
peroxidize (GSH) acts as an electron donor in
the glutathione peroxidase-catalyzed
reduction of organic and hydrogen peroxides.
Therefore, the oxidized glutathione formed
through this reaction removed from the cell
using NADPH-dependent reduction
mechanism by glutathione reductase (Meister
et al., 1983; Ehrhart et al., 2003).
History and clinical signs
Gastritis and Peptic Ulcer disease are not
depending on breed, age or sex. The disease
depends upon history of non-steroidal anti-
inflammatory drug (NSAIDs) administration,
ingestion of foreign materials, chemicals,
poisons, coarse food materials and any other
systemic disease like hepatic disease, renal
disease, tumour, pregnancy gastric or
secondary metastases vomiting frequency and
contents of vomitus like bile, food, froth,
blood (frank or digested) or evidence of an
ingested substance (e.g. grass, bones, foreign
material, etc).The most common clinical sign
of gastric ulcer is acute or chronic vomiting
with or without hematemesis. All animals
have gastric ulcer should be vomit, but all
animals those are vomit blood should not
have gastric ulcers (Otto et al., 1991). The
most common clinical sign in gastric disease
of animals are underweight, pale mucous
membrane, tachycardia from severe anaemia
or shock, pain on palpation may be observed
if there is widespread of perforated ulcer and
spread of contamination into the peritoneum,
vomiting, haemoptysis, melena, weight loss,
anaemia, abdominal pain, inappetence or
anorexia, oedema, septicaemia, liver disease,
renal diseases, neurologic diseases. Gastric
and duodenal perforated ulcers show sign of
extensive pain of abdomen, abdominal
distension, high fever, shock and death caused
by peritonitis. Only mild signs of abdominal
disease with perforated ulcers have presented
by the animals is rarely reported (Cortese et
al., 2010). Gastrointestinal lymphosarcoma
induced gastric ulceration produces anorexia,
vomiting, diarrhoea, progressive loss of body
weight, dullness and depression. In NSAIDs
induced ulceration has these similar signs
with melena and paleness of the tongue has
been observed (Shaw et al., 1997).
Laboratory findings
In gastric ulcer disease laboratory findings
indicated that clinical abnormalities are how
much severe (anemia or septic abdominal
fluid sample) and prediction of stimulating
cause e.g. (renal failure). The main findings
of piroxicam induced gastric ulceration are
neutrophilic leucocytosis while the. Phenol
poisoning induced gastric ulceration has
abnormal hematological changes like
neutropenia with toxic neutrophils,
thrombocytopenia and increased muscular
enzymes (Talbert et al., 2012). The important
hormone for the maintenance of normal
gastric homeostasis is Gastrin-17 (Fourmy et
al., 2011) secreted by G cells of gastric
antrum which acts with acetylcholine into
receptors of enterochromaffin cells, results in
releases of histamine. The secreted histamine
binds to receptors on the surface of the
parietal cell produces c-AMP whereas
Gastrin-17 and acetylcholine open calcium
channel leads to stimulating effects on gastric
acid secretion from the apical H+K+ ATPase
(Guarsio et al., 2009). Serum gastrin-17 has
become an important biomarker for gastric
antrum inflammation (Fourmy et al., 2011).
The PGI and PGII are secreted into the gastric
lumen and out of the 1 % leaked into
circulations (Griti et al., 2000). The
Pepsinogen I (PGI) value proportionally
decreases with the development of fundic
atrophy while Pepsinogen II (PGII) has not
shown any pattern with fundic or antral
atrophy (Griti et al., 2000). However, the
decline in value of PGI to PGII ratio
Int.J.Curr.Microbiol.App.Sci (2018) 7(3): 2475-2501
(PGI/PGII) has been revealed for detection of
fundic atrophy and diagnostic biomarkers for
atrophic gastritis and patients with high risk
of gastric cancer (Vaanenen et al., 2003;
Graham et al., 2006). The gastric diseases,
second-degree dehydration, and the sign of
shock have been detected by skin fold test and
relative polycythemia. It must be required
emergency treatment with different
haematological test e.g. complete blood count
(Total erythrocyte Count, Total leucocyte
Count, Total platelet count, Haemoglobin
concentration, Packed cell volume), Blood
urea nitrogen [BUN], Serum creatinine level,
Blood glucose level, AST (aspartate
aminotransferase), Alanine aminotransferase
(ALT), Alkaline phosphatase (ALP) level
and, if available, lactate, pH, and electrolytes
levels also measured. ALT, AST, ALP and
BUN, Serum creatinine level are the
biochemical marker of hepatic disease and
renal diseases which also leads to GI
Serum Gastrin-17 is the most important
biomarker for gastric antrum inflammation
(Fourmy et al., 2011). The reference range of
serum Gastrin-17 concentration is 1040 ng/L
(Garcia et al., 2005; Parente et al., 2014). The
serum gastrin concentration has been
markedly increased in severe gastric disorders
(Garcia et al., 2005). Serological biopsy has
been reported that serum PG level shows to
the morphologic and functional alteration to
the gastric environment (Taggart and Samloff,
1987). Serum pepsinogen A level (18 to 129
µg/L) can be used as a diagnostic marker for
gastric diseases in the dog (Suchodolski et al.,
2002; Suchodolski et al., 2003).
