Gastric ulcers in horses refer to erosions or lesions in the lining of the stomach, often resulting from an imbalance between protective and harmful factors affecting the gastric mucosa. These ulcers are a common condition in equine populations, affecting both performance and non-performance horses. The condition is typically categorized into Equine Gastric Ulcer Syndrome (EGUS), with further classification into squamous and glandular ulcers based on their location within the stomach. Factors such as diet, stress, and exercise intensity can influence the development of gastric ulcers. This page compiles peer-reviewed research studies and scholarly articles that explore the prevalence, pathophysiology, diagnostic methods, and management strategies for gastric ulcers in horses.
Irving J, Pineau V, Shultz S, Ter Woort F, Julien F, Lambey S, van Erck-Westergren E.Equine gastric disease (EGD) is a common condition in performance horses (), potentially compromising behaviour, performance, and welfare. EGD is often attributed to high-starch, high-sugar feeds and limited forage. Evidence for diet-induced changes on digestive microbiota is lacking. Nine elite showjumping horses were housed at the same performance yard with standardised diet and management throughout the study. Horses were transitioned from a high-sugar and -starch (31%) feed to a low-starch and -sugar (16.5%) concentrate feed. Gastroscopies, blood, and faecal samples were taken pre- and 12 ...
Hardy L, Martin M, Barré C, Tanquerel L.Equine gastric ulceration syndrome (EGUS) is a common condition, affecting both glandular (EGGD) and squamous (ESGD) mucosa of the stomach. It has a high prevalence, particularly in racehorses and sport horses, causing clinical signs from poor performance to colic. Gastroscopy, the reference standard diagnostic method, is expensive, prompting the search for alternative tests. Previous studies noted changes in blood markers, including elevated gamma-glutamyl transpeptidase (GGT) activity in ulcerated horses. This study aimed to report the prevalence of EGUS in sport horses and evaluate the asso...
Herbst AC, Coleman MC, Macon EL, Harris PA, Adams AA.A proportion of senior horses (≥15 years of age) are still used for competition. Information about this particular group of horses is currently sparse. Objective: To provide an overview of the demographics, management and health of competing U.S. senior horses (≥15 years of age). Methods: Online survey. Methods: Descriptive and inferential (Kruskal-Wallis test) analysis of 246 surveys from owners of U.S.-resident senior horses used for competition. Confidence intervals were calculated for prevalence estimates of clinical signs and medical conditions. Results: Competing senior horses we...
Pineau V, Ter Woort F, Julien F, Vernant M, Lambey S, Hébert C, Hanne-Poujade S, Westergren V, van Erck-Westergren E.Gastric disease is highly prevalent in sport horses and may lead to poor performance, cause behavioral changes and impact welfare. Objective: Assess whether diet affects gastric disease and pain expression during riding, and whether it has an impact on physiological and locomotor variables during an exercise test, including jumps. Methods: Nine healthy show-jumping Warmbloods trained at the same stable. Methods: Prospective observational cohort study. The horses receiving a pelleted diet, high in sugar and starch (>30%), were examined at T0 and after 12 weeks (T12) of changing to a cooked, m...
Barton CK, True A, Fenn M, Thampi P, Watson A, Smanik LE.The objective of this Case Report was to describe the clinical manifestation and postmortem findings of a horse evaluated for recurrent colic diagnosed with pyloric aplasia and an ectopic duodenal papilla. Methods: 13-year-old Quarter Horse gelding. Unassigned: The horse was presented to a referral center for signs of colic that were unresponsive to management on the farm. No abnormalities were noted on rectal palpation; however, upon passage of a nasogastric tube, 31 L of net gastric reflux was obtained. Gastroscopy noted grade IV squamous ulceration and moderate glandular ulceration, severe ...
Busechian S, Bindi F, Orvieto S, Zappulla F, Marchesi MC, Nisi I, Rueca F.Equine Squamous Gastric Disease (ESGD) and Equine Glandular Gastric Disease (EGGD) are two terms used to indicate the presence of lesions of the squamous and glandular mucosa of the stomach. Prevalences, pathophysiology, and risk factors are different, and the latter have been investigated in different populations. The aim of this study was to investigate the prevalence and risk factors of ESGD and EGGD in a cohort of pleasure, breeding, and retired horses in Italy. To the authors' knowledge, this is the first study to investigate such a diverse population of animals and the first one that inc...
