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Sundra T, Gough S, Rossi G, Kelty E, Rendle D. Comparison of oral esomeprazole and oral omeprazole in the treatment of equine squamous gastric disease. Equine Vet J 2024; 56:952-958. [PMID: 37678812 DOI: 10.1111/evj.13997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 08/19/2023] [Indexed: 09/09/2023]
Abstract
BACKGROUND 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. OBJECTIVES To compare the efficacy and safety of oral esomeprazole and omeprazole pastes in the treatment of ESGD and, where present, concurrent equine glandular gastric disease (EGGD). STUDY DESIGN Randomised, single-blinded controlled trial. METHODS Horses presenting with grade ≥2 ESGD lesions were randomly allocated to receive 4 mg/kg of either a buffered esomeprazole or omeprazole paste orally once daily for 28 days before gastroscopy being repeated within a further 3 days. Videos and images were anonymised and subsequently graded blind by one researcher. The severity of ESGD (and EGGD) lesions before and after treatment, and thereby treatment responses, were compared using univariable logistic regression. RESULTS A higher proportion of horses had ESGD healing in response to esomeprazole treatment (63/74, 85%) than with omeprazole treatment (43/73, 59%) (odds ratio [OR]: 4.00, 95% confidence interval [CI]: 1.81, 8.82, p = 0.001). In a subset of horses that had concurrent EGGD, a greater proportion of the horses treated with esomeprazole had lesions ≤grade 1 (esomeprazole 28/51, 55%; omeprazole 6/24, 25%; OR: 3.65, 95% CI: 1.25, 10.71, p = 0.02) Using grade 0 as the benchmark for EGGD healing, the difference remained significant (OR: 4.44, 95% CI: 1.33, 14.85, p = 0.02). MAIN LIMITATIONS It may not be possible to extrapolate these results to other populations with different signalment or management. CONCLUSIONS Oral-buffered esomeprazole was a more effective treatment for ESGD (and concurrent EGGD) than oral-buffered omeprazole.
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Affiliation(s)
- Tania Sundra
- Avon Ridge Equine Veterinary Services, Brigadoon, Western Australia, Australia
| | - Sarah Gough
- Hunter Equine Centre, Scone, New South Wales, Australia
| | - Gabriele Rossi
- School of Veterinary and Biomedical Sciences, Murdoch University, Murdoch, Western Australia, Australia
| | - Erin Kelty
- School of Population and Global Health, The University of Western Australia, Crawley, Western Australia, Australia
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Muñoz-Prieto A, Llamas-Amor E, Cerón JJ, Hansen S. Changes in saliva analytes in equine gastric ulcer syndrome (EGUS) after treatment: a pilot study. Res Vet Sci 2024; 176:105346. [PMID: 38968646 DOI: 10.1016/j.rvsc.2024.105346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Revised: 05/21/2024] [Accepted: 06/30/2024] [Indexed: 07/07/2024]
Abstract
Equine gastric ulcer syndrome (EGUS) is a prevalent condition in horses, affecting up to 93% of racehorses. Comprising the equine squamous gastric disease (ESGD) and the equine glandular gastric disease (EGGD), EGUS poses significant health challenges. Saliva, a non-invasive and easily obtainable sample, is increasingly recognized for its potential as a source of biomarkers in horses. This study investigates changes in saliva analytes using automated assays before and after EGUS treatment, aiming to identify biomarkers indicative of treatment success or failure. A total of 28 horses diagnosed with EGUS were treatment with omeprazole for six weeks and further divided into successful (n = 15) or unsuccessful (n = 13) treatment group. Saliva samples were collected before and after treatment, and analytes related to enzymes, metabolites, proteins, redox biomarkers, and minerals were measured using an automated chemistry analyzer. Results revealed that horses with successful treatment, indicated by reduced EGGD and ESGD scores, showed significant increases in bicarbonate and urea, and decreases in adenosine deaminase (ADA), and creatine kinase (CK). Conversely, horses with non-successful treatment showed no significant changes in salivary analytes. These analytes have the advantages of an easy and fast measurement and the possibility of being applied in routine. Further studies with larger populations should be performed to establish the possible practical application of these analytes as biomarkers of treatment.
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Affiliation(s)
- Alberto Muñoz-Prieto
- Interdisciplinary Laboratory of Clinical Analysis (Interlab-UMU), Regional Campus of International Excellence 'Campus Mare Nostrum', University of Murcia, Campus de Espinardo s/n, 30100 Murcia, Spain.
| | - Eva Llamas-Amor
- Interdisciplinary Laboratory of Clinical Analysis (Interlab-UMU), Regional Campus of International Excellence 'Campus Mare Nostrum', University of Murcia, Campus de Espinardo s/n, 30100 Murcia, Spain.
| | - José Joaquín Cerón
- Interdisciplinary Laboratory of Clinical Analysis (Interlab-UMU), Regional Campus of International Excellence 'Campus Mare Nostrum', University of Murcia, Campus de Espinardo s/n, 30100 Murcia, Spain.
| | - Sanni Hansen
- Department of Veterinary Clinical Sciences, Section Medicine and Surgery, University of Copenhagen, Agrovej 8, 2630 Taastrup, Denmark.
