Physical vs. Behavioral Clinical Signs in Horses with Squamous and Glandular Gastric Ulcers.

Overview

• This study investigated how the location of gastric ulcers in horses (squamous vs. glandular) is related to the clinical signs they show, distinguishing between physical and behavioral symptoms.
• The researchers found a significant link between ulcer location and the type of clinical signs presented, with squamous ulcers mainly causing physical signs, and glandular ulcers more often associated with behavioral or mixed signs.

Background

• Equine Gastric Ulcer Syndrome (EGUS) is a common condition in horses characterized by ulcerations in the stomach lining.
• Diagnosing EGUS clinically is difficult because many of the symptoms are nonspecific and can overlap with other conditions.
• The stomach of horses has two main regions where ulcers occur: the squamous (upper, non-glandular) and the glandular areas, each possibly linked with different clinical manifestations.
• The study aimed to clarify how ulcer location correlates with physical versus behavioral signs observed in affected horses.

Methods

• The researchers performed a retrospective review of medical records for 52 horses diagnosed with gastric ulcers confirmed by gastroscopy.
• Clinical signs were categorized into three types:
  • Physical signs (e.g., weight loss, poor body condition)
  • Behavioral signs (e.g., changes in attitude, reluctance to work)
  • Mixed signs (both physical and behavioral)
• Ulcers were classified according to location into:
  • Equine Squamous Gastric Disease (ESGD)
  • Equine Glandular Gastric Disease (EGGD)
  • Mixed (both squamous and glandular ulceration)
• Statistical tests used included chi-square and Fisher’s exact tests with a significance cutoff of p < 0.05 to identify associations.

Key Findings

• A strong association was found between ulcer location and the type of clinical signs (p < 0.001):
  • Horses with ESGD primarily showed physical clinical signs.
  • Horses with EGGD or mixed ulcerations more frequently exhibited behavioral or mixed signs.
• Both the type of clinical signs and ulcer location correlated with the horse’s sport activity, suggesting activity type may influence clinical presentation or ulcer development.
• Ulcer severity did not show a significant relationship with the clinical signs presented, indicating that symptom type is more influenced by ulcer location rather than how severe the lesions are.
• No significant association was found between ulcer location and the horse’s sex, implying sex is not a factor in ulcer site distribution.

Implications

• This study highlights that the anatomical location of gastric ulcers in horses influences the type of clinical signs observed, which can help veterinarians tailor diagnostic and therapeutic approaches.
• Understanding that ESGD tends to cause more physical signs while EGGD is linked to behavioral changes can improve the accuracy of clinical diagnosis without relying solely on gastroscopy.
• Veterinarians should consider the horse’s sport activity when evaluating clinical signs and when suspecting gastric ulcers in specific stomach regions.
• Since ulcer severity did not correlate with clinical signs, relying on symptom severity alone may miss or underestimate the ulcer’s anatomical context or presence.

Conclusion

• The study concludes that gastric ulcer location is a critical factor influencing clinical presentations in horses with EGUS.
• ESGD and EGGD represent distinct clinical patterns, with physical signs dominated in squamous ulcers and behavioral signs more frequent in glandular ulcers.
• These findings can guide clinicians in better identifying and managing gastric ulcers in horses based on observable signs and ulcer localization.