The gastrointestinal (GI) mucosal barrier is continuously exposed to noxious toxins, reactive oxygen species, microbes, and drugs, leading to the development of inflammatory, erosive, and ultimately ulcerative lesions. This report offers a consensus opinion on the rational administration of GI protectants to dogs and cats, with an emphasis on proton pump inhibitors (PPIs), histamine type‐2 receptor antagonists (H₂RAs), misoprostol, and sucralfate. These medications decrease gastric acidity or promote mucosal protective mechanisms, transforming the management of dyspepsia, peptic ulceration, and gastroesophageal reflux disease. In contrast to guidelines that have been established in people for the optimal treatment of gastroduodenal ulcers and gastroesophageal reflux disease, effective clinical dosages of antisecretory drugs have not been well established in the dog 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 of gastritis, pancreatitis, hepatic disease, and renal disease in dogs 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. Consensus Statement Consensus Statements of the American College of Veterinary Internal Medicine (ACVIM) provide the veterinary community with up‐to‐date information on the pathophysiology, diagnosis, and treatment of clinically important animal diseases. The ACVIM Board of Regents oversees selection of relevant topics, identification of panel members with the expertise to draft the statements, and other aspects of assuring the integrity of the process. The statements are derived from evidence‐based medicine whenever possible and the panel offers interpretive comments when such evidence is inadequate or contradictory. A draft is prepared by the panel, followed by solicitation of input by the ACVIM membership that may be incorporated into the statement. It is then submitted to the Journal of Veterinary Internal Medicine, where it is edited before publication. The authors are solely responsible for the content of the statements.

Disorders of cobalamin (vitamin B₁₂) metabolism are increasingly recognized in small animal medicine and have a variety of causes ranging from chronic gastrointestinal disease to hereditary defects in cobalamin metabolism. Measurement of serum cobalamin concentration, often in combination with serum folate concentration, is routinely performed as a diagnostic test in clinical practice. While the detection of hypocobalaminemia has therapeutic implications, interpretation of cobalamin status in dogs can be challenging. The aim of this review is to define hypocobalaminemia and cobalamin deficiency, normocobalaminemia, and hypercobalaminemia in dogs, describe known cobalamin deficiency states, breed predispositions in dogs, discuss the different biomarkers of importance for evaluating cobalamin status in dogs, and discuss the management of dogs with hypocobalaminemia.

Background: Urinary catecholamines and metanephrines are used for the diagnosis of pheochromocytoma (PHEO) in dogs. Hyperadrenocorticism (HAC) is an important differential diagnosis for PHEO. Objectives: To measure urinary catecholamines and metanephrines in dogs with HAC. Animals: Fourteen dogs with HAC, 7 dogs with PHEO, and 10 healthy dogs. Methods: Prospective clinical trial. Urine was collected during initial work‐up in the hospital; in dogs with HAC an additional sample was taken at home 1 week after discharge. Parameters were measured using high‐pressure liquid chromatography and expressed as ratios to urinary creatinine concentration. Results: Dogs with HAC had significantly higher urinary epinephrine, norepinephrine and normetanephrine to creatinine ratios than healthy dogs. Urinary epinephrine, norepinephrine, and metanephrine to creatinine ratios did not differ between dogs with HAC and dogs with PHEO, whereas the urinary normetanephrine to creatinine ratio was significantly higher (P= .011) in dogs with PHEO (414, 157.0–925.0, median, range versus (117.5, 53.0–323.0). Using a cut‐off ratio of 4 times the highest normetanephrine to creatinine ratio measured in controls, there was no overlap between dogs with HAC and dogs with PHEO. The variables determined in urine samples collected at home did not differ from those collected in the hospital. Conclusion and Clinical Importance: Dogs with HAC might have increased concentrations of urinary catecholamines and normetanephrine. A high concentration of urinary normetanephrine (4 times normal), is highly suggestive of PHEO.

