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Home / Equine Research Bank / Equine Vet J / Risk factors associated with equine gastric ulceration syndr...
Equine veterinary journal2009; 41(7); 625-630; doi: 10.2746/042516409x441929

Risk factors associated with equine gastric ulceration syndrome (EGUS) in 201 horses in Denmark.

Abstract: The prevalence (up to 93% in Thoroughbred racehorses) and severity of equine gastric ulceration syndrome (EGUS) has been associated with type of training and differing management practices. However, there have been few studies to confirm these findings in nonracehorses in Europe. Objective: To investigate the prevalence of EGUS in a population of Danish horses, during winter when the horses had been housed and fed for at least 8 weeks and to analyse the influence of feed, work level and environment on the risk of EGUS of > or = grade 2 in severity. Methods: A total of 201 horses, not in active race-training, were evaluated, representing 23 different stables from all 5 regions within Denmark. All horses were considered to be healthy and not on medical treatment for EGUS. Endoscopically observed ulcer lesion scores were based on the number present (0-4) and severity (0-5). Univariate and multivariable mixed effects logistic regression models were developed using EGUS score as the dependent variable. An ulceration severity score of > or = 2 was regarded as being clinically significant. Separate models were developed for horses with ulcers in either the glandular or nonglandular regions of the stomach graded > or = 2 (EGUS > or = 2) and for those horses that had nonglandular ulcers graded > or = 2 (NG > or = 2). Results: In this population, 53% (107/201) of horses were graded as having EGUS > or = 2 with 95 (47%) horses having NG > or = 2. Three variables were significantly (P<0.05) associated with EGUS > or = 2: straw being the only forage available; exceeding 2 g/kg bwt of starch intake/day or >1 g/kg bwt/meal; and water not being available in the turn out paddock. Risk of NG > or = 2 significantly increased when straw was the only forage available, 1 g/kg bwt of starch/meal was exceeded, water was not available in the turnout paddock and the interval between forage feeding was >6 h. Conclusions: This study has confirmed that components of the diet, readily modifiable, may have an important impact on the risk of EGUS in the nonracehorse. Differences in the multivariable models produced for all ulcers and nonglandular ulcers support differences in the aetiology of ulcers in different locations of the stomach.
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Publication Date: 2009-11-26 PubMed ID: 19927579DOI: 10.2746/042516409x441929Google Scholar: Lookup
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  • Journal Article

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.

This research examines factors related to the high prevalence of equine gastric ulceration syndrome (EGUS) in Danish horses, during winter season. The study specifically looks at the influence of feed, exercise level, and environment on the risk and severity of EGUS. The research findings indicate that components of the diet and certain management practices have a significant impact on the risk of EGUS in horses.

Research Methodology

  • The study centered on a total of 201 horses, not in active race-training, representing 23 different stables from all 5 regions of Denmark.
  • These horses were considered healthy and were not on medical treatment for EGUS.
  • The evaluation of the horses involved endoscopically observed ulcer lesion scores. The scores were based on the number of ulcers present (0-4) and severity (0-5).
  • To analyse the data, both univariate and multivariable mixed effects logistic regression models were developed, using the EGUS score as the dependent variable.
  • Ulceration severity scores of 2 and above were deemed clinically significant and separate models were developed for horses with ulcers in either the glandular or non-glandular regions of the stomach or for those horses with non-glandular ulcers only.

Results and Findings

  • In the population studied, 53% (107/201) of horses were graded as having EGUS of grade 2 or above. Out of these, 47% had ulcers in non-glandular areas.
  • Three variables were significantly associated with EGUS of grade 2 or above: straw being the only forage available; exceeding 2 g/kg body weight of starch intake per day or more than 1 g/kg body weight per meal; and no water availability in the turn-out paddock.
  • Risk of EGUS grade 2 or above in non-glandular areas increased when straw was the only forage available; when starch intake per meal exceeded 1 g/kg body weight; when water was not available in the turnout paddock, and when the interval between forage feeding was more than 6 hours.

Conclusions

  • The study confirms that readily modifiable components of the horse’s diet can significantly impact the risk of EGUS. Changes in dietary and management practices can thus help to control the prevalence of EGUS in non-racehorses.
  • Moreover, the differences observed in the multivariable models produced for all ulcers and non-glandular ulcers signify possible differences in the causes of ulcers in different regions of the stomach.