Busechian S, Bindi F, Pieramati C, Orvieto S, Pisello L, Cozzi S, Ortolani F, Rueca F.Equine gastric ulcer syndrome (EGUS) is a worldwide disease, and includes two different syndromes, Equine Squamous Gastric Disease (ESGD), affecting the squamous mucosa, and Equine Glandular Gastric Disease (EGGD), affecting the glandular mucosa. These two diseases are present in different categories (different activities, ages, etc.) and breeds of horses. The effect of sex on gastric health is not clear: some studies found a higher prevalence of ESGD in geldings and stallions, while others found no influence of sex on the squamous mucosa. The few studies conducted on glandular diseases failed...
Busechian S, Orvieto S, Nocera I, Rueca F.Equine Gastric Ulcers Syndrome (EGUS) is a worldwide disease present in equids of different breeds, activity levels, and age groups. It is divided into two different illnesses: Equine Squamous Gastric Disease (ESGD) affecting the squamous mucosa and Equine Glandular Gastric Disease (EGGD) affecting the glandular mucosa. The historical horserace is a traditional competition that is common in Italy. They can be divided into two different types: speed races and jousting tournaments. Anglo-Arabians and Thoroughbreds are used for the two competitions with training and management systems similar to ...
Muñoz-Prieto A, Llamas-Amor E, Contreras-Aguilar MD, Ayala I, Martín Cuervo M, Cerón JJ, Hansen S.Ammonia (NH3) and bicarbonate (HCO3) have been related to gastric ulcers in humans. Ammonia is considered a possible cause of gastric ulcers, whereas bicarbonate has a protective function. The presence of ulcers in the stomach of horses is defined as Equine Gastric Ulcer Syndrome (EGUS), which is a frequent disease in this species, and it has been associated with changes in saliva composition, such as in analytes related to inflammation, immune system and oxidative stress. The objectives of this study were (1) to perform an analytical validation of two automated spectrophotometric assays, one ...
Leleu C, Couroucé A.Equine squamous gastric disease (ESGD), as part of the equine gastric ulcer syndrome (EGUS), are common in racing horses. The use of buffering feed supplements to treat and/or prevent gastric ulcers is an option to control this condition. Objective: The purpose of this study was to evaluate the effect of a 30-day supplementation with a blend of magnesium oxide (MgO) on ESGD scores in trotters under training. Methods: Forty-two young trotters were submitted to a gastroscopic evaluation to assess their ESGD score and were randomly assigned in a group supplemented with MgO or in a control group. ...
Luthersson N, Þorgrímsdóttir ÚÝ, Harris PA, Parkin T, Hopster-Iversen C, Bennet ED.A high prevalence of both squamous (ESGD) and glandular (EGGD) ulcers was previously found in, mainly young, Icelandic horses coming into training for the first time. This study evaluated risk factors for gastric ulcers in Icelandic riding horses at various ages and stages of training. The horses (n = 211) were gastroscoped from 21 equine establishments across Iceland. A variety of morphometric, clinical, behavioural and management factors were evaluated as potential risk factors for gastroscopically significant (grade ≥ 2/4: found in 27% of horses) or gastroscopically severe (grade 3 or 4/4...
Williams Louie E, Nieto J, Wensley F, Morgan JM, Finno CJ, Berryhill EH.Omega-3 fatty acid and alpha-tocopherol supplementation reduces gastric ulcer formation in humans and rodents; however, efficacy of prevention in horses is unknown. Equine Omega Complete (EOC) is an oral supplement containing omega-3 fatty acids and alpha-tocopherol. Objective: Determine if EOC supplementation prevents gastric ulcers and increases serum alpha-tocopherol concentrations in healthy horses. Methods: Nine thoroughbred geldings; 5-13 years old. Methods: Prospective randomized block design, repeated in crossover model. Horses were administered EOC, omeprazole, or water PO for 28 ...
Sundra T, Gough S, Rossi G, Kelty E, Rendle D.Oral omeprazole is the accepted treatment for equine squamous gastric disease (ESGD); however, it is not universally effective. Esomeprazole results in more consistent and pronounced acid suppression in men and is more effective than omeprazole in the treatment of oesophageal and gastric disease. Pharmacodynamic and pilot clinical studies have indicated esomeprazole might also be more effective than omeprazole in horses. Objective: To compare the efficacy and safety of oral esomeprazole and omeprazole pastes in the treatment of ESGD and, where present, concurrent equine glandular gastric disea...
Clark B, Steel C, Vokes J, Shan JR, Gedye K, Lovett A, Sykes BW.Rebound gastric hyperacidity (RGH) secondary to hypergastrinemia has been suggested to contribute to the rapid recurrence of equine squamous gastric disease (ESGD) in horses after discontinuation of omeprazole. Objective: To evaluate changes in serum gastrin and chromogranin A (CgA) concentrations in response to medium-term (57-day) omeprazole treatment and after omeprazole discontinuation. Methods: Fourteen mature Thoroughbred racehorses in simulated race training. Methods: Horses received 2.28 g of oral omeprazole PO q24h for 57 days within a 61-day period, excluding a withholding period...
