Omeprazole alternatives for dogs?

[Displaced_Yankee]

Are there any alternatives to Omeprazole for dogs? Even something like the supplement Outlast for horses? A quick browse of Chewy seems to only offer probiotics, which our dog is already on.

The dog has never tolerated Omeprazole. It has always caused her to vomit but it is recommended for esophagitis (see below)

The History:
Back in September 2024 our 15 year old dog was diagnosed with esophagitis via a scope of her airways
and esophagus (some may remember her problems here: Laryngeal Paralysis in Dogs - (update post 10, 1 month later))

We were prescribed Cisapride, sulcalfrate and Omeprazole. I was skeptical of the Omeprazole because it has always made her vomit…and sure enough she deteriorated quickly due to the vomiting. The vet had is discontinue the Omeprazole and ‘would get back to us about an alternative or restarting it’. Well we never heard back from him and had opted for pallative care, assuming we would put her down by the end of the year.

Old girl has rallied. At first we thought it was one more rally before it was “time”. But she has sustained this rally for 10 weeks. She has no mobility issues. She does not have accidents in the house. She is always eager to lick her dish clean. She still gets the zoomies from time to time. Overall her quality of life is good other than she gags often when eating (cookies or her meal). Her meal is Purina ProPlan Sensitive Skin + Tummy, in a slow feeder bowl, elevated off the ground, served 4-5 times a day to make the meals as small as possible.

I have emailed the internal medicine vet that diagnosed the dog, but unless I am in front of him it has been very difficult to get a hold of him. I am wondering if such product even exists!

[Simkie]

Have you tried pepcid for her ever? Do you have any idea or gut feel on why she vomits on the omeprazole?

Pepcid will also raise the pH of the stomach, but in a different way than omeprazole. It’s my go to for gastric stuff for my small animals and I find it very useful.

Something like outlast also raises the pH of the stomach. You could do that in the same way by just giving her tums with her meals. But if there’s something about that pH coming up that’s triggering the vomiting, it probably wouldn’t matter how it comes up?

But different meds often are tolerated in different ways, so either pepcid or something like tums could be worth a shot. (I’d start with pepcid, personally.)

[Displaced_Yankee]

@Simkie

Have you tried pepcid for her ever?

We did, in the work with our primary vet before the referral to the internal medicine vet who did the work to diagnose the esophagitis. We didn’t see improvement…but we also didn’t have a diagnosis at that time. Now that we have seen improvement with the cisapride/sucralfate combo…it may be enough to help get her over the last hump.

@Simkie

Do you have any idea or gut feel on why she vomits on the omeprazole?

No, other than it just doesn’t seem to agree with her. Once was during an extended bout of vomiting and diarrhea that resulted in a full abdominal ultrasound (results unremarkable). Another time was when she was on heavy antibiotics for a nasty infection. And now again as treatment for esophagitis. My poor carpet…

I am happy for any attempt to just bring the pH down. She isn’t actually vomiting now…but I wonder if there is some ‘bubbly acid’ or reflux going on that is preventing more healing. I am happy to try anything to bring that pH down!

Thanks!

[Simkie]

You want to bring the pH up The pH of the stomach is naturally about as low as possible–very acidic.

Omeprazole is a proton pump inhibitor. It breaks the acid pumps directly, so they produce less acid, so the pH comes up.

Pepcid is an h2 agonist. It blocks the receptor that triggers the acid pumps, so they produce less acid, so the pH comes up.

Tums or Outlast or other buffers interact with the acid itself, neutralizing it. That’s why they don’t last very long…once they’ve been depleted, or move out of the stomach, the pH drops again.

Sometimes one class of something just doesn’t work well but other classes do work. I have this issue myself! Proton pump inhibitors just don’t do much. Pepcid is much better for me.

Worth a try

[Displaced_Yankee]

Whoops! I’m accountant by day…biochemist I am not!

Thanks friend!

[Simkie]

I hope you find something that helps your girl! 15 years is such a good long life, esp with issues. Well done on keeping her happy and healthy!

[chestnutmarebeware]

I have to give @Simkie a shout-out here on the pepcid (famotidine)! I now have two small dogs on it it daily (1/2 tab of 10mg pill) based on their recommendation and it’s improved one’s compulsive licking/vomiting and the other’s varying degrees of not wanting to eat to an amzing amount.

[Simkie]

Yay!!! How exciting is that?! I’m so glad it’s worked well for your puppers!!