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Campbell MLH, Sykes BW. Should the use of omeprazole be allowed during equestrian competition? Equine Vet J 2024. [PMID: 38994580 DOI: 10.1111/evj.14129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 06/05/2024] [Indexed: 07/13/2024]
Abstract
BACKGROUND Prioritising equine welfare, making evidenced-based policy, and consistent decision-making across sports are crucial to maintaining the social licence for equestrian sport. Regulations on the use of omeprazole during competition differ; all regulators argue that their rules prioritise welfare. This discrepancy is a matter of concern to the public and equestrian stakeholders. OBJECTIVES To apply Campbell's Ethical Framework for the use of Horses in Sport to the question: 'Should the use of omeprazole be allowed during equestrian competition?' STUDY DESIGN A desk-based ethico-legal study. METHODS Campbell's Ethical Framework for the Use of Horses in Sport was applied in a stepwise fashion: definition of the ethical question; analysis of the evidence base; consideration of stakeholders' interests; harm:benefit analysis; application of the three central tenets of the framework, and formulation of conclusions and recommendations. RESULTS Stakeholders in equine sports have a variety of (frequently conflicting) interests; all of them share an interest in optimising equine welfare. The incidence of EGUS in competition horses is high. Omeprazole is a cornerstone treatment. There are currently discrepancies in regulation about the use of omeprazole during competitions. Recent evidence suggests that withholding omeprazole treatment for two clear days before competition allows the recurrence of squamous EGUS, whereas withholding treatment on the day of competition only does not have that effect. MAIN LIMITATIONS The current state of scientific knowledge about the use of omeprazole in horses. The analysis did not consider possible health and thus welfare effects of the out-of-competition treatment with omeprazole. CONCLUSIONS Based on recent scientific evidence, if horses are being treated with omeprazole outside of competition then treatment on the day of competition should be permitted on welfare grounds. Revision of regulations around the use of omeprazole during competition by governing bodies is necessary to safeguard the ethical use of horses in sport.
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Affiliation(s)
| | - Benjamin W Sykes
- School of Veterinary Sciences, Massey University, Palmerston North, New Zealand
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Sundra T, Kelty E, Rendle D. Five- versus seven-day dosing intervals of extended-release injectable omeprazole in the treatment of equine squamous and glandular gastric disease. Equine Vet J 2024; 56:51-58. [PMID: 36977610 DOI: 10.1111/evj.13938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 03/23/2023] [Indexed: 03/30/2023]
Abstract
BACKGROUND An extended-release injectable omeprazole formulation (ERIO) has become a popular treatment for equine squamous gastric disease (ESGD) and equine glandular gastric disease (EGGD) where it is available; however, published data are limited and optimal treatment regimens have not been determined. OBJECTIVES To compare effects of treatment on ESGD and EGGD when an ERIO formulation is administered at either 5- or 7-day intervals. STUDY DESIGN Retrospective clinical study. METHODS Case records and gastroscopy images of horses with ESGD or EGGD treated with ERIO were reviewed. Images were anonymised and graded by one researcher masked to treatment group. Treatment responses were compared between the two treatment schedules using univariable ordered logistic regression. RESULTS Forty-three horses were treated with ERIO at 5-day intervals and 39 horses at 7-day intervals. Signalment and presenting signs did not differ between groups. The proportions of horses with EGGD healing (to grade 0 or 1) in association with ERIO used at 5-day intervals (93%) were higher than associated with treatment at 7-day intervals (69%; odds ratio [OR]: 2.41, 95% CI: 1.23-4.74, p = 0.01). For ESGD, there was no significant difference in the proportion of horses healing in association with treatment at 5-day intervals (97%) compared with 7-day intervals (82%; OR: 2.75, 95% CI: 0.91-8.31, p = 0.07). Four of 328 injections were associated with an injection-site reaction (1%). MAIN LIMITATIONS Retrospective study design, lack of randomisation and limited case numbers. CONCLUSIONS The use of ERIO at 5-day intervals might be more appropriate than the 7-day interval that is used currently.
