{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T17:54:30Z","timestamp":1793123670662,"version":"4.5.0"},"reference-count":51,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2021,4,23]],"date-time":"2021-04-23T00:00:00Z","timestamp":1619136000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Centro de Investiga\u00e7\u00e3o Interdisciplinar em Sanidade Animal - Faculdade de Medicina Veterin\u00e1ria - Universidade de Lisboa; Funda\u00e7\u00e3o para a Ci\u00eancia e Tecnologia","award":["UIDB00276\/2020"],"award-info":[{"award-number":["UIDB00276\/2020"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Veterinary Sciences"],"abstract":"<jats:p>In both human and veterinary healthcare, gastrointestinal protectants (GIPs) are considered a staple of clinical practice in that they are prescribed by general practitioners (GPs) and specialists alike. Concerning GIP use, overprescription of proton pump inhibitors (PPIs) has become a growing concern among human healthcare providers. This trend has also been documented within veterinary practice, prompting the American College of Veterinary Internal Medicine (ACVIM) to publish a consensus statement in 2018 concerning evidence-based indications for GIP use. This observational cross-sectional study evaluated self-reported prescribing protocols among Portuguese GPs to determine whether there is adherence to the consensus guidelines. Respondents were Portuguese GPs recruited by social media posts in veterinarian online forums. Data were collected from 124 respondents concerning their GIPs of choice and their rationales for prescribing them. Data were mined for prescription patterns and protocols. Among GIPs, PPIs were prescribed more often. Rationales for use included gastrointestinal ulceration and erosion (GUE), prophylactic management of nonerosive gastritis, pancreatitis, reflux esophagitis, and steroid-induced ulceration. Once-daily administration of PPIs was the most frequent dosing regime among respondents. Ninety-six percent of PPI prescribers advocated that the drug be administered either shortly before or at mealtime. Forty-nine percent of respondents supported long-term use of PPIs. Fifty-nine percent of respondents acknowledged discontinuing PPIs abruptly. This study supports that Portuguese GPs commonly prescribe GIPs in accordance with ACVIM recommendations to medically manage GUE. However, misuse of GIPs does occur, and they have been prescribed where their therapeutic value is debatable. Educational strategies should target GPs in an effort to reduce GIP misuse.<\/jats:p>","DOI":"10.3390\/vetsci8050070","type":"journal-article","created":{"date-parts":[[2021,4,25]],"date-time":"2021-04-25T02:12:57Z","timestamp":1619316777000},"page":"70","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Survey-Based Analysis of Current Trends for Prescribing Gastrointestinal Protectants among Small-Animal General Practitioners in Portugal"],"prefix":"10.3390","volume":"8","author":[{"given":"Rita","family":"Baptista","sequence":"first","affiliation":[{"name":"Hospital Escolar Veterin\u00e1rio, Faculdade de Medicina Veterin\u00e1ria\u2014Universidade de Lisboa, Av. Universidade T\u00e9cnica, 1300-477 Lisbon, Portugal"},{"name":"Hospital Veterin\u00e1rio do Oeste, EN 247 Condom\u00ednio Valpraia Loja B, Vale de Adares, 2530-086 Lourinh\u00e3, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7184-4978","authenticated-orcid":false,"given":"Ryane","family":"Englar","sequence":"additional","affiliation":[{"name":"College of Veterinary Medicine, University of Arizona, 1580 E Hanley Blvd., Oro Valley, AZ 85737, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2688-0459","authenticated-orcid":false,"given":"Berta","family":"S\u00e3o Braz","sequence":"additional","affiliation":[{"name":"Hospital Escolar Veterin\u00e1rio, Faculdade de Medicina Veterin\u00e1ria\u2014Universidade de Lisboa, Av. Universidade T\u00e9cnica, 1300-477 Lisbon, Portugal"},{"name":"CIISA-Centro de Investiga\u00e7\u00e3o Interdisciplinar em Sanidade Animal, Faculdade de Medicina Veterin\u00e1ria, Universidade de Lisboa, Av. Universidade T\u00e9cnica, 1300-477 Lisbon, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2463-4062","authenticated-orcid":false,"given":"Rodolfo","family":"Leal","sequence":"additional","affiliation":[{"name":"Hospital Escolar Veterin\u00e1rio, Faculdade de Medicina Veterin\u00e1ria\u2014Universidade de Lisboa, Av. Universidade T\u00e9cnica, 1300-477 Lisbon, Portugal"},{"name":"CIISA-Centro de Investiga\u00e7\u00e3o Interdisciplinar em Sanidade Animal, Faculdade de Medicina Veterin\u00e1ria, Universidade de Lisboa, Av. Universidade T\u00e9cnica, 1300-477 Lisbon, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,4,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12875-016-0460-9","article-title":"General practice variation when initiating long-term prescribing of proton pump inhibitors: A nationwide cohort study","volume":"17","author":"Haastrup","year":"2016","journal-title":"BMC Fam. Pract."