Sucralfate was administered concurrently with acid injury and immediately after the injury with the aim of determining its efficacy both as a protective and reparative drug. treatment is unknown. Overall, a meta\analysis concluded that the evidence for SUP in human ICU patients is limited and further work is needed to determine the role of various SUP protocols on outcome.15 A recent review of SRMD in dogs recommended standard use of SUP, particularly PPIs, in BBD critically ill dogs. 16 Just as the efficacy of SUP for critically ill dogs has not been established, the adverse effects of acid suppression in critically ill dogs is unknown. There might be as yet unidentified risk factors for SRMD in dogs, as in people, that would be an indication for SUP. Sucralfate, an alternative prophylactic Gja7 treatment for SRMD, is a complex of sucrose and aluminum salts. Sucralfate binds to negatively charged subepithelial proteins exposed during mucosal injury, forming a viscous layer that protects the vascular bed and proliferative zone, allowing for epithelial restitution.17 Sucralfate absorbs and reduces the activity of pepsin, and is cytoprotective as well as antiapoptotic.18, 19 Sucralfate stimulates mucus synthesis and secretion and bicarbonate secretion.20, 21 Compared with H2RAs and PPIs, this drug does not increase bacterial colonization and therefore has a lower likelihood of CDAD and is protective against the development of nosocomial pneumonia in people.14 It was as effective as H2RAs for prevention of overt gastric bleeding events in critically ill people with lower rates of ventilator\associated pneumonia and gastric colonization.22 Sucralfate does not affect CYP450 enzymes, so there is no effect on the therapeutic effect of concurrently administered medications. No SUP protocol has been examined for treatment or prevention of SRMD in dogs. The objectives of this study were to develop an ex vivo SRMD model of canine gastric mucosa and to examine the effect of sucralfate on mucosal barrier function. Sucralfate was administered concurrently with acid injury and immediately after the injury with the aim of determining its efficacy both as a protective and reparative drug. The antral and pyloric regions of gastric mucosa were used as they are the most frequent sites for gastric ulceration in dogs.13, 23 2.?MATERIALS AND METHODS 2.1. Gastric tissue acquisition Tissue samples were obtained from dogs that were euthanized at a local animal shelter for the purpose of local population control. The investigators had no influence on the selection of dogs for euthanasia or the timing of euthanasia. The NC State University Institutional Animal Care and Use Committee reviewed the study, and waived approval of the study because investigators solely collected tissues from euthanized dogs, and did not take part in the euthanasia of dogs. Shelter staff used an overdose of pentobarbital to euthanize dogs. Dogs that were surrendered for illness or had obvious signs of systemic disease were excluded. The precise age of the dogs was unknown in most cases, but ranged from 8 months to 10 years\of\age. The dogs were typically mixed breed, ranging in size from 10 to 30 kg. All dogs were euthanized with an overdose of sodium pentobarbital. Immediately after BBD euthanasia, the entire antral\pyloric section of the belly was excised, then incised along the greater curvature and placed mucosa part down in oxygenated (95% O2, 5% CO2) Ringer’s answer (Ringer’s answer additives, in mM: 114.0 NaCl, 5.0 KCl, 1.25 CaCl2, 1.10 MgCl2, 25.0 NaHCO3, 0.3 NaH2PO4, and 1.65 Na2HPO4) at space heat. After a 20\ to 25\minute transport time to the laboratory, the cells was transferred to oxygenated Ringer’s BBD answer at room heat and the seromuscular coating was eliminated via blunt dissection. The remaining antral mucosa cells was mounted on Ussing chambers (1.1 cm2 diameter). Cells were mounted on Ussing chambers from each animal for those control and treatment organizations. Cells samples from numerous areas of the antral mucosa were randomly assigned as either control or treatment organizations. 2.2. Ussing chambers Mucosa was bathed on both the mucosal and serosal sides of the cells mounted within the chambers with 10 mL of oxygenated Ringer’s answer managed at 37C by water\jacketed reservoirs. As previously described,24 10 mmol/L glucose was added to the serosal bathing answer, which was balanced with the help of 10 mmol/L mannitol in the mucosal bathing answer. Treatments were applied to individual cells after a 30\minute incubation period. 2.3. Objective 1: SRMD model development 2.3.1. Stage 1: Optimization.