Read before Using Acid Reducers

Hi. I often see people suggesting Pepcid for nausea. This article shows why that’s not a good idea and not good for CKD either.

https://www.cliniciansbrief.com/art...aign=Online 200102&oly_enc_id=1340G9943023D1V

 

You always need to way up risk vs benefit. The article concentrates on PPIs (proton pump inhibitors) which are indicated to be used when 1st line therapies like Pepcid fail. It is common knowledge that PPIs affect bone mineral density - one of the reasons it is used 2nd line. However, PPIs are the best treatment for treating ulcers and severe reflux/acid. If your cat clinically appears to have acid problems and you don’t treat with Pepcid or similar, you run the real risk of ulceration which will then need to be treated with PPIs. It is also often easier to deal with the side effects of some drugs rather than what can happen if you don’t (in this case no treatment could result in ulceration, leading to bleeding which can’t always be cured with PPIs). I know that their is a bit of anti-vet sentiment on this board but, in general, this is their job - to weigh up risk vs benefit when treating your cat, you just have to trust them sometimes. They have a lot more knowledge than we do from reading a couple of articles on the internet.

 

Not suggesting anyone not follow their vet’s advice. Of course vets have more knowledge. It’s worth reading because ulcers apparently are rare in cats. Many here suggest using Pepcid for nausea when there are other drugs better for it such as ondansetron and cerenia. It’s worth knowing potential side effects. I don’t feel this board is anti vet at all. I do see many that don’t seem to know much about diabetes though.

 

I used slippery elm bark powder syrup for my CKD cats and it worked quite well to help with the acid buildup from CKD. My vet is very hesitant to use anti-acids like Pepcid because, just as in people, they eliminate all acid, not just excess and we all need acid to digest food. She prefers using alternative remedies like slippery elm.

Bottom line is we each should do what we feel is best for our own cat working with our vet.

 

You’re right I had forgotten about slippery elm I used to use it years ago when I had a ckd cat - and it did work well and I think it was quite soothing to her tummy. No anti acid medication (Pepcid type or PPIs) eliminate all acid - they only block the production of excess acid by quite complex mechanisms of action. That’s why sometimes you need to try a few medications to find the right one to block enough acid and stop it being a problem. I have years of pharmaceutical experience (also launched one of the early PPIs) and I know through personal experience that it doesn’t matter what I take - I rarely manage to eliminate enough acid - let alone all of it.

 

Thank you. I stand corrected about anti-acids .