The adrenal glands of 30 dogs with primary adrenal insufficiency (hypoadrenocorticism) were measured ultrasonographically and compared with those of 14 healthy dogs and those of 10 dogs with diseases mimicking hypoadrenocorticism. Thickness and length of the adrenals were measured on abdominal ultrasonography and the results for each group were compared. Dogs with primary hypoadrenocorticism had significantly thinner adrenals compared with the other two groups, and their left adrenal glands were also significantly shorter than those of healthy dogs. Adrenal ultrasonography may be of diagnostic value in dogs with clinical signs suggestive of primary hypoadrenocorticism, as a left adrenal gland measuring less than 3.2 mm in thickness is strongly suggestive of the disease.

Background: Serum lipase activities measured by catalytic assays are claimed to be of limited utility for diagnosing pancreatitis in cats. The Spec fPL assay currently is believed the most sensitive test; however, studies comparing different lipase assays are lacking. 1,2-o-dilauryl-rac-glycero-3-glutaric acid-(6′-methylresorufin) ester (DGGR) assay for the determination of lipase activity has been evaluated in dogs, but no information is available in cats. Objectives: To investigate the agreement of DGGR-lipase activity and Spec fPL concentration in cats with clinical signs consistent with pancreatitis. Animals: Two hundred fifty-one client-owned cats. Methods: DGGR-lipase activity and Spec fPL concentration measured from the same blood sample in cats undergoing investigation for pancreatitis. The agreement between DGGR-lipase and Spec fPL at different cutoffs was assessed using Cohen's kappa coefficient (κ). Sensitivity and specificity were calculated for 31 cases where pancreatic histopathology was available. Results: DGGR-lipase (cutoff, 26 U/L) and Spec fPL (cutoff, >5.3 μg/L) had a κ of 0.68 (standard error [SE] 0.046). DGGR-lipase (cutoff, 26 U/L) and Spec fPL (cutoff, >3.5 μg/L) had a κ of 0.60 (SE, 0.05). The maximum κ at a Spec fPL cutoff >5.3 μg/L was found when the DGGR-lipase cutoff was set >34 U/L and calculated as 0.755 (SE, 0.042). Sensitivity and specificity were 48% and 63% for DGGR-lipase (cut-off, 26 U/L) and 57% and 63% for Spec fPL (>5.3 μg/L), respectively. Conclusions and Clinical Importance: Both lipase assays agreed substantially. DGGR assay seems a useful and cost-efficient method compared to the Spec fPL test.

Background: Spec cPL is the most sensitive and specific test for diagnosing pancreatitis in dogs. Its results have not been compared to those of the 1,2-o-dilauryl-rac-glycero-3-glutaric acid-(6′-methylresorufin) ester (DGGR) lipase assay or those of abdominal ultrasonography. Objectives: To investigate agreement of Spec cPL with DGGR lipase activity and pancreatic ultrasonography in dogs with suspected pancreatitis. Animals: One hundred and forty-two dogs. Methods: DGGR lipase activity (reference range, 24–108 U/L) and Spec cPL were measured using the same sample. The time interval between ultrasonography and lipase determinations was 108, >216 U/L) and Spec cPL (>200 μg/L) had κ values of 0.79 (95% confidence interval [CI], 0.69–0.9) and 0.70 (CI, 0.58–0.82). DGGR lipase (>108, >216 U/L) and Spec cPL (>400 μg/L) had κ values of 0.55 (CI, 0.43–0.67) and κ of 0.80 (CI, 0.71–0.9). An ultrasonographic diagnosis of pancreatitis and DGGR lipase (>108, >216 U/L) had κ values of 0.29 (CI, 0.14–0.44) and 0.35 (CI, 0.18–0.52). Ultrasonographically diagnosed pancreatitis and Spec cPL (>200, >400 μg/L) had κ values of 0.25 (CI, 0.08–0.41) and 0.27 (CI, 0.09–0.45). Conclusions and Clinical Importance: Although both lipase assays showed high agreement, agreement between ultrasonography and lipase assays results was only fair. Because lipase results are deemed more accurate, ultrasonography results should be interpreted carefully.