Li Z, Du S, Wang X, Zhang L, Liu X, Fan Q, Yang H, Gao R.Phenylbutazone (PBZ) is the most commonly used drug to treat symptoms of lameness in horses; however, it is associated with adverse effects such as gastric ulcer syndrome (EGUS). Interestingly, many practitioners prescribe omeprazole (OME) concurrently with PBZ to prevent the development of EGUS. However, the efficacy and safety of this practice in Mongolian horses with chronic lameness remain unknown. Objective: To evaluate the clinical effects of a combination of PBZ and OME on chronic lameness in Mongolian horses. Methods: Randomised block experimental design. Methods: Eighteen Mongolian ho...
Chaucheyras-Durand F, Sacy A, Karges K, Apper E.Horses are large non-ruminant herbivores and rely on microbial fermentation for energy, with more than half of their maintenance energy requirement coming from microbial fermentation occurring in their enlarged caecum and colon. To achieve that, the gastro-intestinal tract (GIT) of horses harbors a broad range of various microorganisms, differing in each GIT segment, which are essential for efficient utilization of feed, especially to use nutrients that are not or little degraded by endogenous enzymes. In addition, like in other animal species, the GIT microbiota is in permanent interplay with...
Louie EW, Berryhill EH, Nieto J, Wensley F, Knych H, Finno CJ, Morgan JM.Gastric ulceration can be induced by athletic training and is a significant welfare concern. The objective of this study was to evaluate the effect of gastric ulcer induction on heart rate variability (HRV) in the horse. We hypothesized that induction of gastric ulcers would decrease HRV and increase low frequency fluctuations, consistent with increased sympathetic tone. A convenience sample of 8 horses in a larger study were enrolled. Horses were randomly assigned to receive water or 2 mg/kg omeprazole orally once daily for 28 days. Gastric ulcers were induced through intermittent feed withho...
Schusser GF, Köller G, Recknagel S, Lindner A.The hay producing plants, concentrate, straw and meadows could be contaminated by the aerosols of glyphosate based herbicide during spraying process of crops and pre-harvest desiccation treatment of cereals. The aim of this study is to investigate the concentration of glyphosate in the duodenal fluid of horses with gastric ulcer syndrome. The stomach and duodenum of referred untreated horse patients (n=92) with colic, weight loss, diarrhoea, anemia or performance intolerance were endoscopically examined right after the admission. Duodenal fluid (40 ml) was collected from the duodenal region ...
Hwang H, Dong HJ, Han J, Cho S, Kim Y, Lee I.Gastric ulcer is one of the prevalent diseases in racehorses. However, it has not been recognized as important in Korea, and drugs used to treat gastric ulcers are included in the doping test list, so they are not allowed to be administered to racehorses in training. Objective: This study was performed 1) to investigate the prevalence and the severity of gastric ulcers in Thoroughbred racehorses in Korea, 2) to confirm the therapeutic effect of ranitidine and omeprazole, and 3) to compare the efficacy between ranitidine and omeprazole. Methods: Forty-nine horses were randomly recruited, and ga...
Jansson A, Harris P, Davey SL, Luthersson N, Ragnarsson S, Ringmark S.Straw's low energy content means it is a roughage option for horses with low energy requirements. Previously, in a field study, straw was associated with an increased risk for gastric ulcers. This study evaluated the effect on gastric ulcers, metabolic profile and behaviour of replacing, in a forage-only ration, 50% of the daily allowance with wheat straw. Six equines were studied in a 2 × 21-day cross-over design. The control diet (CON: 100% grass forage) and the straw diet (S: 50% grass forage and 50% straw [DM basis]) were iso-energetic. Gastroscopy was performed prior to the study and on ...
Sasaki N, Nishi Y, Fujiwara Y, Takeyama T, Kumagai H, Senarathna S, Ushiya S, Tokuyama T, Tokuyama T, Tokuyama T, Mii T, Ayaki S, Matsuno K....Gastric ulcers cause appetite loss, poor body condition, and colic in horses. This study investigated the protective effect of a rice fermented extract on the gastric mucosa in 17 healthy Thoroughbreds. For one month, horses in the rice fermented extract (nine horses) and control (eight horses) groups were orally administered a rice fermented extract (100%; 0.2 ml/kg, SID) and tap water (0.2 ml/kg), respectively. Gastric endoscopic images were obtained before and one month after rice fermented extract administration. The gastric ulcer score was lower after administration (median, 1; maximum, 2...