Additional clinico pathological tests are
required to detect the liver and renal diseases,
hypoadrenocorticism, hypothyroidism,
pancreatitis which may lead to gastric
mucosal lesions.
Helicobacters organisms produce urease
enzyme in gastric mucosa which hydrolyzes
urea to ammonia, results increase ammonia
concentration in the gastric mucosal layer
leads to raises gastric pH in which bacterial
populations were survived (Marshall et al.,
1990). Rapid urea test (RUT) and modified
rapid urease (MRU) test are used for
determination of Helicobacter infection of
gastric mucosa in gastric biopsy samples
(Katelaris et al., 1992). These organisms also
confirmed by phase microscopic examination.
Oxidative stress measurement is difficult to
perform directly because unpaired electron
makes free radical very unstable and high
reactive (hence, short half-life) thus, their
measurement needs specific tools like,
electron spin resonance that can identify
compounds with unpaired electrons. In
biological samples products of ROS, reactions
are easier to measurable through biological
assays e.g. measure the DNA adduct 8-
hydroxy-2‟- deoxyguanosine, protein
carbonylation, and many lipid breakdown
products. Sthiobarbituric acid reactive
substances (TBARS), Malondialdehyde, 4-
hydroxy-2-nonenal, Isoprostane, Ethane,
Pentane, and Lipid hydroperoxides are the
most Common measurable lipid products.
Antioxidants enzymes activity Catalase
(CAT) activity (Aebi, 1984) has been
determined (U/g Hb) after isolation and lysis
of RBCs and glutathione peroxidase (GPx)
activity were measured (mU/mg Hb) on
whole blood. Healthy dogs have a good
defense system against oxidative stress that
compensated by balanced redox mechanism
by revert the overproduction of free radicals
and come again to homeostasis. However,
most sick animals unable to show this
mechanism and it will promote the occurrence
of an extreme oxidative stress. This
mechanism is possible by production of the
antioxidant agents, which prevents from
oxidative stress and lead to regeneration of
cells, taking the reduced glutathione (GSH),
Int.J.Curr.Microbiol.App.Sci (2018) 7(3): 2475-2501
superoxide dismutase (SOD), catalase (CAT)
and glutathione peroxidase (GPx) enzymes in
the frontline (Bae et al.,2011; Naito et al.,
2010). It increases the production of H2O2 in
response to the activity of antioxidant
enzymes CAT and GPx levels are elevated.
Catalase enzyme activity present in all tissues
but higher in RBCs, hepatic, renal, adipose
tissues and lower in nervous tissue converts
hydrogen peroxide (H2O2) to oxygen and
water (Pacheco et al., 2009; Zamocky et al.,
2008,). GPx enzyme has been used
glutathione as a substrate along with other
organic hydroperoxides and catalyzes the
H2O2 reduction mechanism (Bae et al., 2011).
The acute stage of GI haemorrhage leads to
normocytic normochromic anaemia while
chronic stage of GI haemorrhage leads to
microcytic hypochromic anaemia in iron
deficiency anaemia (Waldrop et al., 2003).
The acute haemorrhagic diarrhoea with
increased haematocrit count and plasma
protein concentration indicates haemorrhagic
gastroenteritis. The faecal occult blood test
should be done in the unclear cases of GI
haemorrhage but it gives false positive results
due to dietary causes (e.g. vegetables, fruits,
red meat, fish meat) or some bacterial
population in the alimentary tract so that it
suggests that 72 hour before performing of
this test meat-free diet fed to the patients. It is
generally used for coagulation defects that are
not the primary cause of GI haemorrhage but
noticeable intensifying blood loss e.g.
rodenticide toxicity or clotting factor
deficiencies. The Total Platelet count is a very
useful measure of coagulation defects. In
dogs, immune-mediated thrombocytopenia
(ITP) is the common factor of GI
haemorrhage. If no any cause of ulceration
has been found then electrolyte level can be
estimated and ACTH stimulation test should
be done because it has been reported that
hypo adrenocorticism coupled with GI
haemorrhage in dogs (Medinger et al., 1993).
