Changes

|-

|-

|'''Drug - induced'''

|'''Drug - induced'''

|Non-steroidal anti-inflammatory drugs (NSAIDs)

|[[NSAIDs|Non-steroidal anti-inflammatory drugs (NSAIDs)]]

|-

|-

|'''Idiopathic'''

|'''Idiopathic'''

|}

|}

Gastric ulceration is caused by damage to the gastric mucosa through the above mechanisms. NSAIDs directly damage the mucosa and interfere with the prostaglandin synthesis. Gastric ulceration is worsened by the use of NSAIDs in combination with corticosteroids. This risk can be minimised by using cyclooxygenase-1 (COX-1) sparing NSAIDs (carprofen, meloxicam and deracoxib.  

Gastric ulceration is caused by damage to the gastric mucosa through the above mechanisms. [[NSAIDs|NSAIDs]] directly damage the mucosa and interfere with the prostaglandin synthesis. Gastric ulceration is worsened by the use of [[NSAIDs|NSAIDs]] in combination with corticosteroids. This risk can be minimised by using cyclooxygenase-1 (COX-1) sparing [[NSAIDs|NSAIDs]] (carprofen, meloxicam and deracoxib).  

Gastric acid hypersecretion following mast cell degranulation of histamine and gastrin secretion from gastrinomas is a major cause of gastric ulceration. Sled dogs and equine race horses are prone to gastric ulceration.

Gastric acid hypersecretion following mast cell degranulation of histamine and gastrin secretion from gastrinomas is a major cause of gastric ulceration. Sled dogs and equine race horses are prone to gastric ulceration.

===History and Clinical Signs===

===History and Clinical Signs===

History may involve:

History may involve:

*Access to toxins and drugs such as NSAIDs

*Access to toxins and drugs such as [[NSAIDs|NSAIDs]]

Clinical Signs:

Clinical Signs:

*Vomiting

*Vomiting

===Endoscopy and Biopsy===

===Endoscopy and Biopsy===

Diagnostic test of choice and allows biopsies to be taken. NSAID related ulcers are reguarly located in the antrum and there is limited mucosal thickening or irregularity whereas ulcerated [[Gastric Neoplasia - WikiClinical|gastric tumours]] will have thickened mucosa and edges. Any biopsies should be taken at the edge of normal and diseased to avoid further deepening or perforation.

Diagnostic test of choice and allows biopsies to be taken. [[NSAIDs|NSAID]] related ulcers are reguarly located in the antrum and there is limited mucosal thickening or irregularity whereas ulcerated [[Gastric Neoplasia - WikiClinical|gastric tumours]] will have thickened mucosa and edges. Any biopsies should be taken at the edge of normal and diseased to avoid further deepening or perforation.

==Treatment==

==Treatment==

===Mucosal protectants===

===Mucosal protectants===

Such as misoprostol can be given alongside NSAIDs to decrease the risk of ulceration. '''[[Gastroprotective Drugs#Binding Agents|Sucralfate]]''', which is polyaluminium sucrose sulphate, binds to damaged mucosa and assists in the treatment of gastric ulceration. It is best given 2 hours after acid inhibitors to prevent interference.  

Such as misoprostol can be given alongside [[NSAIDs|NSAIDs]] to decrease the risk of ulceration. '''[[Gastroprotective Drugs#Binding Agents|Sucralfate]]''', which is polyaluminium sucrose sulphate, binds to damaged mucosa and assists in the treatment of gastric ulceration. It is best given 2 hours after acid inhibitors to prevent interference.  

===Prophylaxis===

===Prophylaxis===