Wise JC, Hughes KJ, Edwards S, Jacobson GA, Narkowicz CK, Raidal SL.Omeprazole preparations vary in bioavailability in horses. Objective: To characterize the pharmacokinetics and pharmacodynamics of an existing enteric-coated oral omeprazole paste (REF) and a novel, in-feed, enteric-coated dry granule preparation (NOV). Methods: Twelve Standardbred/Thoroughbred mares free from clinical disease. Methods: A prospective, blinded randomized interventional study was trial, conducted in 3 parts: (a) bioavailability study, (b) dose titration study, and (c) comparative clinical pharmacodynamic study, each using a blocked crossover design. Results: Consistent with the ...
Padalino B, Davis GL, Raidal SL.Transportation has been suggested as a risk factor for gastric ulceration in horses, but limited evidence supports this assumption. Methods: Twenty-six Standardbred, Thoroughbred, and Warmblood mares from a university teaching herd. Methods: Twelve mares were confined for 12 hours, overnight, in reproductive stocks with indwelling nasogastric tubes (NGTs) to assess pH of gastric fluid (GF). Gastric ulceration was assessed endoscopically before and after confinement. Subsequently, 26 horses were transported for 12 hours, overnight, in 2 consignments. During transportation, GF was aspirated ...
Reed L, MacNicol JL, Charchoglyan A, Brewer D, Murrant C, Pearson W.The objective of this study was to evaluate the effect of a botanical-based equine nutraceutical on contractility of gastric smooth muscle in vitro. Gastric ulcers are prevalent in performance horses and negatively impact horse welfare. Gastric hypermotility has been positively associated with the development of gastric ulceration in nonequine species, and reduction of hypermotility may be protective against their development. Stomachs from 12 pigs processed for food at a provincially inspected abattoir were collected within 1 hour of slaughter. Explants of nonglandular gastric tissue were p...
Luthersson N, Bolger C, Fores P, Barfoot C, Nelson S, Parkin T, Harris P.Diet is an accepted risk factor for equine squamous gastric disease (ESGD), but there is little published evidence for the benefit of dietary change (DC). This study evaluated the effect of DC with or without initial omeprazole medication. Twelve pairs of exercising horses with ESGD Grade 2/4 (EM) and 17 pairs with ESGD Grade ≥3/4 (ES), were monitored. Paired horses had similar management, feeding times, workloads, and initially feed or forage. One of each pair was randomly assigned, postgastroscopy (Scope1), to a specified restricted starch ration; the other remained on their original diet....
Poltep K, Tesena P, Yingchutrakul Y, Taylor J, Wongtawan T.Silent gastric ulceration occurs without evidence of clinical signs and is common in horses. There is currently no a simple and effective method to diagnose this disease. Proteomics can be used to identify serum biomarkers, but the most abundant serum protein, albumin, could conceal candidate biomarkers. Therefore, it is recommended to remove albumin before a proteomic study; however, there is no specific albumin depletion kit or standard protocol available for horse samples. The objectives of this study were to optimise a protocol to remove equine serum albumin and to use albumin-depleted ser...
Bass L, Swain E, Santos H, Hess T, Black J.The objective of this study was to evaluate two feeding regimens: traditional grain feeding (twice a day, traditional fed [TF]) compared with horses fed with an automated feeder programmed to deliver grain in 20 equal aliquots (fractioned fed [FF]) and its effects on gastric ulceration, body weight, and body condition score (BCS). Thirty-one Quarter Horses were maintained in individual stalls during the 60-day experimental period and worked at moderate exercise intensity. Gastroscopies were performed before grain adaptation at 0, 30, and 60 days. Weight and BCS were evaluated biweekly. There ...
Bush J, van den Boom R, Franklin S.Anecdotally, aloe vera is used to treat gastric ulceration, although no studies have yet investigated its efficacy in horses. Objective: To test the hypothesis that aloe vera would be noninferior to omeprazole in the treatment of equine gastric ulcer syndrome. Methods: Randomised, blinded clinical trial. Methods: Forty horses with grade ≥2 lesions of the squamous and/or glandular mucosa were randomly assigned to one of two groups. Horses received either aloe vera inner leaf gel (17.6 mg/kg bwt) b.i.d. or omeprazole (4 mg/kg bwt) s.i.d. for approximately 28 days, after which a repeat gastrosc...
Saps M, Miranda A.There is little evidence for most of the medications currently used to treat functional abdominal pain disorders (FAPDs) in children. Not only are there very few clinical trials, but also most have significant variability in the methods used and outcomes measured. Thus, the decision on the most appropriate pharmacological treatment is frequently based on adult studies or empirical data. In children, peppermint oil, trimebutine, and drotaverine have shown significant benefit compared with placebo, each of them in a single randomized clinical trial. A small study found that cyproheptadine was be...
