Gastroduodenal Ulceration

Gastroduodenal ulceration and perforation is an increasingly recognized cause of morbidity and mortality in dogs. The most commonly identified predisposing factors for gastroduodenal ulceration in dogs include nonsteroidal anti-inflammatory drug (NSAID) therapy, corticosteroid therapy, liver disease, shock or sepsis, and underlying neoplasia. The gastroduodenal ulceration and perforation is less frequently recognized in cats. Most commonly, ulceration is described secondary to neoplasia, including systemic mastocytosis, gastric lymphosarcoma and adenocarcinoma, and gastrinoma. There are many available drug therapies aimed at decreasing or neutralizing acid secretion or directed at cytoprotection. Usually, a combination of acid-suppressing treatments and cytoprotective agents are used. Commonly prescribed medications include histamine H2-receptor antagonists, proton pump inhibitors, prostaglandin analogs, sucralfate, and antacids. For patients with the gastroduodenal perforation, severe ulceration with hemorrhage, or failure to respond to medical therapy, surgery is typically warranted.