Clinical, clinicopathologic, and gastrointestinal changes from aspirin, prednisone, or combination treatment in healthy research dogs: A double‐blind randomized trial

Abstract

Abstract Background Dogs with immune‐mediated disease are often coadministered glucocorticoids and aspirin, but ulcerogenic effects of current protocols are unknown. Objectives To compare gastrointestinal changes among dogs administered aspirin, prednisone, and combination treatment. Animals Twenty‐four healthy research dogs. Methods Double‐blinded, placebo‐controlled randomized trial of dogs administered placebo, aspirin (2 mg/kg q24h), prednisone (2 mg/kg q24h), or combination treatment PO for 28 days. Clinical signs were recorded daily, with laboratory work performed at baseline and day 28. Gastrointestinal mucosal hemorrhages, erosions, and ulcers were numerated for endoscopic studies performed on days 0, 14, and 28; endoscopic mucosal lesion scores were calculated. Results were compared using mixed model repeated‐measures analyses of variance and generalized estimating equation proportional odds models. P < .05 was considered significant. Results Gastric mucosal lesion scores differed by treatment‐by‐time (F[6, 40] = 4.4, P = .002), treatment (F[3, 20] = 7.1, P = .002), and time (F[2, 40] = 18.9, P < .001). Post hoc analysis revealed increased scores in the aspirin (day 14 only), prednisone, and prednisone/aspirin groups during treatment. Ulcers were identified on 14 studies, representing 10 dogs. Dogs receiving prednisone and prednisone/aspirin had 11.1 times (95% CI, 1.7‐73.6) and 31.5 times (95% CI, 3.5‐288.0) higher odds, respectively, of having endoscopic mucosal lesion scores ≥4 than dogs receiving placebo (P ≤ .01). Conclusions and Clinical Importance Gastrointestinal bleeding occurs commonly in dogs administered aspirin, prednisone, or prednisone/aspirin treatment, with higher lesion scores for dogs receiving combination treatment. Even severe lesions are not accompanied by clinical signs.

Keywords

• antiplatelet
• corticosteroid
• gastrointestinal bleeding
• glucocorticoid
• thromboprophylaxis
• ulcer