Cats with moderate to advanced chronic kidney disease (CKD) often display gastrointestinal (GI) signs such as nausea, vomiting, and decreased appetite. Acid suppressants such as proton pump inhibitors (PPIs; e.g., omeprazole) are one of the most commonly prescribed medications for the treatment of such clinical signs. There is no evidence that PPI administration and, in particular omeprazole, will improve the GI signs associated with CKD in cats. The aim of this study is to evaluate the effect of oral omeprazole administration on appetite or vomiting in cats with moderate to advanced CKD.

Thirteen client-owned cats with moderate to advanced CKD showing signs of inappetence or vomiting were recruited at three academic institutions and one referral hospital in the United States.

A multi-institutional, prospective, double-blinded, randomized, crossover study was performed. Vomiting frequency and appetite were compared in cats with CKD treated with either omeprazole or placebo. All cats were randomized to receive omeprazole (1 mg/kg PO q 24 h) or placebo (lactose gel capsule PO q 24 h) for 14 days. Cats underwent a 14-day washout between treatments. A daily log was completed by the owner assessing appetite and vomiting during and for 14 days before and after each treatment. Appetite was assessed by scoring system (decreased, unchanged, or increased) and percentage of food consumed in a day (0%, 25%, 50% and 75%). An ANOVA was performed to determine if average daily percentage food consumed, average appetite score, vomit percentage, and total number of times vomited were different between treatments.

The average age of the 13 cats was 12.8 years. IRIS staging was as follows: 46% (6/13) stage II, 46% (6/13) stage III, and 8% (1/13) stage IV. All cats included had signs of inappetence as noted by owners. A statistically significant difference was observed for the percentage of food consumed between treatments (p=0.0322). Post hoc analysis revealed that on average, using least squares means, approximately 3% more food was consumed with omeprazole treatment compared to placebo. There was no significant difference in vomiting frequency between treatments.

Overall, this study showed that hyporexic cats with moderate to severe CKD consumed a small but statistically significant greater amount of food with omeprazole compared to placebo; in contrast, no difference in vomiting was seen between the two treatments.

Disclosures

Disclosures to report:
The mentoring author, Dr. Tolbert, is a paid consultant for TriviumVet and a paid speaker for Kindred Biosciences. However, neither company paid for this study nor do they have an interest in the study objectives or outcome.