Cite This Article

APA
Luthersson N, Nielsen KH, Harris P, Parkin TD. (2009). Risk factors associated with equine gastric ulceration syndrome (EGUS) in 201 horses in Denmark. Equine Vet J, 41(7), 625-630. https://doi.org/10.2746/042516409x441929

Publication

Equine veterinary journal
ISSN: 0425-1644
NlmUniqueID: 0173320
Country: United States
Language: English
Volume: 41
Issue: 7
Pages: 625-630

Researcher Affiliations

Luthersson, N
  • Hestedoktoren I/S, 4360 Kr. Eskilstrup, Denmark.
Nielsen, K Hou
    Harris, P
      Parkin, T D H

        MeSH Terms

        • Animal Husbandry
        • Animals
        • Cluster Analysis
        • Data Collection
        • Denmark / epidemiology
        • Horse Diseases / epidemiology
        • Horse Diseases / etiology
        • Horses
        • Risk Factors
        • Seasons
        • Stomach Ulcer / complications
        • Stomach Ulcer / epidemiology
        • Stomach Ulcer / veterinary
        • Surveys and Questionnaires

        Citations

        This article has been cited 36 times.
        1. Taylor DEF, Lancaster BE, Ellis AD. Time Budgets in Domesticated Male Icelandic Horses on Pasture Turnout in Winter and Spring. Animals (Basel) 2025 Nov 4;15(21).
          doi: 10.3390/ani15213206pubmed: 41227536google scholar: lookup
        2. Nilsson E, Moazzami AA, Lindberg JE, Jansson A. The metabolomic profile of a high starch versus no starch diet in athletic horses. Sci Rep 2025 Oct 13;15(1):35576.
          doi: 10.1038/s41598-025-23422-zpubmed: 41083709google scholar: lookup
        3. Hartwig S, Rankovic A, McCrae P, Gagliardi K, Burron S, Ellis J, Ma DWL, Shoveller AK. The effects of a plant-based and a plant- and marine-based n-3 oil supplement on behavioral reactivity, heart rate variability, and plasma fatty acid profile in young healthy horses. J Anim Sci 2025 Jan 4;103.
          doi: 10.1093/jas/skaf117pubmed: 40202435google scholar: lookup
        4. Brandi LA, Nunes AT, Faleiros CA, Poleti MD, Oliveira ECM, Schmidt NT, Sousa RLM, Fukumasu H, Balieiro JCC, Brandi RA. Dietary Energy Sources Affect Cecal and Fecal Microbiota of Healthy Horses. Animals (Basel) 2024 Dec 3;14(23).
          doi: 10.3390/ani14233494pubmed: 39682460google scholar: lookup
        5. Jensen RB, Walslag IH, Marcussen C, Thorringer NW, Junghans P, Nyquist NF. The effect of feeding order of forage and oats on metabolic and digestive responses related to gastric emptying in horses. J Anim Sci 2025 Jan 4;103.
          doi: 10.1093/jas/skae368pubmed: 39656737google scholar: lookup
        6. Muñoz-Prieto A, Rubić I, Rešetar Maslov D, González-Sánchez JC, Mrljak V, Cerón JJ, Hansen S. Towards the Identification of New Biomarkers in Saliva and Serum for Treatment Monitoring of Equine Gastric Ulcer Syndrome: A Liquid Proteomic Approach. Animals (Basel) 2024 Oct 28;14(21).
          doi: 10.3390/ani14213105pubmed: 39518828google scholar: lookup
        7. Lovász L, Sommer-Trembo C, Barth JMI, Scasta JD, Grancharova-Hill R, Lemoine RT, Kerekes V, Merckling L, Bouskila A, Svenning JC, Fages A. Rewilded horses in European nature conservation - a genetics, ethics, and welfare perspective. Biol Rev Camb Philos Soc 2025 Feb;100(1):407-427.
          doi: 10.1111/brv.13146pubmed: 39279124google scholar: lookup
        8. Lashkari S, Beblein C, Christensen JW, Jensen SK. The effect of the fat to starch ratio in young horses' diet on plasma metabolites, muscle endurance and fear responses. J Anim Physiol Anim Nutr (Berl) 2025 Jan;109(1):113-123.
          doi: 10.1111/jpn.14037pubmed: 39163118google scholar: lookup
        9. Busechian S, Bindi F, Orvieto S, Zappulla F, Marchesi MC, Nisi I, Rueca F. Prevalence and Risk Factors for the Presence of Gastric Ulcers in Pleasure and Breeding Horses in Italy. Animals (Basel) 2024 Jun 17;14(12).
          doi: 10.3390/ani14121806pubmed: 38929425google scholar: lookup