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1111\/j.1365-2036.2004.02120.x","article-title":"Use of anti-secretory medication: A population-based cohort study","volume":"20","author":"Lassen","year":"2004","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1136\/pgmj.2006.051151","article-title":"Inappropriateprescribingofprotonpumpinhibitorsinprimarycare","volume":"83","author":"Batuwitage","year":"2007","journal-title":"Postgrad. Med. J."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1007\/s12328-011-0208-y","article-title":"Proton pump inhibitors: Use, misuse and concerns about long-term therapy","volume":"4","author":"Rakesh","year":"2011","journal-title":"Clin. J. Gastroenterol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1079","DOI":"10.1002\/pds.4043","article-title":"Proton pump inhibitor prescribing patterns in the UK: A primary care database study","volume":"25","author":"Othman","year":"2016","journal-title":"Pharmacoepidemiol. Saf."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"290","DOI":"10.3109\/13814788.2014.905535","article-title":"Rapidly increasing prescribing of proton pump inhibitors in primary care despite interventions: A nationwide observational study","volume":"20","author":"Haastrup","year":"2014","journal-title":"Eur. J. Gen. Pract."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1007\/s11096-019-00955-8","article-title":"The inappropriate use of proton pump inhibitors during admission and after discharge: A prospective cross-sectional study","volume":"42","author":"Sattayalertyanyong","year":"2020","journal-title":"Int. J. Clin. Pharm."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1111\/apt.13649","article-title":"Medical and non-medical predictors of initiating long-term use of proton pump inhibitors: A nationwide cohort study of first-time users during a 10-year period","volume":"44","author":"Haastrup","year":"2016","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"515","DOI":"10.3109\/00365521.2012.746395","article-title":"Systematic review: Symptoms of rebound acid hypersecretion following proton pump inhibitor treatment","volume":"48","author":"Reimer","year":"2013","journal-title":"Scand. J. Gastroenterol."},{"key":"ref_10","unstructured":"Duxbury, S., Sorah, E., Andrews, P., and Tolbert, M.K. (December, January 10). Evaluation of proton pump inhibitor use in canine patients hospitalized in a tertiary referral hospital. Proceedings of the ACVIM online Forum."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s41598-020-72950-3","article-title":"Prospective observational study of the use of omeprazole and maropitant citrate in veterinary specialist care","volume":"10","author":"McCormack","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1823","DOI":"10.1111\/jvim.15337","article-title":"ACVIM consensus statement: Support for rational administration of gastrointestinal protectants to dogs and cats","volume":"32","author":"Marks","year":"2018","journal-title":"J. Vet. Intern. Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1111\/apt.12857","article-title":"Gaviscon Double Action Liquid (antacid & alginate) is more effective than antacid in controlling post-prandial oesophageal acid exposure in GERD patients: A double-blind crossover study","volume":"40","author":"Ruigh","year":"2014","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1014","DOI":"10.1111\/apt.15746","article-title":"Randomised clinical trial: The effectiveness of Gaviscon Advance vs non-alginate antacid in suppression of acid pocket and post-prandial reflux in obese individuals after late-night supper","volume":"51","author":"Deraman","year":"2020","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1053\/bega.2001.0184","article-title":"Pharmacological and pharmacodynamic essentials of H2-receptor antagonists and proton pump inhibitors for the practising physician","volume":"15","author":"Huang","year":"2001","journal-title":"Best Pract. Res. Clin. Gastroenterol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1016\/S0149-2918(00)80032-6","article-title":"The proton-pump inhibitors: Similarities and differences","volume":"22","author":"Horn","year":"2000","journal-title":"Clin. Ther."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"74S","DOI":"10.1592\/phco.23.13.74S.31929","article-title":"Pharmacologic properties of proton pump inhibitors","volume":"23","author":"Welage","year":"2003","journal-title":"Pharmacotherapy"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"425","DOI":"10.2460\/ajvr.2005.66.425","article-title":"Effects of ranitidine, famotidine, pantoprazole, and omeprazole on intragastric pH in dogs","volume":"66","author":"Bersenas","year":"2005","journal-title":"Am. J. Vet. Res."