The dogs have gastric ulceration and
perforation given with IM injection of
Pentagastrin, @ 6 micrograms/Kg body
weight leads to elevation of the secretion of
gastric juice (hyperacidity).The extent of
endoscopically detected damage shows a
relationship with sucrose permeability. The
decrease in the permeability of sucrose is
more quickly than gastric ulcer
disappearance. Sucrose permeability test is
more responsive for widespread mucosal
damage than to distinct common ulceration
(Meddings et al., 1995).
Diagnostic imaging
The plain and contrast radiographs are useful
for determining possible origin of abdominal
disturbances (gastric foreign bodies) but may
be unsatisfactory in smart verification of
gastric ulceration (Guarino et al., 2008). The
ultrasonography used for recognizing foreign
bodies and masses, identification of GI
perforation and used to detect drug-induced
gastric mucosal changes and sometimes
helpful to suggestion for the need of surgery
(Boysen et al., 2003). Ultrasonography of the
gastrointestinal tract (GIT) is a valuable
diagnostic imaging technique in animals
(Penninck et al., 1990). The complete
abdominal ultrasonographic evaluation by 5,
7.5 and/or 10 MHz transducers has been
performed in all age dogs, gastric lesions are
considered by gastric wall thickening, wall
layering and contents of gastric lumen. Poor
Gastric motility is also considered if the
peristaltic movement of the stomach is one or
less contraction per minute. Ultrasonography
of gastric ulcer can be suspected by the
presence of gastric wall thickening associated
with a wall defect (crater), gastric fluid
accumulation, reduced motility, and
constantly accumulation of microbubbles at
the crater site (Tomooka et al., 1989;
Smithuis et al., 1989). Ultrasonographic
findings of the gastric epithelial tumor are
gastric wall thickening, pseudolayering,
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poorly echogenic wall and regional or distant
lymphadenopathy (Penninck et al., 1998).
Endoscopy is the most sensitive diagnostic
and prognosis of a diversity of gastrointestinal
diseases. Endoscopic examination is
important for the diagnosis and provides the
perfect diagnosis by direct gastric mucosal
visualization, biopsy collection, decided to
prognosis and therapeutic benefits (Shaheen
et al., 2010). For the diagnosis of gastric
mucosal lesions endoscopic examination can
be protected, non-invasive, exact and without
risk of dehiscence or peritonitis for evaluation
of the color and gastric mucosal integrity of
gastric mucosal layer (Happe et al., 1983;
Grooters et al., 1994).
Differential diagnosis
Ingestion of specific foods (mainly protein)
induces immune-mediated response leads to
the sudden onset of gastrointestinal symptoms
due to pruritus of the GIT known as food
allergy in dogs (Webb and Twedt, 2003). In
the starting phase of the gastric neoplasm no
clinical sign appears, thus it can be diagnosed
at later stages in most cases, therefore, the
higher mortality rate has been reported
(Tesensuren et al., 2006). The endoscopic
examination of gastric neoplasm reveals
cauliflower shape cell mass in the gastric wall
and therapy based on clinical signs has not
been responded. The biochemical
examinations reveal elevation of serum
creatinine level, the activity of gastric
enzymes and serum arginase activity while
the level of the total protein concentration
especially albumin level reduces (Meram and
Tarakçıoğlu, 2000). The male dogs mostly
suspected for gastric carcinoma generally
originated from pylorus and microscopic
examination showed diffused penetration of
inadequate differentiated neoplastic cells
coupled with scirrhous reaction and gives
appearance of typical „„signet ring‟‟ cells
(Brown et al., 2007). Due to obstruction of
the lumen or inflammatory pain in the
esophagus reveals star grazing behavior and
clinical signs that are the regurgitation of
food, excessive salivation, dysphagia,
frequent tries to swallow, anorexia, and
progressive weight loss (Frank et al., 2012).
