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Acta veterinaria Scandinavica2017; 59(1); 15; doi: 10.1186/s13028-017-0284-1

Diagnostic accuracy of blood sucrose as a screening test for equine gastric ulcer syndrome (EGUS) in adult horses.

Abstract: Equine gastric ulcer syndrome (EGUS) is common in adult horses, particularly those involved in performance disciplines. Currently, detection of EGUS by gastroscopy is the only reliable ante mortem method for definitive diagnosis; however it is unsuitable as a screening test because it is expensive, time consuming, and is not readily available to most veterinarians. Sucrose permeability testing represents a simple, economical alternative to gastroscopy for screening purposes, and the feasibility of this approach in the horse has been previously reported. The aim of this study was to determine the diagnostic accuracy of blood sucrose as a screening test for EGUS in a large group of adult horses with and without naturally occurring gastric disease. Results: One hundred and one adult horses with or without naturally occurring gastric ulceration were studied. The diagnostic accuracy of blood sucrose for diagnosis of gastric lesions (GL), glandular lesions (GDL), squamous lesions (SQL), and clinically significant lesions (CSL) at 45 and 90 min after administration of 1 g/kg of sucrose via nasogastric intubation was assessed using receiver operator characteristics (ROC) curves and calculating the area under the curve (AUC). For each lesion type, sucrose concentration in blood was compared to gastroscopy, as the gold standard, and sensitivities (Se) and specificities (Sp) were calculated across a range of sucrose concentrations. Ulcer grading was performed blindly by one observer; and the results were validated by comparing them with that of two other observers, and calculating the level of agreement. Cut-off values were selected manually to optimize Se. The prevalence of GL, GDL, SQL, and CSL was 83, 70, 53 and 58% respectively. At the selected cut-offs, Se ranged from 51 to 79% and Sp ranged from 43 to 72%, depending upon the lesion type and time of sampling. Conclusions: Blood sucrose is neither a sensitive or specific test for detecting EGUS in this population of adult horses with naturally occurring gastric ulceration. Further studies aimed at evaluating the performance characteristics of the test in different study populations are warranted. Given the limitations of endoscopy, due consideration should also be given to alternative methods for comparison of blood sucrose with a gold standard.
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Publication Date: 2017-03-11 PubMed ID: 28284214PubMed Central: PMC5346197DOI: 10.1186/s13028-017-0284-1Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The research conducted investigates the effectiveness of blood sucrose as a screening test for equine gastric ulcer syndrome (EGUS) in adult horses. It found the test lacking in sensitivity and specificity for detecting EGUS.

Objective of the Study

The purpose of this study is to evaluate the diagnostic accuracy of blood sucrose as a screening test for equine gastric ulcer syndrome (EGUS). EGUS is a common issue in adult horses, particularly athletic ones. Gastroscopy is the established method to diagnose EGUS, yet it is expensive, time-consuming, and inaccessible to many veterinarians. Hence, this study explores the use of sucrose permeability testing as a simpler, cheaper alternative.

Methodology

  • 101 adult horses with varying levels of gastric ulceration were studied.
  • The diagnostic accuracy of blood sucrose was assessed 45 and 90 minutes after the administration of 1 g/kg of sucrose using nasogastric intubation.
  • Accuracy was measured using receiver operator characteristics (ROC) curves and the area under the curve (AUC).
  • Comparison was made with gastroscopy, which is the gold standard method for EGUS detection.
  • For each type of gastric lesion (GL, GDL, SQL, and CSL), sensitivity (Se) and specificity (Sp) were calculated over various sucrose concentrations.
  • Ulcer grading was independently handled by one observer and the results were cross-verified with the grading of two other observers and the level of agreement was evaluated.

Results

  • The prevalence of GL, GDL, SQL, and CSL was calculated to be 83%, 70%, 53%, and 58%, respectively.
  • The sensitivity and specificity of the test ranged from 51% to 79% and 43% to 72%, respectively, depending on the lesion type and time of testing.

Conclusions

The researchers concluded that blood sucrose is neither a sensitive nor specific test for the detection of EGUS in adult horses. Further research should be carried out to examine the test in different settings and populations. There was also a recommendation to consider alternative methods to gastroscopy for comparison with the gold standard, due to its limitations.

Cite This Article

APA
Hewetson M, Sykes BW, Hallowell GD, Tulamo RM. (2017). Diagnostic accuracy of blood sucrose as a screening test for equine gastric ulcer syndrome (EGUS) in adult horses. Acta Vet Scand, 59(1), 15. https://doi.org/10.1186/s13028-017-0284-1

Publication

Acta veterinaria Scandinavica
ISSN: 1751-0147
NlmUniqueID: 0370400
Country: England
Language: English
Volume: 59
Issue: 1
Pages: 15

Researcher Affiliations

Hewetson, Michael
  • Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland. michael.hewetson@up.ac.za.
  • Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Onderstepoort, South Africa. michael.hewetson@up.ac.za.
Sykes, Ben William
  • School of Veterinary Sciences, University of Queensland, Brisbane, Australia.
Hallowell, Gayle Davina
  • School of Veterinary Medicine and Science, University of Nottingham, Nottingham, UK.
Tulamo, Riitta-Mari
  • Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland.

MeSH Terms

  • Animals
  • Female
  • Gastroscopy / veterinary
  • Horse Diseases / blood
  • Horse Diseases / diagnosis
  • Horses
  • Male
  • Sensitivity and Specificity
  • Stomach Ulcer / blood
  • Stomach Ulcer / diagnosis
  • Stomach Ulcer / veterinary
  • Sucrose / blood

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