You always need to way up risk vs benefit. The article concentrates on PPIs (proton pump inhibitors) which are indicated to be used when 1st line therapies like Pepcid fail. It is common knowledge that PPIs affect bone mineral density - one of the reasons it is used 2nd line. However, PPIs are the best treatment for treating ulcers and severe reflux/acid. If your cat clinically appears to have acid problems and you don’t treat with Pepcid or similar, you run the real risk of ulceration which will then need to be treated with PPIs. It is also often easier to deal with the side effects of some drugs rather than what can happen if you don’t (in this case no treatment could result in ulceration, leading to bleeding which can’t always be cured with PPIs). I know that their is a bit of anti-vet sentiment on this board but, in general, this is their job - to weigh up risk vs benefit when treating your cat, you just have to trust them sometimes. They have a lot more knowledge than we do from reading a couple of articles on the internet.