The anesthesia-induced gastro-esophageal
reflex leads to esophagitis which is the most
common cause of esophageal pain (Poier et
al., 2014). Omeprazole is used for the
treatment of the stargazing behavior of dogs
due to esophagitis because it enhances gastric
pH (Tolbert et al., 2011). The Bravo pH
monitoring system calculates Gastro-
Esophageal reflux, Nuclear scintigraphy,
positive contrast esophagogram and
fluoroscopy method (GER) in canines
(Tolbert et al., 2011). If the dog is suffering
from obsessive-compulsive disorder, reveals
signs of excessive licking to foreign objects
continuously like floor, wall, furnitures, lead
to nauseous sensation and discomforts
without GIT disorders (Overall et al., 2002;
Bonnet et al., 2012) should be treated with
combination of serotonergic drug with
behavioral therapy (Overall and Dunham,
2002).If the lipolysis mechanism has been
disturbed lead to the generation of an
excessive amount of ketone bodies which
hampers the blood buffer system and
development of acidemia with diabetic
ketoacidosis (Kerl, 2001). The disturbed
lipolysis mechanism will also lead to GI
disturbances and produce polyurea,
polydipsia, anorexia, vomiting, progressive
weight loss, haematuria, pollakiuria, shock
and death of the dogs is generally due to a
severe metabolic acidosis or complications to
the vital and visceral organs (Hume et al.,
2006). If the pH is less than 7.10, bicarbonate
and insulin therapy for the treatment of DKA
is recommended (Causmaecker et al., 2009).
The most important clinical sign of the
haemorrhagic gastroenteritis is acute onset of
vomiting, profuse bloody diarrhoea,
dehydration, and depression. The puppies
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having age between six weeks to six months
are more susceptible, but more severe in an
age of less than six-month young dogs or old
dogs (Sutton et al., 2013). In young one GI
system and Cardiac system are mostly
affected but only GI system is maximally
affected in adult dogs. The parvovirus has
been identified with the help of ELISA and
PCR. In the condition of shock, rapid infusion
(over 10-20 minutes) of a bolus of 10-
20ml/kg BW of lactated Ringers solution
should be administered because lactate has
been further converted into bicarbonate in the
Principles of therapy
The Principles of therapy of gastritis and
peptic ulcer diseases are following (a)
Withdrawal of food for prevents stimulation
of gastric glands. (b) Removal of the
etiological factor that is the hepatic failure,
hepatic bacterial infection, NSAIDs or
corticosteroid therapy.(c) Ulcer healing
supported by- i) stabilization of the
cardiovascular system and preserve mucosal
perfusion by appropriate fluid therapy ii)
diminishing gastric acidity iii) shielding from
ulcer by cytoprotective agents (iv) correcting
secondary circumstances (dehydration,
anemia, weight loss).(d) After the stabilized,
the perfusion in the patient than broad-
spectrum antibiotics or combination of
antibiotic therapy has been started.
Fluid therapy with gastric mucosal therapy
Dehydration, relative polycythemia,
Hypokalemia, and hyponatremia are
commonly found in dogs after vomiting and
diarrhoea. Immediate correction of
hypokalemia with antispasmodics is required
because hypokalemia leads to hindrance in
gastric emptying (Rebar et al., 2001; Bichard
and Sherding, 2005). Reflux of duodenal
contents (bile, pancreatic juice etc) into the
stomach can damage the gastric mucosal
barrier (Rodriguez et al., 1997). In the drug-
induced ulcerations, NSAIDs and other
steroidal drugs should be stopped; if
medication is necessary for therapy of
specific disease then it will be considered. GI
protectants in combination used for therapy
containing H-2 receptor antagonists
(cimetidine, ranitidine, famotidine), proton
pump inhibitors (omeprazole, pantoprazole),
cytoprotectants (sucralfate) and synthetic
prostaglandins (misoprostol). Cimetidine is
the first H2 receptor antagonist used in dogs
and it is administered 3-4 times daily dose of
@ 2.5-5 mg/lb body weight for suppressing
gastric acid secretion (Ephgrave et al., 1987).
Even so, there is only mild to moderate
inhibition of acid secretion over a 24 hours
period. The fact that it works clinically for
ulcer therapy suggests that even partial
suppuration of gastric acid secretion is
beneficial for the healing of most gastro-
duodenal ulcers. In the GI haemorrhage and
vomiting in significantly ill dogs, it must be
considered dose and route of drug
administration because oral route can the drug
absorption. Ranitidine @2mg/kg IV q 12 hr
has not been shown a major effect on gastric
acid suppression (Bersenas et al., 2005).
Proton pump inhibitors are the most potent
agents for suppression of gastric acid
secretion by the inhibition of the gastric
H+/K+- ATPase enzyme (the proton pump),
which leads to failing the gastric secretion and
rising the intragastric mucosal pH (Miner et
al., 2003; Scott et al., 2002). Mainly clinically
available proton pump inhibitors (PPI) are
omeprazole, esomeprazole, lansoprazole,
rabeprazole, and pantoprazole (Miner et al.,
2003). Omeprazole is the first PPI that used
clinically in 1988 at Losec in Europe, and in
1990 at Prilosec in the United States.
