Equine gastric ulcers are lesions that occur in the stomach lining of horses, often associated with stress, diet, and management practices. These ulcers can affect horses of all ages and disciplines, leading to varying degrees of discomfort and performance issues. The condition is typically categorized into Equine Gastric Ulcer Syndrome (EGUS), which includes lesions in both the squamous and glandular regions of the stomach. Diagnosis often involves endoscopic examination, and management strategies may include dietary modifications, stress reduction, and pharmacological interventions. This page compiles peer-reviewed research studies and scholarly articles that explore the etiology, diagnosis, treatment, and management of gastric ulcers in horses.
Murray MJ, Grady TC.This study examined whether a product containing a pectinlecithin complex (Pronutrin) (1) could prevent gastric lesions induced in the equine gastric squamous epithelial mucosa using a protocol of intermittent feed deprivation that resulted in prolonged increased gastric acidity (Murray and Eichorn 1996). Eight ponies were used and served as their own controls in 2 trials in which there were 72 h cumulative deprivation (alternating 24 h with no feed, then 24 h free choice hay), with a 4-week interval between trials. Ponies were assigned randomly to receive either 250 g Pronutrin plus 200 g pel...
Sequeira JL, Tostes RA, Oliveira-Sequeira TC.The objective of the present study was to investigate the prevalence of Gasterophilus nasalis larvae in Botucatu, the central west region of São Paulo State, Brazil, and to describe the lesions caused by the parasite. The climate of Botucatu is warm and rainy during the months of December through March and cool and dry during the months of May through August. The prevalence of G. nasalis was 16.84%, and the period of peak infestation corresponded to the months of cold and dry weather. The lesions detected at the sites of larval attachment were examined macro- and microscopically. Erosions and...
Jeffrey SC, Murray MJ, Eichorn ES.Growth factors are important in healing and restoration of injured gastrointestinal tissues and, therefore, we characterised temporally the distribution and density of epidermal growth factor receptor (EGFr) in normal and peptic-injured gastric squamous epithelium of horses. Lesions were induced in the equine gastric squamous epithelium using a feed deprivation protocol that results in prolonged increased gastric acidity. Fifteen mature horses, 9 geldings and 6 mares, age 3 to 20 years, were used and divided into 3 groups: Group 1 (n = 5) were subjected to euthanasia for problems unrelated to ...
Murray MJ, Eichorn ES, Jeffrey SC.The objective of the study reported here was to characterise the microscopic appearance of peptic-injured equine gastric squamous epithelium in relation to the duration of peptic injury. Erosions and ulcers were induced in equine gastric squamous epithelium using a feed deprivation protocol that results in prolonged increased gastric acidity. Specimens of normal gastric mucosa and mucosa with lesions created after 48 and 96 h of feed deprivation were compared for characteristics associated with angiogenesis and mucosal proliferation. Fifteen mature horses, 9 geldings and 6 mares, age 3-20 year...
Turnquist SE, Ostlund EN, Kreeger JM, Turk JR.Twenty of 25 horses in a well-managed Missouri boarding stable were diagnosed with gingivitis/stomatitis. Gross examination of the affected horses revealed varying degrees of gingivitis ranging from mild periodontal swelling to marked swelling and erythema with ulceration and hemorrhage. Fine hair-like material was embedded within the intensely affected areas. Gingival biopsies from 4 affected horses contained pyogranulomatous inflammation with, in some cases, numerous eosinophils and several grass awns in cross and longitudinal section. Numerous foxtail seed heads were identified in hay sampl...
Murray MJ, Nout YS, Ward DL.Medical records and endoscopy images were examined for 209 horses that had gastroscopic examinations performed with a 2.5- or 3-m-long endoscope by one of the authors (MJM) during a 4-year period (1996-2000). The antrum and pylorus were viewed in 162 horses, and the duodenum was viewed in 94 horses. Of these 162 horses, the gastric squamous mucosa was seen in 157 horses and 50% or more of the glandular mucosa of the body of the stomach was seen in 156 horses. Erosions or ulcers were seen in the gastric squamous mucosa in 91 (58%) horses. Erosions or ulcers were seen in the glandular mucosa of ...
Wada S, Yoshinari M, Mizuno Y.Therapeutic soft contact lenses (TSCL) were applied to a thoroughbred racehorse with corneal ulcer refractory to topical medication. The insertion of the TSCL was conducted on day 36 using a nose twitch under sedation, auriculopalpebral nerve block, and topical anesthesia. The lens was retained, with the duration of wear lasting 114 days. Ocular pain improved immediately and fluorescein tests were negative 17 days after insertion. The horse was able to undergo training and ran in two races while wearing the TSCL. Thus a TSCL was found to be clinically useful for treating corneal ulcers in race...
