You’ve probably heard of stomach ulcers in people, but you may be unaware that dogs, too, can suffer from ulcers.
Ulcers are erosions or sores in the lining of the stomach or in the duodenum (the first part of the small intestine). They can cause serious problems — even life-threatening ones — if it perforates all the way through the stomach or duodenum.
Ulcers are not very common in young dogs, but senior dogs are at risk of developing them. Here’s what you need to know about ulcers in senior dogs.
Causes Of An Ulcer
There are many things that can cause an ulcer in senior dogs.
Any serious illness can cause a stomach ulcer, but the three most common diseases associated with ulcers are:
- chronic kidney failure,
- cancer, and
- Helicobacter pylori infections.
Chronic kidney failure is a common problem in geriatric dogs. It can cause nausea, vomiting, dehydration and a decrease in the pH of the fluid in the stomach. These factors increase the formation of gastric ulcers.
Cancer in the stomach or lymphoma in the GI tract can also produce stomach and intestinal ulcers. Gastrinomas are a rare cancer that increase the production of stomach acid and ulcers. Mast cell tumors are commonly seen in senior dogs, and they can also increase the acidity in the stomach. Fortunately they do not usually produce ulcers.
Helicobacter pylori is a type of bacterium directly associated with ulcer formation in people. Dogs can also have Helicobacter infections, and they might produce stomach ulcers along with chronic vomiting.
There are several medications that can cause ulcers.
Non-steroidal anti-inflammatory drugs (NSAIDS) are commonly used in senior dogs with arthritis and other painful conditions. Unfortunately NSAIDS can also produce ulcers, and they may be the most common cause of ulcers. This is frequently seen in large breed dogs. Human NSAIDS like aspirin, ibuprofen, and naproxen typically have a higher risk of causing an ulcer than do the veterinary-specific NSAIDS. Cortisone at high doses is sometimes used in senior dogs to treat cancer or to suppress the immune system. High doses of cortisone may produce ulcers. Cortisone used at the same time as a NSAID will almost always cause stomach ulcers.
Some of the chemotherapy agents used to treat cancer in senior dogs can also cause ulcers.
Stress can also play a role in ulcer formation. Boarding and grooming can be stressful for older dogs. Adding a new animal to the household, moving and holidays can also be stressful to older dogs. Senior dogs with separation anxiety or cognitive dysfunction syndrome may also experience high levels of stress.
The increased stress level may increase the risk for developing ulcers. This is more common in the small breed dogs.
Toxic And Sharp Objects
Ingestion of some toxic products such as bleach, household cleaners, yard sprays, and bug sprays can damage the stomach wall and cause ulcers to form.
Likewise eating metal or other sharp objects can cause an ulcer. Dogs that chew and ingest bones can also develop ulcers. This seems to be more common with chicken bones that tend to splinter and damage the stomach and duodenum.
Signs Of An Ulcer
What signs do dogs with ulcers show? Commonly dogs with ulcers will have a decreased appetite or no appetite, abdominal pain, lethargy and vomiting.
The vomitus will sometimes contain blood. The partially digested blood in the vomitus may look like “coffee grounds.” Blood from the stomach and duodenum can also produce a dark “tarry” look to the feces (melena). The blood loss may cause moderate to severe anemia.
In severe cases the stomach may actually perforate (the ulcer creates a hole all the way through the wall of the stomach). This is usually fatal. Fortunately perforations are rare in dogs.
Diagnosis Of An Ulcer
It can be hard for your veterinarian to diagnose an ulcer. Routine bloodwork is used to rule out other causes of vomiting. Anemia from blood loss and some electrolyte abnormalities from vomiting are common but nonspecific. Radiographs (X-rays) may help to see if there is a foreign body or bone fragment in the stomach or intestinal tract, but this is not sensitive enough to detect an ulcer. Abdominal ultrasound can be used to look for cancer in the stomach or intestinal tract and to look for thin areas in the stomach wall. Unfortunately, ultrasound also isn’t sensitive enough to detect most ulcers.
The only way to definitively diagnose an ulcer is to do a gastroscopy. This requires passing a long flexible tube with a small camera at the end (an endoscope) through the mouth and into the stomach and duodenum to actually look for any ulcers.
Treatment Of An Ulcer
Treatment of an ulcer is aimed at treating the ulcer itself; supportive care to increase the appetite; and correcting the underlying cause of the ulcer when possible.
The main treatment for the ulcer is to reduce the amount of stomach acid. This can be done with an antacid such as omeprazole (Prilosec) or famotidine (Pepcid AC). Sucralfate (Carafate) is commonly called the “ulcer band aid.” It is used to coat the ulcer before meals. This will help reduce the abdominal pain associated with eating, and this will also help prevent further damage by reducing the amount of stomach acid hitting the ulcer.
In cases where Helicobacter is involved, the use of two antibiotics (amoxicillin with clarithromycin or metronidazole) will be needed.
A bland, highly digestible diet designed for intestinal diseases will also help reduce the irritation to the ulcer.
In those rare cases of a perforated ulcer, emergency surgery will be needed to repair the hole in the stomach wall.
Correcting the underlying cause will depend on what the actual cause is. In dogs with a NSAID-induced ulcer, the NSAID will need to be stopped and another pain medication that is safer for the stomach will need to be used. In cases of chronic kidney failure, fluid therapy can help rehydrate the dog, help the kidneys filter the blood, and increase the blood supply to the stomach and intestinal tract. A low protein diet designed for kidney disease will also help. Treatment for cancer may require surgery to remove any tumors (gastrinomas, carcinomas) from the stomach and from the intestinal tract (lymphoma). Surgery may also be needed to remove bones and foreign objects from the stomach and intestinal tract.
Some ulcers can be prevented.
Talk to your veterinarian about using an antacid or misoprostol if your senior dog needs to use a NSAID for long-term pain control. It also helps to give the NSAID right after a meal.
Always avoid giving your senior dog any bones to chew on or to eat. This will prevent one potential cause of ulcers. Likewise preventing your dog from having access to toxic products can eliminate another potential cause.
Unfortunately most cancers and kidney failure cannot be prevented, but therapy to control dehydration and stomach acid production may help prevent ulcers from developing in these dogs.
Senior dogs are at risk for ulcer formation; however, dogs do not develop ulcers as commonly as humans do. Most dogs with ulcers respond well to treatment. Most ulcers do not reoccur, but the ulcers associated with Helicobacter infections may be prone to recurrences. Unfortunately some of the underlying causes of ulcers (cancer, kidney failure) cannot be cured, and those dogs are also at risk of developing more ulcers in the future.