Esomeprazole commonly used with
omeprazole that is very much effective for
Int.J.Curr.Microbiol.App.Sci (2018) 7(3): 2475-2501
inhibition of gastric acid secretion (Andersson
et al., 2000). The esomeprazole (40 mg) is
more effective than lansoprazole (30 mg) for
healing erosive esophagitis and heartburn
condition. For intragastric acid control
intravenously once-daily dosing with
esomeprazole provides faster and more
prominent healing results than intravenously
once-daily dosing with pantoprazole (Wilder
et al., 2004).In the patients with signs of
GERD esomeprazole presents faster and
greater acid control results to longer period
maintain the intragastric mucosal pH than
lansoprazole, omeprazole, pantoprazole, and
rabeprazole (Rohss et al., 2004). Famotidine
@ 0.5mg/kg IV q12hr, omeprazole @1mg/ kg
orally q24hr) and pantoprazole @ 1mg/kg IV
q24hr each have a notable property of the
gastric acid secretion in dogs. Omeprazole
acts as a Proton pump inhibitor that inhibits
the H+-K+ ATPase pump and the production
of hydrochloric acid from gastric parietal
cells. Omeprazole enhances regulations of
GKNs and produces anti-inflammatory
effects, gastric homeostasis and tumor
suppression (Kang et al., 2001; Menheniott et
al., 2013; Xing et al., 2012). Omeprazole
inhibits c-AMP pathway of hydrogen ion
generation and leads to prevent ulcer
formation and enhance ulcer healing by
increasing of gastric mucosal circulation and
mucosal epithelial cells migration. The
median value of 24-hour intragastric pH on
days 2 and 6 were significantly higher when
dogs were given famotidine, pantoprazole, or
omeprazole than dogs were given ranitidine
(Bersenas et al., 2005). Misoprostol is an
analog of PGE2 gives at the doses of 0.5 to
2.3μg/lb body weight twice in a day. In
NSAID induced ulceration, misoprostol may
provide additional benefit with sucralfate and
H2 antagonist therapy. Prostaglandin E is
contraindicated in hypotensive animals
because it may lead to increasing of gastric
damage. These drugs shield healthy and
uncovered mucosa from more harm and
encourage epithelialization of gastric mucosa
(Kuwayama et al., 1991). Sucralfate is a non-
absorbable aluminum salt of sucrose
octasulfate compound that used as an optional
extra to H2 antagonists for treating peptic
ulcers, because when ulcerative clinical signs
are noticeable It is more effective in NSAID-
induced ulceration than other drugs such as
sucralfate and H2 receptor antagonists, so it is
choice of drug for NSAIDs producing ulcers
(Lanza et al., 2009). Acid-reducing drugs are
work on cellular level metabolism to inhibit
hydrogen ion secretion (e.g. prostaglandins)
(Lanza et al., 2009). Intravenous
administration of metoclopramide @1-
2mg/kg/24hr act as dopamine- antagonists
that raise the threshold activity level of
chemoreceptor trigger zone in vomiting center
and decrease visceral nerve input that
prevents vomiting (Sawant et al., 2004). If the
GI ulceration is coupled with the acute
abdominal pain of unclear etiology, opioid
analgesics should be administered for
stabilization of GIT motility as well as relieve
pain suffering. Antispasmodic drugs (e.g.
dicyclomine) can also be administered.
Triple therapy
In considerable GI haemorrhage, broad-
spectrum antibiotics should be administered
for check the formation of bacterial colonies
in the gastric mucosa as well as systemic
translocation of the bacterial population. The
culture of samples and Antibiotic sensitivity
test should be done before started antibiotic
therapy. Single Antibiotics does not gives
significant effect against Helicobacter spp.
