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Capsule endoscopy detects insufficient treatment of gastric bleeding in a dog with chronic hepatitis
  1. M Katherine Tolbert1,
  2. Ashley Spencer2,
  3. Alex M Lynch2,
  4. Mark G Papich3 and
  5. Jonathan A Lidbury1
  1. 1Small Animal Clinical Sciences, Texas A&M University, College Station, Texas, USA
  2. 2Department of Clinical Sciences, North Carolina State University College of Veterinary Medicine, Raleigh, North Carolina, USA
  3. 3College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
  1. Correspondence to Dr M Katherine Tolbert; ktolbert{at}


A five-year-old dog was presented for a chronic non-regenerative anaemia, copper-associated chronic hepatitis and suspected portal hypertension. The anaemia was suspected to be from gastrointestinal (GI) bleeding and persisted despite chronic omeprazole treatment (1.1 mg/kg orally every 12 hours). Capsule endoscopy confirmed severe gastric bleeding. A pH capsule was orally administered to evaluate the efficacy of gastric acid suppressant treatment. The mean gastric pH of the dog over the three-hour monitoring period was 4.7, and the percentage time that the intragastric pH were ≥3 and 4 were 100 per cent and 99 per cent, respectively. Substantial upper GI bleeding persisted despite excellent gastric acid suppression, bringing into question the value of routinely recommending such therapy in dogs with hepatic failure without additional monitoring for adequacy of treatment.

  • omeprazole
  • canine
  • rivaroxaban
  • portal hypertension
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  • Contributors All authors were involved in the conception and design of the case report, acquisition of data or analysis and interpretation of data, and drafting the article.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.

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