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Affiliation(s)
- Tania Sundra
- Avon Ridge Equine Veterinary Services, Brigadoon, Western Australia, Australia
| | - Erin Kelty
- School of Population and Global Health, The University of Western Australia, Crawley, Western Australia, Australia
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Hammond A, Sage W, Hezzell M, Smith S, Franklin S, Allen K. Heart rate variability during high-speed treadmill exercise and recovery in Thoroughbred racehorses presented for poor performance. Equine Vet J 2023; 55:727-737. [PMID: 36537845 DOI: 10.1111/evj.13908] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 12/01/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Heart rate variability (HRV) analysis measures the inter-beat interval variation of successive cardiac cycles. Measurement of these indices has been used to assess cardiac autonomic modulation and for arrhythmia identification in exercising horses. OBJECTIVES To report HRV indices during submaximal exercise, strenuous exercise and recovery, and explore relationships with clinical conditions (arrhythmias, lameness, equine gastric ulcer syndrome [EGUS], lower airway inflammation and upper respiratory tract obstructions [URTOs]) in Thoroughbred racehorses. STUDY DESIGN Retrospective, observational cross-sectional study. METHODS One hundred and eighty Thoroughbred horses underwent a treadmill exercise test with simultaneous electrocardiographic recording. Time-domain HRV indices (standard deviation of the R-R interval [SDRR]; root mean square of successive differences [RMSSD]) were derived for submaximal and strenuous exercise and recovery segments. Clinical conditions (arrhythmia [during each phase of exercise], lameness, EGUS, lower airway inflammation and URTO) were assigned to binary categories for statistical analysis. Relationships between selected HRV indices and the clinical conditions were explored using linear regression models. RESULTS During submaximal exercise, lameness was associated with decreased logRMSSD (B = -0.19 95% confidence interval [CI] -0.31 to -0.06, p = 0.006) and arrhythmia was associated with increased logRMSSD (B = 0.31 95% CI 0.01-0.608, p = 0.04). During strenuous exercise, arrhythmia was associated with increased HRV indices (logSDRR B = 0.51 95% CI 0.40-0.62, p < 0.001; RMSSD B = 0.60 95% CI 0.49-0.72, p < 0.001). During recovery, arrhythmia was associated with increased HRV indices (logSDRR B = 0.51 95% CI 0.40-0.62, p < 0.001, logRMSSD B = 0.60 95% CI 0.49-0.72, p < 0.001). MAIN LIMITATIONS The main limitations of this retrospective study were that not every horse had the full range of clinical testing, therefore some horses may have had undetected abnormalities. CONCLUSIONS The presence of arrhythmia increased HRV in both phases of exercise and recovery. Lameness decreased HRV during submaximal exercise.
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Affiliation(s)
- Anna Hammond
- Bristol Veterinary School, University of Bristol, Bristol, UK
- Perth Equine Vets, Perth, UK
| | - William Sage
- Bristol Veterinary School, University of Bristol, Bristol, UK
| | - Melanie Hezzell
- Bristol Veterinary School, University of Bristol, Bristol, UK
| | - Sarah Smith
- Bristol Veterinary School, University of Bristol, Bristol, UK
- B&W Equine, Gloucestershire, UK
| | - Samantha Franklin
- School of Animal & Veterinary Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Kate Allen
- Bristol Veterinary School, University of Bristol, Bristol, UK
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Julliand S, Buttet M, Hermange T, Hillon P, Julliand V. Effect of diet composition on glandular gastric disease in horses. J Vet Intern Med 2023; 37:1528-1536. [PMID: 37264707 PMCID: PMC10365063 DOI: 10.1111/jvim.16747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 05/07/2023] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND Nutritional factors are suggested to influence the incidence and severity of glandular gastric disease (GGD) in horses. OBJECTIVES 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. ANIMALS 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 scored (0-4 severity scale) at day 0 (D0). Biochemical composition of the diet fed was compared between ulcerated and nonulcerated groups. After D0, horses either received the same diet (control, n = 41) or pelleted dehydrated alfalfa substituting 50% concentrates (alfalfa, n = 41). Glandular scores were recorded in both groups after 21 (D21) and 42 days (D42). The first end point was a successful outcome, defined as a horse with a glandular score of 2 to 4 on D0, decreasing to a score of 0 to 1 on days 21 or 42. RESULTS Horses scored 0 to 1 at D0 ingested more (P = .01) soluble sugars from concentrates than those scored 2 to 4 before D0 (77.5 g/kg BW; 95% confidence interval [CI]: 71.1-84.0, vs 59.1 g/kg BW; 95% CI: 48.0-70.3), whereas starch intake did not differ between groups (P = .24). Among horses scored 2 to 4 at D0, fewer were scored 2 to 4 in the alfalfa group (1 out of 6) compared with the control group (6 out of 6) at D42 (P = .02). Clinical success was 47.7 times more likely in horses fed alfalfa compared with horses in the control group (95% CI: 1.6-1422.8). CONCLUSION AND CLINICAL IMPORTANCE Relationships were found between diet composition and integrity of the glandular mucosa. Feeding pelleted dehydrated alfalfa could help to reduce the incidence and severity of GGD.