Knych HK, Stanley SD, Arthur RM, McKemie DS.The use of anti-ulcer medications, such as cimetidine, ranitidine, and omeprazole, is common in performance horses. The use of these drugs is regulated in performance horses, and as such a withdrawal time is necessary prior to competition to avoid a medication violation. To the authors' knowledge, there are no reports in the literature describing repeated oral administrations of these drugs in the horse to determine a regulatory threshold and related withdrawal time recommendations. Therefore, the objective of the current study was to describe the disposition and elimination pharmacokinetics o...
Chaucheyras-Durand F, Sacy A, Karges K, Apper E.Horses are large non-ruminant herbivores and rely on microbial fermentation for energy, with more than half of their maintenance energy requirement coming from microbial fermentation occurring in their enlarged caecum and colon. To achieve that, the gastro-intestinal tract (GIT) of horses harbors a broad range of various microorganisms, differing in each GIT segment, which are essential for efficient utilization of feed, especially to use nutrients that are not or little degraded by endogenous enzymes. In addition, like in other animal species, the GIT microbiota is in permanent interplay with...
Dionne RM, Vrins A, Doucet MY, Paré J.This study was performed to estimate the prevalence of gastric ulcers in Standardbred racehorses, to describe the lesion score and location, and to identify potential risk factors. Two hundred seventy-five (275) Standardbred horses from 5 training centers and 2 racetracks in Quebec, Canada, were studied. Historical data for the 2 months before examination were recorded for each horse, and the presence of gastric ulcers was determined by gastroscopy. A previously reported scoring system that used grades 0-3 for gastric lesions was used. Overall, 121 horses (44.0%; 95% CI, 38.1-50.1%) had gastri...
Padalino B, Davis GL, Raidal SL.Transportation has been suggested as a risk factor for gastric ulceration in horses, but limited evidence supports this assumption. Methods: Twenty-six Standardbred, Thoroughbred, and Warmblood mares from a university teaching herd. Methods: Twelve mares were confined for 12 hours, overnight, in reproductive stocks with indwelling nasogastric tubes (NGTs) to assess pH of gastric fluid (GF). Gastric ulceration was assessed endoscopically before and after confinement. Subsequently, 26 horses were transported for 12 hours, overnight, in 2 consignments. During transportation, GF was aspirated ...
Rabuffo TS, Orsini JA, Sullivan E, Engiles J, Norman T, Boston R.To determine associations between age, sex, or medical treatment and prevalence and severity of gastric ulceration in Standardbred racehorses in training. Methods: Cross-sectional study. Methods: 224 Standardbred racehorses in training. Methods: Gastroscopy was performed on each horse, and mucosal ulceration was graded from 0 (normal mucosa, no lesions) to 3 (extensive, often coalescing, lesions with areas of deep ulceration). Associations between age, sex, or treatment and prevalence and severity of ulcers were evaluated. Results: Prevalence of gastric ulceration was 87%. Although there was l...
Hammond CJ, Mason DK, Watkins KL.Routine post mortem examination of 195 Thoroughbreds in Hong Kong revealed that 66 per cent suffered from gastric ulceration. Racehorses killed straight out of training suffered a significantly greater incidence of ulceration (80 per cent) than those having been retired for a month or more (52 per cent). The macroscopic findings post mortem enabled a classification of equine gastric ulceration to be suggested (Types 1, 2, 3), according to severity. Severe lesions (Types 2 and 3) were present in 45 per cent of horses put down from training and 5 per cent of retired horses. This difference was s...
MacAllister CG, Sifferman RL, McClure SR, White GW, Vatistas NJ, Holste JE, Ericcson GF, Cox JL.A multicentre, blinded, randomised complete-block, field trial was conducted with 140 horses and foals age 4 weeks-28 years to determine if omeprazole paste is effective and safe in promoting healing of spontaneous gastric ulcers under a variety of field conditions and in different breeds and ages of horses. Horses in the study had gastric ulceration as determined by gastroscopy and were divided into replicates of 4 or 5 animals. One horse in each replicate was assigned randomly to receive an empty omeprazole syringe (sham-dosed control) and the remaining horses received omeprazole paste once ...
McClure SR, Carithers DS, Gross SJ, Murray MJ.To determine whether conditions representing activities that are typical in the recreational use of horses, including transport to and from show grounds, stall confinement in unfamiliar surroundings, and light exercise, are associated with increased incidence of gastric ulcers in horses. Methods: Randomized controlled study. Methods: 20 client-owned horses. Methods: Horses had no gastric ulcers as determined by endoscopic examination on study day -1. Ten control horses were maintained on-site with no changes in management variables. Ten horses were transported via trailer for 4 hours on day 0 ...