        10. Tesena P, Vinijkumthorn R, Preuksathaporn T, Piyakul P, Chotikaprakal T, Sirireugwipas R, Wong-Aree K, Prapaiwan N. Evaluation of gastrointestinal tract lesions and serum malondialdehyde levels after repeated oral administration of phenylbutazone in horses. Vet Res Commun 2024 Aug;48(4):2343-2355.
          doi: 10.1007/s11259-024-10415-ypubmed: 38771448google scholar: lookup
        11. Luthersson N, Þorgrímsdóttir ÚÝ, Harris PA, Parkin T, Hopster-Iversen C, Bennet ED. Risk Factors for Equine Gastric Ulcer Syndrome Incidence in Adult Icelandic Riding Horses. Animals (Basel) 2023 Nov 14;13(22).
          doi: 10.3390/ani13223512pubmed: 38003130google scholar: lookup
        12. Alshut F, Venner M, Martinsson G, Vervuert I. The effects of feeding sodium chloride pellets on the gastric mucosa, acid-base, and mineral status in exercising horses. J Vet Intern Med 2023 Nov-Dec;37(6):2552-2561.
          doi: 10.1111/jvim.16851pubmed: 37776109google scholar: lookup
        13. Martin A, Lepers R, Vasseur M, Julliand S. Effect of high-starch or high-fibre diets on the energy metabolism and physical performance of horses during an 8-week training period. Front Physiol 2023;14:1213032.
          doi: 10.3389/fphys.2023.1213032pubmed: 37745248google scholar: lookup
        14. Kranenburg LC, van der Poel SH, Warmelink TS, van Doorn DA, van den Boom R. Changes in Management Lead to Improvement and Healing of Equine Squamous Gastric Disease. Animals (Basel) 2023 Apr 28;13(9).
          doi: 10.3390/ani13091498pubmed: 37174535google scholar: lookup
        15. Ermers C, McGilchrist N, Fenner K, Wilson B, McGreevy P. The Fibre Requirements of Horses and the Consequences and Causes of Failure to Meet Them. Animals (Basel) 2023 Apr 20;13(8).
          doi: 10.3390/ani13081414pubmed: 37106977google scholar: lookup
        16. Harvey AM, Ramp D, Mellor DJ. Review of the Foundational Knowledge Required for Assessing Horse Welfare. Animals (Basel) 2022 Dec 1;12(23).
          doi: 10.3390/ani12233385pubmed: 36496906google scholar: lookup
        17. Albanese V, Munsterman A, Klohnen A. Prevalence of Gastric Ulceration in Horses with Enterolithiasis Compared with Horses with Simple Large Intestinal Obstruction. Vet Sci 2022 Oct 25;9(11).
          doi: 10.3390/vetsci9110587pubmed: 36356064google scholar: lookup
        18. Colombino E, Raspa F, Perotti M, Bergero D, Vervuert I, Valle E, Capucchio MT. Gut health of horses: effects of high fibre vs high starch diet on histological and morphometrical parameters. BMC Vet Res 2022 Sep 8;18(1):338.
          doi: 10.1186/s12917-022-03433-ypubmed: 36076239google scholar: lookup
        19. Raspa F, Tarantola M, Muca E, Bergero D, Soglia D, Cavallini D, Vervuert I, Bordin C, De Palo P, Valle E. Does Feeding Management Make a Difference to Behavioural Activities and Welfare of Horses Reared for Meat Production?. Animals (Basel) 2022 Jul 6;12(14).
          doi: 10.3390/ani12141740pubmed: 35883287google scholar: lookup
        20. Hewetson M, Tallon R. Equine Squamous Gastric Disease: Prevalence, Impact and Management. Vet Med (Auckl) 2021;12:381-399.
          doi: 10.2147/VMRR.S235258pubmed: 35004264google scholar: lookup
        21. Lerch N, Cirulli F, Rochais C, Lesimple C, Guilbaud E, Contalbrigo L, Borgi M, Grandgeorge M, Hausberger M. Interest in Humans: Comparisons between Riding School Lesson Equids and Assisted-Intervention Equids. Animals (Basel) 2021 Aug 28;11(9).
          doi: 10.3390/ani11092533pubmed: 34573500google scholar: lookup
        22. Jansson A, Harris P, Davey SL, Luthersson N, Ragnarsson S, Ringmark S. Straw as an Alternative to Grass Forage in Horses-Effects on Post-Prandial Metabolic Profile, Energy Intake, Behaviour and Gastric Ulceration. Animals (Basel) 2021 Jul 24;11(8).
          doi: 10.3390/ani11082197pubmed: 34438656google scholar: lookup