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1111\/j.1939-1676.2010.0651.x","article-title":"Efficacy of oral famotidine and 2 omeprazole formulations for the control of intragastric pH in dogs","volume":"25","author":"Tolbert","year":"2011","journal-title":"J. Vet. Intern. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1111\/jvim.12493","article-title":"EEvaluation of the effect of orally administered acid suppressants on intragastric pH in cats","volume":"29","author":"Parkinson","year":"2015","journal-title":"J. Vet. Intern. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"540","DOI":"10.1111\/j.1748-5827.2009.00818.x","article-title":"The effect of omeprazole on oesophageal pH in dogs during anaesthesia","volume":"10","author":"Panti","year":"2009","journal-title":"J. Small Anim. Pract."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1111\/j.1939-1676.2012.00929.x","article-title":"The influence of esomeprazole and cisapride on gastroesophageal reflux during anesthesia in dogs","volume":"26","author":"Zacuto","year":"2012","journal-title":"J. Vet. Intern. Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1111\/j.1939-1676.2009.0454.x","article-title":"Efficacy of omeprazole versus high-dose famotidine for prevention of exercise-induced gastritis in racing Alaskan sled dogs","volume":"24","author":"Williamson","year":"2010","journal-title":"J. Vet. Intern. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1111\/jvim.12580","article-title":"The Effect of Orally Administrated Ranitidineand Once-Daillyor Twice-Daily Orally Administrated Omeprazoleon Intragastricp Hin Cats","volume":"29","author":"Sutalo","year":"2015","journal-title":"J. Vet. Intern. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1002\/j.1875-9114.1997.tb03675.x","article-title":"Proton pump inhibitors and acid-related diseases","volume":"17","author":"Sachs","year":"1997","journal-title":"Pharmacotherapy"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"691","DOI":"10.2746\/042516403775696339","article-title":"Effect of GastroGard and three compounded oral omeprazole preparations on 24 h intragastric pH in gastrically cannulated mature horses","volume":"35","author":"Merritt","year":"2003","journal-title":"Equine Vet. J."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1267","DOI":"10.1046\/j.1365-2036.2000.00829.x","article-title":"Proton pump inhibitors: Better acid suppression when taken before a meal than without a meal","volume":"14","author":"Hatlebakk","year":"2000","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s40360-020-00433-2","article-title":"Effect of food on the pharmacokinetics of omeprazole, pantoprazole and rabeprazole","volume":"21","author":"Ochoa","year":"2020","journal-title":"BMC Pharm. Toxicol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1016\/0016-5085(86)90565-2","article-title":"Influence of the stimulation state of the parietal cells on the inhibitory effect of omeprazole on gastric acid secretion in dogs","volume":"91","author":"DeGraef","year":"1986","journal-title":"Gastroenterology"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1209","DOI":"10.1038\/ajg.2011.113","article-title":"Proton pump inhibitors and risk of fracture: A systematic review and meta-analysis of observational studies","volume":"106","author":"Ngamruengphong","year":"2011","journal-title":"Am. J. Gastroenterol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1016\/j.cgh.2011.09.030","article-title":"Association between proton pump inhibitor therapy and Clostridium difficile infection in a meta-analysis","volume":"10","author":"Deshpande","year":"2012","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1001","DOI":"10.1038\/ajg.2012.179","article-title":"Clostridium difficile-associated diarrhea and proton pump inhibitor therapy: A meta-analysis","volume":"107","author":"Janarthanan","year":"2012","journal-title":"Am. J. Gastroenterol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1011","DOI":"10.1038\/ajg.2012.108","article-title":"Risk ofClostridium difficileInfection With Acid Suppressing Drugs and Antibiotics: Meta-Analysis","volume":"107","author":"Kwok","year":"2012","journal-title":"Am. J. Gastroenterol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1531","DOI":"10.1038\/ajg.2010.81","article-title":"Dyspeptic symptom development after discontinuation of a proton pump inhibitor: A double-blind placebo-controlled trial","volume":"105","author":"Niklasson","year":"2010","journal-title":"Am. J. Gastroenterol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1095","DOI":"10.1053\/gast.2001.28649","article-title":"Step-down management of gastroesophageal reflux disease","volume":"121","author":"Inadomi","year":"2001","journal-title":"Gastroenterology"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1093\/fampra\/cmu050","article-title":"Strategies for discontinuation of proton pump inhibitors: A systematic review","volume":"31","author":"Haastrup","year":"2014","journal-title":"Farm. Pract."