Endoscopic evaluation of the gastrointestinal safety of meloxicam with dexamethasone for a short period in healthy dogs
Intervertebral disk disease is a common neurological disease of dogs, especially chondrodystrophoid breeds, which is often treated with corticosteroids and surgical decompression. Historically, the combination of corticosteroids and nonsteroidal antiinflammatory drugs (NSAIDs) was contraindicated due to the potential for gastrointestinal side effects. A better understanding of the pathophysiology of NSAID-mediated gastric mucosal injury has led to the development of NSAIDs with less gastrointestinal side effects. These new NSAIDs may have utility in the treatment of post-operative pain in cases of IVDD. However, it is not known if the combination of these newer NSAIDs and corticosteroids is safe.;The objective of this study was to evaluate the gastrointestinal safety, with respect to gastric ulceration and erosions, of the concurrent use of meloxicam and dexamethasone administered for three days to healthy dogs. The study utilized twenty conditioned, purpose-bred research beagles.;Seven days prior to treatment, the dogs were anesthetized for upper gastrointestinal endoscopy. Two investigators scored five regions of the gastroduodenum. The dogs were randomly assigned to one of four treatment groups: (1) Saline injections; (2) saline/meloxicam; (3) dexamethasone/saline and (4) dexamethasone/meloxicam. The investigators were blinded as to the group assignment. On days 1, 2 and 3, the dogs received either dexamethasone or saline injections twice daily. On days 2, 3 and 4, the dogs received either meloxicam or saline injections once daily. On day 2, the dogs were anesthetized for a sham surgery (stimulation with a Grass stimulator). On day 5 the gastroduodenum of each dog was re-evaluated and scored by endoscopy and biopsy.;The total endoscopic score of the dexamethasone/meloxicam group was significantly greater than the other groups. The dexamethasone group had a mean cumulative score that was significantly greater than the meloxicam or saline groups. The meloxicam group was not significantly different from the saline group. There were no significant histological differences between groups.;In healthy dogs, meloxicam appears to be safe with regards to its gastrointestinal side effects. Dexamethasone caused more erosions than meloxicam alone. Dexamethasone and meloxicam used concurrently are more likely to cause gastric erosions. Although the lesions were mild in nature, the simultaneous use of dexamethasone and meloxicam is not recommended at this time.