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The Influence of Esomeprazole and Cisapride on Gastroesophageal Reflux During Anesthesia in Dogs

  1. A.C. Zacuto1,
  2. S.L. Marks2,*,
  3. J. Osborn3,
  4. K.L. Douthitt1,
  5. K.L. Hollingshead1,
  6. K. Hayashi4,
  7. A.S. Kapatkin4,
  8. B.H. Pypendop4,
  9. P.C. Belafsky5

Article first published online: 10 APR 2012

DOI: 10.1111/j.1939-1676.2012.00929.x

Issue

Journal of Veterinary Internal Medicine

Journal of Veterinary Internal Medicine

Volume 26, Issue 3, pages 518–525, May-June 2012

Additional Information

How to Cite

Zacuto, A.C., Marks, S.L., Osborn, J., Douthitt, K.L., Hollingshead, K.L., Hayashi, K., Kapatkin, A.S., Pypendop, B.H. and Belafsky, P.C. (2012), The Influence of Esomeprazole and Cisapride on Gastroesophageal Reflux During Anesthesia in Dogs. Journal of Veterinary Internal Medicine, 26: 518–525. doi: 10.1111/j.1939-1676.2012.00929.x

Author Information

  1. 1

    Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis, Sacramento, CA

  2. 2

    Department of Medicine & Epidemiology, School of Veterinary Medicine, University of California, Davis, Sacramento, CA

  3. 3

    Sandhill Scientific, Inc, Highlands Ranch, CO

  4. 4

    Department of Surgery & Radiological Sciences, School of Veterinary Medicine, Sacramento, CA

  5. 5

    Department of Otolaryngology, The Center for Voice and Swallowing, School of Medicine, University of California, Davis, Sacramento, CA

*Corresponding author: Dr Stanley Marks, University of California, Davis, School of Veterinary Medicine, Dept. of Medicine & Epidemiology, One Shields Avenue, Davis, CA 95616; e-mail: slmarks@ucdavis.edu

Publication History

  1. Issue published online: 2 MAY 2012
  2. Article first published online: 10 APR 2012
  3. Manuscript Accepted: 10 MAR 2012
  4. Manuscript Revised: 21 JAN 2012
  5. Manuscript Received: 1 NOV 2011

Funded by

  • Students Training in Advanced Research (STAR)

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Keywords:

  • Esophagitis;
  • Impedance;
  • pH;
  • Reflux

Background

Gastroesophageal reflux (GER) is common in anesthetized dogs and can cause esophagitis, esophageal stricture, and aspiration pneumonia.

Objective

To determine whether preanesthetic IV administration of esomeprazole alone or esomeprazole and cisapride increases esophageal pH and decreases the frequency of GER in anesthetized dogs using combined multichannel impedance and pH monitoring.

Animals

Sixty-one healthy dogs undergoing elective orthopedic surgery procedures.

Methods

Prospective, randomized, placebo-controlled study. Dogs were randomized to receive IV saline (0.9% NaCl), esomeprazole (1 mg/kg) alone, or a combination of esomeprazole (1 mg/kg) and cisapride (1 mg/kg) 12–18 hours and 1–1.5 hours before anesthetic induction. An esophageal pH/impedance probe was utilized to measure esophageal pH and detect GER.

Results

Eight of 21 dogs in the placebo group (38.1%), 8 of 22 dogs in the esomeprazole group (36%), and 2 of 18 dogs in the combined esomeprazole and cisapride group (11%) had ≥1 episode of GER on impedance testing during anesthesia (P < .05). Esomeprazole was associated with a significant increase in gastric and esophageal pH (P = .001), but the drug did not significantly decrease the frequency of GER (P = .955). Concurrent administration of cisapride was associated with a significant decrease in the number of reflux events (RE) compared to the placebo and esomeprazole groups (P < .05).

Conclusions and Clinical Relevance

Preanesthetic administration of cisapride and esomeprazole decreases the number of RE in anesthetized dogs, but administration of esomeprazole alone was associated with nonacid and weakly acidic reflux in all but 1 dog.

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