Because rapidly development of drug
resistance “Triple therapy” is effective against
Helicobactor organism; this contains three
antibiotic combinations or a combination of
two antibiotics and one acid reducing agent
like omeprazole or H2 receptor antagonist
(Bichard and Shreding, 2005). In H. pylori
induced gastric disease, progressive
Int.J.Curr.Microbiol.App.Sci (2018) 7(3): 2475-2501
diminution of GKNs gene expression is
known through disease progression chronic
condition to oncogenic transformation (Choi
et al., 2013). Removal of H. pylori organisms
from stomach leads to restoration of normal
tissue level for proper expression of GKNs
gene (Nardone et al., 2007). Gastric
Helicobactor infection treated with “Triple
therapy” consisting anioxycillin 20 mg/kg
BID, metronidazole 10 mg/kg BID and
bismuth subcitrate 6 mg/kg BID orally for
two to four weeks. Alternative eradication
therapy with tetracycline 20 mg/kg BID and
omeprazole 0.7 mg/kg OD administered
orally for next 10 and 14 days was given after
triple therapy for eradication of subsequently
persisting helicobacter organism (Happonen
et al., 2000). Triple therapy with amoxycillin,
metronidazole and famotidine also
successfully eradicate gastric Helicobactor
infection in dog and cat (Simpson et al.,
Antioxidant therapy
It is difficult to prevent the generation of ROS
but the proper strategies prevent the gastric
mucosal damage and fastening of recovery
from oxidative stress. In the diet of sled dog,
ROS scavengers such as vitamin E have been
used to diminish cellular damage due to
exercise (Hinchcliff et al., 2000). Some
antioxidants are used to protect
gastrointestinal mucosa and apical epithelial
membrane. In rats, the Cacao Liquor water-
soluble crude polyphenols (CWSP) has been
shown radical scavenging ability as well as
reduce ethanol-induced gastric lesions
(Osakabe et al., 1998). The normal blood
level of vitamin-C is 3.2-8.9m/ L in dogs,
(Hishiyama et al., 2006). Vitamin -C is
necessarily required for absorption of
antioxidants like N- acetylcysteine, and alpha-
tocopherol in young dogs while in geriatric
patient, the oral dosage of Vitamine C gives
minor antioxidant and immunological effects
(Hall et al., 2006; Ogawa et al., 2008; Hesta
et al., 2009). Ascorbic acid reduces oxidative
damage to the gastric mucosal layer by
scavenging ROS and attenuating the H.
pylori-induced inflammatory cascade leads to
decreased incidence of gastric carcinoma and
bleeding from peptic ulcer disease (Aditi et
al., 2012). During scavenging of free oxygen
radicals by ascorbic acid produces 2-fold
greater amount of ascorbyl radicals in the H.
pylori-infected gastric mucosa (Drake et al.,
1998). Vitamin C is also an important dietary
antioxidant because it significantly decreases
the adverse effect of reactive oxygen species
(ROS) that is a source of oxidative damage to
the cell components like, lipids membrane,
DNA, and proteins (Maestro et al., 1980;
Iheanacho et al., 1993). Vitamin C is the only
antioxidant required for complete protection
of endogenous lipids from noticeable
oxidative damage induced by ROS (Polidori
et al., 2004). Before the reaction and
oxidation of lipoprotein lipids, Ascorbate
seizes the activity of ROS. If serum
concentration of Vitamin C has been down,
the remaining antioxidants cannot be able to
provide complete protection from ROS, leads
to oxidative stress and initiate lipid
peroxidation (Ulutas et al., 2006).
N- Acetylcysteine works have mucolytic as
well as antioxidant effect and reduce
colonization of Helicobacter organism in
gastric mucosa (Huynh et al., 2000). N-
acetylcysteine increases liver blood flow and
improves liver function and renal function, as
well as hepatorenal syndrome, lead to reduce
severity of systemic induced gastritis (Holt et
al., 1999; Rank et al., 2000). Silymarin
significantly affects the serum SGPT, SGOT,
Alkaline phosphatase activities, serum urea
and creatinine levels and maintains
malondialdehyde level (MDA) as an
antioxidant in liver and kidney (El-Maddawy
et al., 2012).
Int.J.Curr.Microbiol.App.Sci (2018) 7(3): 2475-2501
New synthetic flavonoid derivatives
gastroprotactant drugs are also used for the
treatment of gastritis and peptic ulcer disease.
It was designed by effervescent floating
matrix system (EFMS) that float the tablet in
gastric fluids and constant release of drug
DA-6034 from tablets in acidic media. It acts
as solubilizing and alkalizing agent like as
sodium bicarbonate has been used as a gas
generating agent. DA-6034 EFMS tablets lead
to enhancing the gastroprotective effects of
gastric ulcer, gastritis and peptic ulcer (Jang
et al., 2008). Electron microscopic
examination showed abundant osmophilic
phospholipids materials are found as a
surfactant within the mucosa of gastric and
duodenum and administration of phospho-
lipids exogenously may prevent gastric
mucosal ulceration (Ethell et al., 1999). If
ulcer patient co-existing with motility
disorders of delayed gastric emptying also
give Cisapride therapy (Natan et al., 1996).