Strubbe DT, Brooks DE, Schultz GS, Willis-Goulet H, Gelatt KN, Andrew SE, Kallberg ME, MacKay EO, Collante WR.Ulcerative keratitis is a common and potentially blinding ocular disease of horses, capable of progressing to corneal perforation in as little as 24 h. This rapid stromal degeneration is mediated in part by exogenous and endogenous proteinases. We measured and compared the concentrations of two matrix metalloproteinases (MMP-2 and MMP-9) and a serine proteinase (neutrophil elastase) present in the precorneal tear film of normal horses and horses with rapidly progressing ulcerative keratitis. Precorneal tear film samples were collected from 23 ulcerated and 21 unaffected eyes of 23 horses with ...
Brooks DE, Andrew SE, Biros DJ, Denis HM, Cutler TJ, Strubbe DT, Gelatt KN.Purpose To describe 11 clinical cases of ulcerative keratitis in horses associated with beta-hemolytic Streptococcus equi in Florida, USA. METHODS: Retrospective clinical study (1996-99). RESULTS: Beta-hemolytic Streptococcus equi was cultured from 11 horses with deep ulcers, descemetoceles or iris prolapse (n = 8), a suture abscess found with a penetrating keratoplasty for a stromal abscess (n = 1), and ulceration that developed following keratectomy/irradiation for corneal squamous cell carcinoma (n = 2). Beta-hemolytic Streptococcus equi subspecies zooepidemicus was found in 10 eyes and sub...
Bullimore SR, Corfield AP, Hicks SJ, Goodall C, Carrington SD.In horses, ulceration of the non-glandular region of the stomach is common and has been attributed to the lack of a protective mucus covering. This study aimed to determine whether the non-glandular region is covered by a mucus layer. A mixture of antibodies raised against human gastric mucin (MUC 5 AC) showed a tissue distribution in the glandular region of the equine stomach similar to that seen in humans. Dot blots of mucus from the glandular and non-glandular regions showed cross-reactivity with these antibodies. Various histological fixation and processing techniques were compared for the...
Kitchen DL, Burrow JA, Heartless CS, Merritt AM.To determine the origin of the nonacid (nonparietal) component of gastric secretions in horses induced by pentagastrin infusion. Methods: 6 horses. Methods: A Latin square design was used, involving 6 horses, 3 treatments, and 2 duodenal intubation conditions (catheter with balloon to obstruct pylorus [B] or without balloon allowing movement of contents between stomach and duodenum [NB]). Each horse had an indwelling gastric cannula and a catheter positioned in the duodenum. Gastric and duodenal contents were collected during 15-minute periods. Each experiment consisted of serial collection pe...
Argenzio RA.Ulceration of the nonglandular, stratified squamous mucosa of the equine and porcine stomach is a common event in both species, although in pigs the fatality rate is significant and it is an economically important disease. Because the barrier function of this mucosa in horses and pigs appears similar, it is probable that similar pathophysiological mechanisms may be responsible for the initiating lesions and reparative events. Recent studies of ulcer pathogenesis in the pig have shown that feed preparation or prolonged fasting can result in disruption of the normal stratification of gastric con...
Andrews FM, Sifferman RL, Bernard W, Hughes FE, Holste JE, Daurio CP, Alva R, Cox JL.Equine gastric ulcer syndrome (EGUS) is very common among performance horses, with a reported prevalence of approximately 90% in racehorses, and also > 50% in foals. Omeprazole, an acid pump inhibitor 5 times more potent than ranitidine, has been used with great success to treat EGUS. This multicentre study of Thoroughbred racehorses with endoscopically verified gastric ulcers was designed to demonstrate the efficacy of an equine oral paste formulation of omeprazole in the treatment and prevention of recurrence of EGUS. Of the 100 horses entered into the study, 25 were sham-dosed for the full ...
Vatistas NJ, Snyder JR, Nieto J, Thompson D, Pollmeier M, Holste J.Gastric ulceration has been found to occur in 80-90% of Thoroughbreds in active race training. Previously, variable success has been reported using mucosal surface protectants and H2 receptor antagonist. Omeprazole, a substituted benzimidazole, has been shown to inhibit gastric acid secretion in both man and animals. Fourteen horses, in active race training and with endoscopic evidence of moderated to severe gastric ulceration were divided into 2 groups: Group 1 (7 horses) were given placebo paste orally once daily for 28 days; Group 2 (7 horses) received 1.54 g active omeprazole in the placeb...
