Quality ofLife
As veterinarians, we cannot solely make recommendations on treatment based on crudely measured outcomes of treatment success such as mean survival time and mortality rates. In a disease like chronic gastritis, with a low mortality rate, these measures of outcome are nonsensical.
Quality of life (QOL) is the most important consideration for the pet owner or caregiver. Compassionate care of patients and consideration of the pet and the caregiver's QOL by veterinarians will improve overall compliance and improve successful treatment. Describing achievable goals from the outset will improve compliance; further emphasis on the possibility of long-term management of disease is an inescapable reality the owners must accept. It is important to not only consider QOL but also take steps to initiate change in patient management to improve the human-animal bond and reduce unnecessary suffering.Chronic gastritis can be considered stressful to both the dog or cat and the owner/ caregiver. Due to the chronic nature of the disease, disease improvement needs to be measured as a decrease in frequency of clinical signs rather than immediate resolution of the vomiting. Encouraging owners to keep logs of the vomiting events and review these episodes at rechecks is recommended. A decrease in frequency of vomiting, rather than resolution, may be an objective index in measuring response to treatment, particularly in those cases that vomit infrequently at presentation. This will allow decision making regarding tapering of immunosuppressive medication or in the case of HLO colonization, predicting lack of eradication.
Idiopathic and food responsive chronic gastritis in general have a good prognosis. The reasons for euthanasia in dogs with chronic gastritis are usually due to comorbid diseases and reports include carcinoma, extragastric lymphoid or myeloid tumors, gastric leiomyoma, Zollinger-Ellinson syndrome, and mesothelioma (van der Gaag and Happe, 1989).
Gastro-intestinal pythiosis and familial stomatocytosis-hypertrophic gastritis have a poor prognosis.