Saps M, Miranda A.There is little evidence for most of the medications currently used to treat functional abdominal pain disorders (FAPDs) in children. Not only are there very few clinical trials, but also most have significant variability in the methods used and outcomes measured. Thus, the decision on the most appropriate pharmacological treatment is frequently based on adult studies or empirical data. In children, peppermint oil, trimebutine, and drotaverine have shown significant benefit compared with placebo, each of them in a single randomized clinical trial. A small study found that cyproheptadine was be...
Bezdekova B, Jahn P, Vyskocil M.Gastroduodenal ulceration is a prevalent disease in foals and adult horses. Decreased performance as well as fatal complications relate to this syndrome. The objective of our study was to determine the prevalence of gastric ulceration in a mixed population of horses by postmortem examination and to evaluate a possible association between equine gastric ulcer syndrome (EGUS) and sex or age of the examined horses, to evaluate the localisation of lesions in the proximal part of the gastrointestinal tract and to determine the occurrence of gastric parasites. Postmortem examinations were performed ...
Andrews FM, Frank N, Sommardahl CS, Buchanan BR, Elliott SB, Allen VA.The study was performed to evaluate the efficacy of omeprazole powder in sterile water, administered intravenously, on gastric juice pH in adult horses with naturally occurring gastric ulcers. Omeprazole (0.5 mg/kg, IV) was administered once daily for 5 days to 6 adult horses with gastric ulcers. Gastric juice was aspirated through the biopsy channel of an endoscope and pH was measured before and 1 hour after administration of omeprazole on day 1, and then before and after administration of omeprazole on day 5. Gastric ulcer scores were recorded on day 1 before administration of omeprazole and...
Frank N, Andrews FM, Elliott SB, Lew J.To assess antiulcerogenic properties of 3 dietary oils. Methods: 8 healthy adult mares. Methods: A protocol to induce gastric ulcers was used and included 240 mL of water plus corn oil, refined rice bran oil, or crude rice bran oil administered each day for 6 weeks according to a 4 x 4 Latin square randomized crossover design with 5-week washout intervals. A 7-day alternating feed deprivation period was included between weeks 5 and 6. Omeprazole was administered daily for the last 14 days of each washout interval. Endoscopic examinations of the stomach were performed at 0, 5, and 6 weeks, and ...
Martineau H, Thompson H, Taylor D.Gastric ulceration is now widely recognised as an important disease in high performance horses. Little is known about gastric histopathology in healthy or diseased animals; a comprehensive assessment would enhance interpretation of gross findings through assessment of their accuracy and allow for identification of lesion variety and pathogenesis in different anatomical regions of the stomach. Objective: To investigate the true extent and variety of gastric lesions in a mixed population of mature horses at post mortem. Methods: Stomachs were removed from a mixed population of 21 horses at post ...
Berschneider HM, Blikslager AT, Roberts MC.Gastric contents were sampled in horses via nasogastric tube to determine changes in pH and bile salt concentrations during feeding and fasting periods. The horses were rotated through 4 feeding protocols. (1) hay; (2) hay with twice daily grain meals; (3) and (4) fasting preceded by either hay only or hay and grain. Sequential, hourly samples were collected from 3 horses prepared with gastric cannulas. Horses were fed hay twice daily and grain mix either twice daily or in small aliquots dispensed every 90 min. The horses were sampled during normal feeding or after 14 h of feed deprivation. Ga...
Feige K, Fürst A, Eser MW.In a random population of Swiss horses 54% suffered from a subclinical to moderate COPD. Cause of a COPD is a hypersensitivity of the respiratory tract to spores of fungi and thermophil actinomyces. Teeth problems are strongly associated with the type of diet and the feeding regime. Problems of the teeth belong to the most often treated equine diseases by large animal practitioners. Racehorses are the population of horses most often affected by gastric ulcers with an ulcer prevalence between 63 and 90%. In contrast, a much lower prevalence (37%) of stomach ulcers is seen in pleasure horses and...
Venner M, Lauffs S, Deegen E.This study compared the study of a pectin-lecithin complex (Pronutrin) on gastric ulcer healing during an 11 day period in 2 groups of 12 horses each. Twenty-four horses suffering from gastric lesions of differing severity were selected from a larger group of clinical cases on the basis of gastroscopic examination. Both gastric mucosal erosions as well as gastric ulcers were found in the 2 mucosal regions (pars nonglandularis and pars glandularis). The gastric mucosal lesions occurred predominantly in the pars nonglandularis in the vicinity of the margo plicatus. The 24 horses were divided equ...
