Clinicopathologic and gastrointestinal effects of administration of prednisone, prednisone with omeprazole, or prednisone with probiotics to dogs: A double‐blind randomized trial

BACKGROUND: The efffect of administering of probiotics or twice‐daily omeprazole on glucocorticoid‐induced gastric bleeding in dogs is unknown. HYPOTHESIS: Compare gastrointestinal bleeding among dogs administered placebo, prednisone (2 mg/kg q24h), prednisone with omeprazole (1 mg/kg q12h), or prednisone with probiotics (Visbiome, 11.2‐22.5 billion CFU/kg q24h) for 28 days. ANIMALS: Twenty‐four healthy research dogs. METHODS: Double‐blinded, placebo‐controlled randomized trial. Clinical signs and endoscopic gastrointestinal mucosal lesion scores at baseline (t (1)), day 14 (t (2)), and day 28 (t (3)) were compared using split‐plot repeated‐measures mixed‐model ANOVAs. RESULTS: Fecal score differed by treatment‐by‐time (F[6,40] = 2.65, P < .03), with higher scores in groups receiving prednisone at t (3) than t (1). Nineteen of thirty‐three episodes of diarrhea occurred in the prednisone with omeprazole group. Gastric mucosal lesion scores differed by treatment‐by‐time (F[6,60] = 2.86, P = .05), among treatment groups (F[3,60] = 4.9, P = .004), and over time (F[2,60] = 16.5, P < .001). Post hoc analysis revealed lesion scores increased over time for all groups receiving prednisone. At t (3), scores for the prednisone (8.7 ± 4.9) and prednisone with probiotics (8.7 ± 4.9) groups differed significantly from placebo (1.8 ± 1.8; P ≤ .04), whereas scores for the prednisone with omeprazole (6.5 ± 5.5) group did not differ from placebo (P = .7). Ulcers occurred only in dogs receiving prednisone. CONCLUSIONS AND CLINICAL IMPORTANCE: Prednisone‐induced gastric bleeding. Co‐administration of omeprazole partially mitigated bleeding, but a similar protective benefit was not demonstrated by co‐administration of the evaluated probiotic.