Therapy of severe bleeding in acute GI
haemorrhage depends on the degree and
length of bleeding time and PCV. Whole
blood or oxyglobin transfusion is the first
protocol of recovery. Blood transfusion in
unclearly observed rate and volume of blood
loss in patients who do not show sign of
shock causes vascular hemodynamic
abnormalities, disturbances in haematological
parameters, and parallel illness are noticed
(Maltz et al., 2000). It may be required if the
patient shows clinical signs of hypoxia (e.g.
tachycardia, hyper-lactataemia, tachypnoea),
or if series of haematological parameters
showed failing haematocrit value after the
therapy started (Maltz et al., 2000). If the
medical therapy fails to respond, surgery
should be indicated for pre-existing surgical
disease (e.g. perforated ulcer, foreign body or
tumours, septic abdomen), Before therapy of
GI haemorrhage, it must be considered in
hepatic disease (coagulation abnormalities)
and renal diseases (uraemia), otherwise it may
lead to intensifying the condition.
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How to cite this article:
Pankaj Kumar Patel, Sawita Kumari Patel S.K. Dixit and Rathore, R.S. 2018. Gastritis and
Peptic Ulcer Diseases in Dogs: A Review. Int.J.Curr.Microbiol.App.Sci. 7(03): 2475-2501.
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... Es común que en estos casos el paciente aun presente polifagia, fue necesario administrar, terapia de fluidos, en la espera del procedimiento. (Patel et al ., 2018) Se procede primero a una endoscopia, donde se encontró una lesión ulcerativa al inicio del esófago, se diagnosticó una esofagitis. Seguido se inicia un procedimiento quirúrgico de laparotomía exploratoria, encontrando en el antro pilórico una masa. ...
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Five Jamunapari goat kids of 3-4 months weighing 5-7 kg were reported with the history of inappetence, diarrhoea and cachexia. Haematological and biochemical examination revealed anaemia and Hypoalbuminemia. On faecal examination infection of Moniezia expansa was confirmed. Here we reported a chronic case of Moniezia expansa was resistant to fenbendazole and praziquantel but responded on single dose of Albendazole and niclosamide combination.
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NOTE Internal Medicine The first report of the ante-mortem diagnosis of Ollulanus tricuspis infection in two dogs Daiki KATO¹⁾, Mariko OISHI¹⁾, Koichi OHNO1)*, Ko NAKASHIMA¹⁾, Atsuhito WADA¹⁾, Tatsushi MORITA²⁾, Soichi IMAI²⁾, Masaya TSUBOI³⁾, James K. CHAMBERS³⁾, Kazuyuki UCHIDA³⁾ and Hajime TSUJIMOTO¹⁾ ¹⁾Department of Veterinary Internal Medicine, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1–1–1 Yayoi, Bunkyo-ku, Tokyo 113–8657, Japan ²⁾Division of Veterinary Infectious Disease, Department of Veterinary Pathobiology, Nippon Veterinary and Life Science University, 1–7–1 Kyonanchyo Musashino, Tokyo 180–8602, Japan ³⁾Department of Veterinary Pathology, Graduate School of Agricultural Should have been NOTE Internal Medicine The first report of the ante-mortem diagnosis of Ollulanus tricuspis infection in two dogs Daiki KATO¹⁾, Mariko OISHI¹⁾, Koichi OHNO1)*, Ko NAKASHIMA¹⁾, Atsuhito WADA¹⁾, Shin-ichiro FUKUMOTO²⁾, Tatsushi MORITA³⁾, Soichi IMAI³⁾, Masaya TSUBOI⁴⁾, James K. CHAMBERS⁴⁾, Kazuyuki UCHIDA⁴⁾ and Hajime TSUJIMOTO¹⁾ ¹⁾,Department of Veterinary Internal Medicine, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1–1–1 Yayoi, Bunkyo-ku, Tokyo 113–8657, Japan ²⁾Laboratory of Veterinary Parasitology, Department of Pathobiology, School of Veterinary Medicine, Rakuno Gakuen University, Ebetsu, Hokkaido 069-8501, Japan ³⁾Division of Veterinary Infectious Disease, Department of Veterinary Pathobiology, Nippon Veterinary and Life Science University, 1–7–1 Kyonanchyo Musashino, Tokyo 180–8602, Japan ⁴⁾Department of Veterinary Pathology, Graduate School of Agricultural
The 5th edition of Jubb, Kennedy, and Palmer's Pathology of Domestic Animals continues the long tradition of this classic set of volumes as the most comprehensive reference book published on the topic of pathology of the common domestic mammals, with emphasis on disease conditions of cattle and small ruminants, swine, horses, dogs and cats. Using a body systems approach, recognized authorities in their fields provide overviews of general characteristics of the system, reactions to insult, and disease conditions broken down by type of infectious or toxic insult affecting the anatomical subdivisions of each body system. Since the publication of the 4th edition in 1993, much has changed. Disease agents, such as Bovine viral diarrhea virus (BVDV) type 2, Porcine reproductive and respiratory syndrome virus (PRRSV), Porcine circovirus 2, Hendra virus, and Leptospira spp., have emerged or further evolved. Molecular-based testing, including polymerase chain reaction (PCR) and in-situ hybridization, have allowed further understanding of pathogenesis of disease, and have greatly furthered our diagnostic capabilities. Thoroughly revised text, including new or evolving pathogens and new diagnostic techniques. Over 250 new illustrations. Maintains the currency of the text, assists the reader in putting new conditions into perspective. Updating of the Bibliography on each subject gives readers new entry points into the rapidly expanding literature on each subject. Illustrations of new conditions or agents. Reader-friendliness improved through highlighting of text, bullet-point lists, italics, diagnostic hints.