},{"key":"ref_37","first-page":"41","article-title":"Management of gastroesophageal reflux disease in adults: A pharmacist\u2019s perspective","volume":"7","author":"MacFarlane","year":"2018","journal-title":"Integr. Pharm. Res. Pract."},{"key":"ref_38","unstructured":"Reviere, J.E., and Papich, M.G. (2009). Drugs affecting gastrointestinal function. Veterinary Pharmacology & Therapeutics, Wiley-Blackwell. [9th ed.]."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1111\/jvim.13932","article-title":"A prospective, placebo-controlled pilot evaluation of the effect of omeprazole on serum calcium, magnesium, cobalamin, gastrin concentrations, and bone in cats","volume":"30","author":"Gould","year":"2016","journal-title":"J. Vet. Intern. Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1886","DOI":"10.1111\/jvim.15897","article-title":"The effect of combined carprofen and omeprazole administration on gastrointestinal permeability and inflammation in dogs","volume":"34","author":"Jones","year":"2020","journal-title":"J. Vet. Inter. Med."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1111\/jvim.14615","article-title":"Repeated famotidine administration results in a diminished effect on intragastric pH in dogs","volume":"31","author":"Tolbert","year":"2017","journal-title":"J. Vet. Intern. Med."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1111\/jvim.15430","article-title":"The frequency of oral famotidine administration influences its effect on gastric pH in cats over time","volume":"33","author":"Golly","year":"2019","journal-title":"J.Vet.Intern.Med."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"2616","DOI":"10.1111\/j.1572-0241.2003.08783.x","article-title":"Gastric acid control with esomeprazole, lansoprazole, omeprazole, pantoprazole, and rabeprazole: A five-way crossover study","volume":"98","author":"Miner","year":"2003","journal-title":"Am. J. Gastroenterol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1111\/jvim.14713","article-title":"Pharmacokinetics and acid suppressant efficacy of esomeprazole after intravenous, oral, and subcutaneous administration to healthy beagle dogs","volume":"31","author":"Hwang","year":"2017","journal-title":"J. Vet. Inter. Med."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1111\/jvim.15383","article-title":"Pharmacokinetics and pharmacodynamics of intravenous esomeprazole at 2 different dosages in dogs","volume":"33","author":"Seo","year":"2019","journal-title":"J. Vet. Inter. Med."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"2494","DOI":"10.1002\/jps.21602","article-title":"Fed and fasted gastric pH and gastric residence time in conscious beagle dogs","volume":"98","author":"Sagawa","year":"2009","journal-title":"J. Pharm. Sci."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"S192","DOI":"10.14309\/00000434-201610001-00429","article-title":"Are Twice Daily Proton Pump Inhibitors Better Than Once Daily in Suspected GERD? 429?","volume":"111","author":"Khalaf","year":"2016","journal-title":"Am. J. Gastroenterol"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"9865963","DOI":"10.1155\/2017\/9865963","article-title":"A meta-analysis and systematic review of the efficacy of twice daily PPIs versus once daily for treatment of gastroesophageal reflux disease","volume":"2017","author":"Zhang","year":"2017","journal-title":"Gastroenterol. Res. Pract."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"200","DOI":"10.14740\/gr1011w","article-title":"Once Versus Twice-Daily Oral Proton Pump Inhibitor Therapy for Prevention of Peptic Ulcer Rebleeding: A Propensity Score-Matched Analysis","volume":"11","author":"Ayoub","year":"2018","journal-title":"Gastroentrol. Res."},{"key":"ref_50","first-page":"140","article-title":"The Effect of Manufacturer on the Compounding of Omeprazole Suspensions and Their Stability Assessment","volume":"24","author":"Meissner","year":"2020","journal-title":"Int. J. Pharm. Compd."},{"key":"ref_51","first-page":"250","article-title":"Chemical stability of extemporaneously compounded omeprazole formulations: A comparison of two methods of compounding","volume":"13","author":"Garg","year":"2009","journal-title":"Int. J. Pharm. Compd."}],"container-title":["Veterinary Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2306-7381\/8\/5\/70\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T05:51:52Z","timestamp":1760161912000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2306-7381\/8\/5\/70"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,23]]},"references-count":51,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2021,5]]}},"alternative-id":["vetsci8050070"],"URL":"https:\/\/doi.org\/10.3390\/vetsci8050070","relation":{},"ISSN":["2306-7381"],"issn-type":[{"value":"2306-7381","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,23]]}}}