Plue RE, Wall HG, Daurio C, Attebery DK, Cox JL, Wallace DH.Omeprazole has been shown to promote healing of spontaneously occurring gastric ulcers in horses when administered for 28 days at a dose of 4 mg/kg bwt/day and to prevent recurrence of ulcers in almost all horses when treatment is continued at a dose of at least 2 mg/kg bwt/day. The purpose of the 3 studies reported here was to 1) evaluate the evolution of potential effects of omeprazole paste (GastroGard), at a dose of 20 mg/kg bwt/day (5x the recommended dose) for 91 days in mature Thoroughbred horses; 2) evaluate the safety in young horses of omeprazole paste when dosed at 4 mg/kg bwt/day (...
Vatistas NJ, Sifferman RL, Holste J, Cox JL, Pinalto G, Schultz KT.Gastric ulceration is a prevalent condition of racehorses. A number of models of gastric ulceration have been described, but none mimic the conditions of a horse in training. The objectives of this study were to determine whether gastric ulcers could be induced and maintained in a group of horses in simulated race training. In addition, serum cortisol was measured on a weekly basis to investigate the possibility that stress may be important in the pathogenesis of gastric ulceration. Thirty horses used in the trial were fed Bermuda grass hay and 6 kg of a concentrate diet, and exercised 6 days/...
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 ...
Daurio CP, Holste JE, Andrews FM, Merritt AM, Blackford JT, Dolz F, Thompson DR.In a multicentre trial, 13 cannulated horses were treated orally once daily with a paste that delivered omeprazole at a dose of 4 and 5 mg/kg bwt in a 2-period crossover design to evaluate steady state gastric acid suppression. In each period, basal (unstimulated) and pentagastrin-stimulated gastric output were evaluated at 5-8 h after 5 doses, at 13-16 h after 10 doses, and at 21-24 h after 15 doses. Baseline data for gastric acid secretion were collected once for each horse in the month prior to initiation of omeprazole treatment. The inhibition of gastric acid secretion relative to baseline...
Merritt AM.This article represents an attempt to provide an overview of the current knowledge of equine gastroduodenal secretory and motor activity, with respect to how these functions are controlled and interact. First, the equine gastric mucosal anatomy is discussed in comparison with other monogastric species, with some attention directed at the large nonglandular portion in relation to its function, or lack thereof. Next, control of gastric acid secretion, as assessed by the collection of gastric contents from a cannula or continuous measurement of their changes in pH, is reviewed, pointing out that ...
Widenhouse TV, Lester GD, Merritt AM.To determine the effect of pH with or without pepsin or taurocholic acid on the bioelectric properties of gastric squamous mucosa in horses. Methods: Gastric tissues obtained from 16 adult horses that did not have evidence of gastric disease. Methods: Bioelectric properties of squamous mucosa were determined, using modified Ussing chambers. Tissues then were exposed to mucosal pepsin (1 mg/ml) or taurocholic acid (2.5 mM) under neutral (pH 74) or acidic (pH 1.7) conditions. Results: Exposure of mucosal sheets to an acidic pH resulted in an immediate and sustained decrease in transmembrane pote...
Sanz MG, Viljoen A, Saulez MN, Olorunju S, Andrews FM.The objective of this study was to evaluate the effect of a commercial feed supplement containing pectin-lecithin on squamous mucosa ulceration in horses exposed to an experimental ulceration model. Five mares were treated while five mares were controls for this crossover, blinded study. The mares were fed concentrates and hay and were stabled with a two-hour turn out per day for a period of four weeks. The pectin-lecithin complex was fed for the duration of the study on the treated group. At the end of a four-week period, all mares underwent a seven-day alternating feed deprivation (week 5). ...
Julliand S, Buttet M, Hermange T, Hillon P, Julliand V.Nutritional factors are suggested to influence the incidence and severity of glandular gastric disease (GGD) in horses. Objective: To retrospectively assess whether dietary fermentable carbohydrates increase the severity of GGD and to prospectively evaluate whether the partial substitution of concentrates by dehydrated alfalfa would decrease GGD severity scores. Methods: In total, 82 trotters from 4 training centers exercised ≥5 days/week. Methods: Multicenter retrospective observational study, and prospective 2-arm randomized trial. Glandular mucosae were observed by gastroscopy and score...
