1986;90:1463. and cat to date. Similar to the situation in human medicine, practice of inappropriate prescription of acid suppressants is also commonplace in veterinary medicine. This report challenges the dogma and clinical practice of administering GI protectants for the routine management TES-1025 of gastritis, pancreatitis, hepatic disease, and renal disease in dogs TES-1025 and cats lacking additional risk factors for ulceration or concerns for GI bleeding. Judicious use of acid suppressants is warranted considering recent studies that have documented adverse effects of long\term supplementation of PPIs in people and animals. IVArvidsson2 The relationship between this abstract and the experimental study listed above is uncertain. Hence, the data are not listed.Holroyde3 DogExperimental1, 5, and 10 g/kg PO given before each dose of ACAACA (65?mg/kg 4X in 24?hours)MIS reduced gastric mucosa injury as determined endoscopicallyJohnson4 DogExperimentalpeptic ulcers147 and GERD148 are universally considered indications for PPIs. Treatment of erosive esophagitis,149 benign gastric ulcers,150 dyspepsia,151 hypersecretory states (eg, Zollinger\Ellison syndrome),152 and prophylaxis for NSAID\associated ulcers153 also are listed as indications for PPI treatment. Table 2 The Food and Drug Administration (FDA) indications for the use of proton pump inhibitors in people compared to lists of questionable indications found in other publications gastritis, a distinct infection not recognized in dogs and cats. The benefit of IL2RA gastric acid suppression in instances of idiopathic gastritis is not explored. Vomiting may be the primary sign of gastritis in dogs and cats, but acid\suppressant drugs should not be used as antiemetics. Acid suppression with famotidine (0.5 mg/kg q24h) did not affect treatment efficacy or frequency of clinical signs in 23 pups with histologic evidence of gastritis and spiral bacteria in gastric mucosal biopsy samples.157 Helicobacter\negative gastritis can occur in people and may be comparable to idiopathic gastritis in cats and dogs, but no therapeutic regimens have been reported effective for this condition.158 Consensus opinion on prophylactic use of gastroprotectants for management of dogs and cats with non\erosive gastritis infection status.172 However, gastritis and GUE can be complications of end\stage renal disease in human being patients.173, 174 Acid suppression in people is often recommended for renal disease individuals with ulcer TES-1025 bleeding.175 There is no recommendation for the use of prophylactic acid suppressant treatment in human individuals with renal disease, but acid suppressants generally are recommended if other risk factors (eg, NSAID or corticosteroid treatment) for ulcer development are present. Dose modifications of H2RAs based on projected glomerular filtration rate are recommended because of the renal removal of these medicines.176 Gastroduodenal ulceration and erosion is not a typical finding in dogs and cats with advanced renal disease.177, 178, 179, 180 Moreover, in a recent study of 10 pet cats with chronic renal disease and 9 healthy age\matched control pet cats, no significant variations were observed in serum gastrin concentrations and gastric pH between groups, suggesting that pet cats with CKD may not have gastric hyperacidity compared to healthy pet cats, and for that reason, may not need acidity suppression.181 However, despite this evidence, acid suppressants are commonly prescribed to dogs and cats with TES-1025 CKD. 182 Chronic administration of acid suppressants to dogs and cats with CKD may not be benign. Continuous administration of acid suppressants has been associated with derangements in serum calcium and PTH concentrations, osteoporosis, TES-1025 and pathologic fractures in at\risk human being populations.183 Approximately 36%\80% of pet cats with moderate to severe CKD have renal secondary hyperparathyroidism,184, 185 with possible consequences of decreased bone mineral denseness and increased bone resorption cavities.186 Thus, the deleterious effects of chronic acid suppressant administration on calcium metabolism and bone remodeling in dogs.