Palmer JE.Few foals escape gastrointestinal disease during the first weeks of life. Diarrhea is an extremely common problem; fortunately, however, it is usually mild and self-limiting. When it is not, the underlying cause is often an infectious agent, such as rotavirus or Salmonella spp. Our understanding of many of the infectious agents causing neonatal diarrhea is far from complete. Gastric and duodenal ulcers are a less common disease of neonatal foals. There has been an apparent increase in the incidence of ulcer disease in foals during the past few years. The most effective way of decreasing seriou...
Sangiah S, MacAllister CC, Amouzadeh HR.The basal gastric pH and free acid contents from five young adult healthy horses were determined at one hour intervals for eight hours. The basal gastric pH and free acid contents varied from 1.63 +/- 0.06 to 1.97 +/- 0.11 and 26.42 +/- 4.14 to 17.92 +/- 5.28 mmol litre-1, respectively. Misoprostol, a methylester analogue of prostaglandin (5 micrograms kg-1, orally) produced a time-dependent increase in the basal gastric pH to above 3.5 (P less than 0.05) at three, four and five hours after administration with a concomitant reduction of 80 to 90 per cent in the basal gastric free acid contents...
Bush J, van den Boom R, Franklin S.Anecdotally, aloe vera is used to treat gastric ulceration, although no studies have yet investigated its efficacy in horses. Objective: To test the hypothesis that aloe vera would be noninferior to omeprazole in the treatment of equine gastric ulcer syndrome. Methods: Randomised, blinded clinical trial. Methods: Forty horses with grade ≥2 lesions of the squamous and/or glandular mucosa were randomly assigned to one of two groups. Horses received either aloe vera inner leaf gel (17.6 mg/kg bwt) b.i.d. or omeprazole (4 mg/kg bwt) s.i.d. for approximately 28 days, after which a repeat gastrosc...
Hwang H, Dong HJ, Han J, Cho S, Kim Y, Lee I.Gastric ulcer is one of the prevalent diseases in racehorses. However, it has not been recognized as important in Korea, and drugs used to treat gastric ulcers are included in the doping test list, so they are not allowed to be administered to racehorses in training. Objective: This study was performed 1) to investigate the prevalence and the severity of gastric ulcers in Thoroughbred racehorses in Korea, 2) to confirm the therapeutic effect of ranitidine and omeprazole, and 3) to compare the efficacy between ranitidine and omeprazole. Methods: Forty-nine horses were randomly recruited, and ga...
Birkmann K, Junge HK, Maischberger E, Wehrli Eser M, Schwarzwald CC.GastroGard, an omeprazole powder paste formulation, is considered the standard treatment for gastric ulcers in horses and is highly effective. Gastrozol, an enteric-coated omeprazole formulation for horses, has recently become available, but efficacy data are controversial and sparse. Objective: To investigate the efficacy of GastroGard and Gastrozol at labeled doses (4 and 1 mg of omeprazole per kg bwt, respectively, PO q24h) in healing of gastric ulcers. Methods: 40 horses; 9.5 ± 4.6 years; 491 ± 135 kg. Methods: Prospective, randomized, blinded study. Horses with an ulcer score ≥1 (Equi...
Nieto JE, Spier S, Pipers FS, Stanley S, Aleman MR, Smith DC, Snyder JR.To compare effects of a commercially available omeprazole paste and a compounded omeprazole suspension on healing of gastric ulcers in Thoroughbred racehorses in active training. Methods: Randomized controlled trial. Methods: 32 horses with gastric ulcers. Methods: Horses were assigned to 2 groups on the basis of endoscopic gastric ulcer severity. Group-1 horses were treated with omeprazole suspension for 30 days and with omeprazole paste for an additional 30 days. Group-2 horses were treated with omeprazole paste for 30 days and omeprazole suspension for an additional 30 days. Serum omeprazol...
Martineau H, Thompson H, Taylor D.High numbers of racehorses in training are reported to have gastric ulceration. Gross lesion scoring systems exist, but there is no fixed protocol with which to record gastric microscopic findings. In man, the histological classification of stomach lesions helps in the identification of recognised and emerging aetiologies of gastric disease and aids accurate comparison of findings between studies. In horses, the development of such a system would therefore be of benefit. Objective: To develop a pathological scoring system that can be applied to examine samples of the equine stomach at biopsy a...