McKeever JM, McKeever KH, Albeirci JM, Gordon ME, Manso Filho HC.A large percentage of performance horses develop gastric ulcers and many of those horses are treated with omeprazole. Unfortunately, no data have been published on the effects of the drug on markers of performance in animals without ulcers. Objective: Omeprazole would alter markers of aerobic and anaerobic performance. Methods: Ten unfit, healthy, ulcer free, Standardbred mares were administered either control (CON; oral apple sauce, 20 ml) or omeprazole (OP; oral paste, 4 mg/kg bwt s.i.d.) in a random crossover fashion with the investigators blind to the treatment. Treatments were administere...
Lo Feudo CM, Stucchi L, Conturba B, Alberti E, Zucca E, Ferrucci F.Equine squamous gastric disease (ESGD) may require prolonged treatments with acid suppressants; therefore, interest in nutraceutical supplements with anti-ulcerogenic properties has increased. This study aims to investigate the efficacy of Trophogast pellet for the treatment of ESGD in endurance horses. Methods: Fifteen endurance horses were included based on their gastroscopic examination and randomly assigned to a treatment group, receiving Trophogast pellet for 30 days together with management changes, or to a control group, only subjected to management modifications. At the end of treatmen...
Gharehaghajlou Y, Raidal SL, Freccero F, Padalino B.Transportation may lead to oxidative stress (OS) and gastric ulceration in horses, and optimal feed management before, or during, transportation is unclear. This study aimed to evaluate the effects of transportation after three different feeding strategies on OS and to explore possible associations between OS and equine gastric ulcer syndrome (EGUS). Twenty-six mares were transported by truck for 12 hours without food or water. Horses were randomly divided into 3 groups; (1) fed 1 hour before departure (BD), (2) fed 6 hours BD, (3) fed 12 hours BD. Clinical examinations and blood collections w...
Robertson SA, Green SL, Carter SW, Bolon BN, Brown MP, Shields RP.Anesthesia and surgery in a Quarter Horse affected with hyperkalemic periodic paralysis resulted in euthanasia after 7 days of postoperative recumbency. Initial recovery was uneventful after extensive sinus surgery, but within 2 hours, the horse had severe muscle weakness. Plasma electrolyte concentrations were within the normal range during the period of recumbency. There was no clinical or laboratory evidence of severe muscle damage. Despite treatment with acetazolamide, isoproterenol, and intensive nursing, the horse was unable to stand for more than a few seconds and developed severe decub...
Peyrecave-Capo X, Saulnier N, Maddens S, Gremillet B, Desjardins I.Human autologous serum (AS) and umbilical cord serum (UCS) both contain growth and neurotrophic factors that promote corneal healing. Unassigned: Our objectives were to compare equine AS and UCS cytokine and growth factor profiles and to assess the safety and clinical feasibility of the therapeutic use of UCS eye drops in cases of spontaneous complex ulcers. Unassigned: Prospective clinical trial. Unassigned: Vitamin A insulin growth factor, platelet-derived growth factor-BB, transforming growth factor (TGF)-β1 (enzyme-linked immunosorbent assay), interleukin (IL)-1β, IL-6, interferon-γ, an...
Vengust M, Baird JD, van Dreumel T, Ackerley C, Bienzle D.A case of a 1-month-old Thoroughbred foal with dysphagia, salivation, pyrexia, oral mucosal pustules, and esophageal ulceration is reported. Swabs from the ulcerated lesions yielded Equid herpesvirus 2 (EHV-2) in virus isolation assays, and histopathology of a biopsy from the esophageal lesion identified nuclear inclusions suggestive of herpesviruses. Immunohistochemical staining with antibodies specific for EHV-2 was positive for epithelial cells in the vicinity of the ulcer but not in more distant mucosa. Electron microscopic evaluation of the biopsy showed herpesviral particles in epithelia...
Conner AL, Davis AJ, Porr CA.This study evaluated the effect of a dietary supplement on the treatment of equine gastric ulcer syndrome (EGUS). Gastroscopy was performed on university riding horses of mixed breeds at two locations and only horses exhibiting gastric ulcers were selected to participate in this study (location A, n = 13; location B, n = 15). Gastric ulcer severity was assessed using two different methods depending on location before treatment (Pre). After gastroscopy, horses were fed the supplement in addition to their regular diet for 44 d (14-d adaptation period followed by 30-d feeding period). All horses ...
Bullimore SR, Corfield AP, Hicks SJ, Goodall C, Carrington SD.In horses, ulceration of the non-glandular region of the stomach is common and has been attributed to the lack of a protective mucus covering. This study aimed to determine whether the non-glandular region is covered by a mucus layer. A mixture of antibodies raised against human gastric mucin (MUC 5 AC) showed a tissue distribution in the glandular region of the equine stomach similar to that seen in humans. Dot blots of mucus from the glandular and non-glandular regions showed cross-reactivity with these antibodies. Various histological fixation and processing techniques were compared for the...