        23. 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, Nakagawa Y, Nishihara Y, Taura Y. Effect of a novel rice fermented extract on gastric ulcers in horses. J Equine Sci 2021 Jun;32(2):27-30.
          doi: 10.1294/jes.32.27pubmed: 34220268google scholar: lookup
        24. Manteca Vilanova X, Beaver B, Uldahl M, Turner PV. Recommendations for Ensuring Good Welfare of Horses Used for Industrial Blood, Serum, or Urine Production. Animals (Basel) 2021 May 20;11(5).
          doi: 10.3390/ani11051466pubmed: 34065236google scholar: lookup
        25. Baumgartner M, Boisson T, Erhard MH, Zeitler-Feicht MH. Common Feeding Practices Pose A Risk to the Welfare of Horses When Kept on Non-Edible Bedding. Animals (Basel) 2020 Mar 2;10(3).
          doi: 10.3390/ani10030411pubmed: 32131415google scholar: lookup
        26. Gough S, Hallowell G, Rendle D. A study investigating the treatment of equine squamous gastric disease with long-acting injectable or oral omeprazole. Vet Med Sci 2020 May;6(2):235-241.
          doi: 10.1002/vms3.220pubmed: 31945806google scholar: lookup
        27. Glatter M, Borewicz K, van den Bogert B, Wensch-Dorendorf M, Bochnia M, Greef JM, Bachmann M, Smidt H, Breves G, Zeyner A. Modification of the equine gastrointestinal microbiota by Jerusalem artichoke meal supplementation. PLoS One 2019;14(8):e0220553.
          doi: 10.1371/journal.pone.0220553pubmed: 31393892google scholar: lookup
        28. Sykes BW, Bowen M, Habershon-Butcher JL, Green M, Hallowell GD. Management factors and clinical implications of glandular and squamous gastric disease in horses. J Vet Intern Med 2019 Jan;33(1):233-240.
          doi: 10.1111/jvim.15350pubmed: 30499188google scholar: lookup
        29. Banse HE, MacLeod H, Crosby C, Windeyer MC. Prevalence of and risk factors for equine glandular and squamous gastric disease in polo horses. Can Vet J 2018 Aug;59(8):880-884.
          pubmed: 30104780
        30. Mönki J, Hewetson M, Virtala AM. Risk Factors for Equine Gastric Glandular Disease: A Case-Control Study in a Finnish Referral Hospital Population. J Vet Intern Med 2016 Jul;30(4):1270-5.
          doi: 10.1111/jvim.14370pubmed: 27461724google scholar: lookup
        31. Vondran S, Venner M, Vervuert I. Effects of two alfalfa preparations with different particle sizes on the gastric mucosa in weanlings: alfalfa chaff versus alfalfa pellets. BMC Vet Res 2016 Jun 14;12(1):110.
          doi: 10.1186/s12917-016-0733-5pubmed: 27301323google scholar: lookup
        32. Sykes BW, Hewetson M, Hepburn RJ, Luthersson N, Tamzali Y. European College of Equine Internal Medicine Consensus Statement--Equine Gastric Ulcer Syndrome in Adult Horses. J Vet Intern Med 2015 Sep-Oct;29(5):1288-99.
          doi: 10.1111/jvim.13578pubmed: 26340142google scholar: lookup
        33. Sykes BW, Sykes KM, Hallowell GD. Administration of trimethoprim-sulphadimidine does not improve healing of glandular gastric ulceration in horses receiving omeprazole: a randomised, blinded, clinical study. BMC Vet Res 2014 Aug 23;10:180.
          doi: 10.1186/s12917-014-0180-0pubmed: 25927827google scholar: lookup
        34. Birkmann K, Junge HK, Maischberger E, Wehrli Eser M, Schwarzwald CC. Efficacy of omeprazole powder paste or enteric-coated formulation in healing of gastric ulcers in horses. J Vet Intern Med 2014 May-Jun;28(3):925-33.
          doi: 10.1111/jvim.12341pubmed: 24628650google scholar: lookup
        35. Hellings IR, Larsen S. ImproWin® in the treatment of gastric ulceration of the squamous mucosa in trotting racehorses. Acta Vet Scand 2014 Mar 13;56(1):13.
          doi: 10.1186/1751-0147-56-13pubmed: 24625291google scholar: lookup
        36. Niedźwiedź A, Kubiak K, Nicpoń J. Endoscopic findings of the stomach in pleasure horses in Poland. Acta Vet Scand 2013 Jun 7;55(1):45.
          doi: 10.1186/1751-0147-55-45pubmed: 24044656google scholar: lookup
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