Ferrucci F, Zucca E, Croci C, Di Fabio V, Ferro E.The severity of the erosive and ulcerative lesions of the squamous gastric mucosa in 10 standardbred racehorses in training was classified according to a standard scoring system. Each horse was then treated orally for 30 days with 50 g/100 kg bodyweight daily of a pectin-lecithin complex mixed into the feed. At the end of the period of treatment, the gastric lesions were re-evaluated gastroscopically and the scores were compared with those assigned at the previous evaluation. In three of the horses the gastric ulcerations had healed completely, and in six others the lesions had improved signif...
Wise JC, Hughes KJ, Edwards S, Jacobson GA, Narkowicz CK, Raidal SL.Omeprazole preparations vary in bioavailability in horses. Objective: To characterize the pharmacokinetics and pharmacodynamics of an existing enteric-coated oral omeprazole paste (REF) and a novel, in-feed, enteric-coated dry granule preparation (NOV). Methods: Twelve Standardbred/Thoroughbred mares free from clinical disease. Methods: A prospective, blinded randomized interventional study was trial, conducted in 3 parts: (a) bioavailability study, (b) dose titration study, and (c) comparative clinical pharmacodynamic study, each using a blocked crossover design. Results: Consistent with the ...
Clark B, Steel C, Vokes J, Shan JR, Gedye K, Lovett A, Sykes BW.Rebound gastric hyperacidity (RGH) secondary to hypergastrinemia has been suggested to contribute to the rapid recurrence of equine squamous gastric disease (ESGD) in horses after discontinuation of omeprazole. Objective: To evaluate changes in serum gastrin and chromogranin A (CgA) concentrations in response to medium-term (57-day) omeprazole treatment and after omeprazole discontinuation. Methods: Fourteen mature Thoroughbred racehorses in simulated race training. Methods: Horses received 2.28 g of oral omeprazole PO q24h for 57 days within a 61-day period, excluding a withholding period...
Poltep K, Tesena P, Yingchutrakul Y, Taylor J, Wongtawan T.Silent gastric ulceration occurs without evidence of clinical signs and is common in horses. There is currently no a simple and effective method to diagnose this disease. Proteomics can be used to identify serum biomarkers, but the most abundant serum protein, albumin, could conceal candidate biomarkers. Therefore, it is recommended to remove albumin before a proteomic study; however, there is no specific albumin depletion kit or standard protocol available for horse samples. The objectives of this study were to optimise a protocol to remove equine serum albumin and to use albumin-depleted ser...
Luthersson N, Bolger C, Fores P, Barfoot C, Nelson S, Parkin T, Harris P.Diet is an accepted risk factor for equine squamous gastric disease (ESGD), but there is little published evidence for the benefit of dietary change (DC). This study evaluated the effect of DC with or without initial omeprazole medication. Twelve pairs of exercising horses with ESGD Grade 2/4 (EM) and 17 pairs with ESGD Grade ≥3/4 (ES), were monitored. Paired horses had similar management, feeding times, workloads, and initially feed or forage. One of each pair was randomly assigned, postgastroscopy (Scope1), to a specified restricted starch ration; the other remained on their original diet....
Leung GN, Leung DK, Wan TS, Wong CH.This paper describes a high throughput LC-MS-MS method for the screening of 75 basic drugs in equine plasma at sub-ppb levels. The test scope covers diversified classes of drugs including some alpha- and beta-blockers, alpha- and beta-agonists, antihypotensives, antihypertensives, analgesics, antiarrhythmics, antidepressants, antidiabetics, antipsychotics, antiulcers, anxiolytics, bronchodilators, CNS stimulants, decongestants, sedatives, tranquilizers and vasodilators. A plasma sample was first deproteinated by addition of trichloroacetic acid. Basic drugs were then extracted by solid-phase e...
McClure SR, White GW, Sifferman RL, Bernard W, Hughes FE, Holste JE, Fleishman C, Alva R, Cramer LG.To determine whether omeprazole oral paste administered at a dosage of 0.5 or 1 mg/kg (0.23 or 0.45 mg/lb), PO, every 24 hours would effectively prevent the recurrence of gastric ulcers in horses in race training. Methods: Prospective study. Methods: 135 horses. Methods: Horses with gastric ulcers were treated with omeprazole at a dosage of 4 mg/kg (1.8 mg/lb), PO, every 24 hours for 28 days. Horses in the dose selection portion of the study were sham dose treated or received 0.5 or 1 mg of omeprazole/kg, PO, every 24 hours for an additional 28 days. Horses in the dose confirmation portion of ...
Traub-Dagartz J, Bayly W, Riggs M, Thomas N, Pankowski R.An Arabian foal with a congenital heart disease died due to hemorrhage secondary to a large gastric ulcer. Previously, death of foals with gastric ulcers has been due to diffuse peritonitis resulting from gastric ulcer perforation. The foal in this case report died due to hemorrhage secondary to a large gastric ulcer.