Pietra M, Morini M, Perfetti G, Spadari A, Vigo P, Peli A.In recent years, gastric ulceration has been recognized as a common, possibly performance-limiting disease, of adult horses. The aim of this study was to compare endoscopic features, histological diagnosis, and mRNA levels of various cytokines (TNF-alpha, IL-1beta, and IL-13) from horse gastric biopsies. Eleven horses suffering from equine gastric ulcer syndrome and seven horses with normal histological gastric features were assessed. No correlation between endoscopic features and histology (i.e., the gold standard) was observed. Based on histological diagnosis, a significant (p < 0.05) increa...
Cerqueira VD, Riet-Correa G, Barbosa JD, Duarte MD, Oliveira CM, de Oliveira CA, Tokarnia C, Lee ST, Riet-Correa F.In the Amazon region of northern Brazil, Panicum maximum cultivars Mombaça, Tanzânia, and Massai cause severe colic and death in horses and mules. The disease occurs in the rainy season, when sprouting pastures are grazed by equidae. In the 8 separate disease outbreaks studied, a total of 52 out of 153 equidae were affected, including 19 that died (10 mules and 9 horses). Clinical signs were colic and abdominal dilatation, with a clinical manifestation period of 12 hr to 4 days. Serum activities of gamma-glutamyl transferase and aspartate aminotransferase were within reference intervals; how...
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...
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 ...
Meissner JM, Chmielińska A, Ofri R, Cisło-Sankowska A, Marycz K.Corneal ulcers, characterized by severe inflammation of the cornea, can lead to serious, debilitating complications and may be vision-threatening for horses. In this study, we aimed to investigate the role of endoplasmic reticulum (ER) stress in corneal stem progenitor cell (CSSC) dysfunction and explore the potential of equine adipose-derived stromal stem cell (ASC)-derived extracellular vesicles (EVs) to improve corneal wound healing. We showed that CSSCs expressed high levels of CD44, CD45, and CD90 surface markers, indicating their stemness. Supplementation of the ER-stress-inducer tunicam...
Ensink JM, Klein WR, Barneveld A, Vulto AG, Van Miert AS.Tissue chambers, implanted subcutaneously in ponies, were inoculated with Streptococcus zooepidemicus. The animals received either no antibiotics or one of the following treatments: pivampicillin per os (19.9 mg/kg, equivalent to 15 mg/kg ampicillin, every 12 h) for 7 or 21 days (7 and 5 ponies, respectively), procaine penicillin G intramuscularly (12 mg/kg = 12,000 IU/kg, every 24 h) for 7 days (7 ponies), or ampicillin sodium intravenously (equivalent to 15 mg/ kg ampicillin, every 8 h) for 1 day (5 ponies). Only intravenous administration was started before infection (prophylactically), the...
Wada S, Yoshinari M, Mizuno Y.Therapeutic soft contact lenses (TSCL) were applied to a thoroughbred racehorse with corneal ulcer refractory to topical medication. The insertion of the TSCL was conducted on day 36 using a nose twitch under sedation, auriculopalpebral nerve block, and topical anesthesia. The lens was retained, with the duration of wear lasting 114 days. Ocular pain improved immediately and fluorescein tests were negative 17 days after insertion. The horse was able to undergo training and ran in two races while wearing the TSCL. Thus a TSCL was found to be clinically useful for treating corneal ulcers in race...
Adamson PJ, Jang SS.Salmonella arizonae 61:1,5, was isolated in pure culture from the eye of a horse with unilateral ulcerative keratitis. The eye responded well to treatment with atropine sulfate and polymyxin B-bacitracin-neomycin ophthalmic ointments. In swab specimens taken after the lesion had healed, Salmonella was not found to be a constituent of the bacterial flora of the horse's eyes.
Yeruham I, Avidar Y, Perl S.Primary photosensitization was observed in 3 Appaloosa mares. The skin lesions were diffuse erythema followed by edema and subsequently weeping and finally dry gangrene and ulceration. The severe photosensitivity dermatitis was apparently induced by gluten ingestion. Resolution of lesions occurred after withdrawal of the suspected dairy concentrate feed and prevention of exposure to sunlight. Neither the ponies nor donkey, which were not fed with the suspected concentrate, exhibited similar skin lesions or other clinical abnormalities. Gluten metabolites may contain photodynamic agents that ca...