Gastrokines (GKNs) are bioactive substances secreted by gastric cells. Evidence supports functional roles for GKNs in gastric homeostasis, immune responses and tumour suppression. Down-regulation has been reported in Helicobacter pylori associated gastritis and other inflammatory gastrointestinal conditions in mice and people. The aim of this study was to evaluate GKN gene expression in dogs positive for other Helicobacter spp both before and after treatment. Expression of Gkn-1 and Gkn-2 mRNA was studied in endoscopic biopsy samples collected from seven healthy dogs over three time-points pre- (T0) and at 1 and 18 weeks post-treatment for Helicobacter spp colonisation (T1 & T2). The relative expression software tool (REST) was used to provide efficiency corrected expression ratios for comparisons between groups and these results were compared to a standard 2∆∆CT methodology. Compared with T1 Gkn1 and Gkn2 mRNA expression was greater at T0 by a mean factor of 2.53 (SE = 1.83 – 3.54) for Gkn1 (P = 0.000) and 2.85 (SE = 2.23 – 3.75) for Gkn2 (P = 0.000). This difference was attenuated when comparisons were made between T0 and T2. Histopathological evidence of gastritis was not present in any Helicobacter spp positive sample. When compared to post-eradication samples Gkn gene expression is increased in the presence of Helicobacter spp. in dogs without evidence for concurrent inflammation. Further evaluation is required to determine the relevance of this finding, however given a suspected role in gastric homeostasis, up-regulation of GKN1 and GKN2 could limit development of gastritis in Helicobacter spp positive dogs.
Gastric disorders are common in dogs and are a major reason for veterinary consultation. In human medicine, the classification of gastric diseases based on histological features, genotypes and molecular phenotypes helps to better understand the characteristics of each subtype, and to improve early diagnosis, prevention and treatment. Canine gastric lesions often show strong histological similarities to their human counterparts. However, such conditions in the canine stomach are poorly studied and their cellular and molecular features are largely unknown. This article reviews the histopathological classification of inflammatory and neoplastic lesions of the canine stomach and provides an update on the application of molecular techniques within the field of canine gastric pathology. The canine disorders are compared with current knowledge of the equivalent human diseases.
A cross sectional study was conducted from November 2010 to April 2011 in Mekelle Veterinary Clinic to assess major health problems of dogs and to determine the associated risk factors. A total of 109 dogs were examined based on history and clinical signs. Out of the total 109 dogs examined, 42 (38.5%), 36 (33.0%), 15 (13.8%) and 16 (14.7%) had skin, gastrointestinal tract, respiratory and injury problems, respectively. Of 42 dogs that had skin problems, 25 (59.5%) were lice and flea infested and 17 (40.5%) were mange mite infested. From 36 dogs that had gastrointestinal tract problems, 21 (58.3%) showed diarrhea, 5 (13.9%) were with vomiting and 10 (27.8%) showed both diarrhea and vomition. Out of the 16 injured dogs, 11 (68.75%) were dog bite wounds and 5 (31.25%) were car accident and bad management inflicted injuries. All 15 dogs that came with respiratory tract infection showed various degrees of coughing and nasal discharges. The occurrence of the disease conditions did not show any statistical significant difference between male and female. Moreover, the difference in occurrence of health problems between the local and exotic breeds of dog was not found to be statistically significant. Nevertheless, the difference in occurrence of major health problems among various age categories was statistically significance. The current study presents new data about the major health problems of dogs in Mekelle City. Further studies should be conducted in other cities of Ethiopia so as to assess major health problems of dogs and their role in the transmission of diseases to humans.