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Affiliation(s)
| | | | - Tanguy Hermange
- Centre Hospitalier Vétérinaire Equin de LivetLivarot‐Pays‐d'AugeFrance
| | - Patrick Hillon
- University of Bourgogne‐Franche ComtéDijonFrance
- INSERM U1231, Lipids, Nutrition, CancerDijonFrance
- Department of HepatogastroenterologyUniversity HospitalDijonFrance
| | - Véronique Julliand
- UMR PAM A 02.102DijonFrance
- University of Bourgogne‐Franche ComtéDijonFrance
- Agrosup DijonDijonFrance
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Busechian S, Conti MB, Sgorbini M, Conte G, Marchesi MC, Pieramati C, Zappulla F, Vitale V, Rueca F. A Comparison of the Efficacy of Two Omeprazole Formulations in the Treatment of Equine Gastric Ulcer Syndrome in Racehorses: A Blinded, Randomized Clinical Trial. J Equine Vet Sci 2023; 126:104296. [PMID: 37003396 DOI: 10.1016/j.jevs.2023.104296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 03/18/2023] [Accepted: 03/23/2023] [Indexed: 04/03/2023]
Abstract
Equine gastric ulcer syndrome (EGUS) is the most common disease of the stomach in horses and treatment is based on the oral administration of omeprazole for at least 28 days. Aim of this study was to compare the efficacy of two formulations of oral omeprazole-powder paste and gastro-enteric resistant granules-in the treatment of naturally occurring gastric ulcers in racehorses. Thirty-two adult racehorses, aged between 2 and 10 years old, with clinical signs of EGUS were included in this blinded, randomized clinical trial. Two gastroscopies were performed to evaluate gastric lesions in the squamous or glandular mucosa before and after 28 days of treatment. After the first gastroscopy, 2/32 horses were excluded because affected by equine squamous gastric disease (ESGD) 1/4. The remaining horses were divided into 4 groups, and were treated with 2 formulations of omeprazole (gastroenteric resistant granules, group 1, or powder paste, group 3) or with 2 placebo formulations (granules, group 2, or paste, group 4). Treatments were performed in the placebo horses affected by ESGD or equine glandular gastric disease after the T28 gastroscopy control. No differences were found between groups at T0. Differences were found between T0 vs. T28 for granular (P = .002) and powder paste (P = .01) formulations. No differences were detected between the two groups receiving omeprazole formulations at T28 (0.34) and between T0 vs. T28 for either of the groups receiving placebo treatments. For all the variables, the size of the effect was greater than 0.5, proving that the treatments had a considerable effect. Gastro-enteric resistant granules and powder paste omeprazole showed similar efficacy in the treatment of ESGD. The glandular mucosa responded poorly to treatment with omeprazole.
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Affiliation(s)
| | | | | | - Giuseppe Conte
- Department of Agricultural, Food and Agro-Environmental Sciences, Pisa, Italy
| | | | | | | | - Valentina Vitale
- Department of animal medicine and surgery, Veterinary teaching Hospital, University CEU Cardenal Herrera, C/ Santiago Ramón y Cajal, Valencia, Spain
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8
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Shan R, Steel CM, Sykes B. The Impact of Two Recommended Withholding Periods for Omeprazole and the Use of a Nutraceutical Supplement on Recurrence of Equine Gastric Ulcer Syndrome in Thoroughbred Racehorses. Animals (Basel) 2023; 13:1823. [PMID: 37889700 PMCID: PMC10251805 DOI: 10.3390/ani13111823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 05/25/2023] [Accepted: 05/26/2023] [Indexed: 10/29/2023] Open
Abstract
The impact of recommended withholding periods (RWPs) for omeprazole on the recurrence of Equine Gastric Ulcer Syndrome (EGUS) is unknown. The study was designed to compare the effect of two RWPs on EGUS recurrence post-omeprazole treatment and to determine if a nutraceutical supplement would reduce EGUS recurrence when administrated during an RWP. The study was a blinded, randomized clinical trial. Part 1: Horses were allocated to an RWP0 or RWP2 and crossed over after 4-weeks. Horses received oral omeprazole once daily, except during the RWPs at the end of the treatment periods. Part 2: Horses received omeprazole for 21 days prior to an RWP2 during which they received a nutraceutical supplement. Gastroscopy was performed on Day 0 and pre- and post- RWP. Part 1: More horses were affected by Equine Squamous Gastric Disease (ESGD) after the '2-clear-days' RWP than the 'not on race-day' RWP (p = 0.012). The prevalence of ESGD post-RWP for '2-clear-days' did not differ from day 0 (p = 0.478). Part 2: The prevalence of ESGD post-RWP was lower than on Day 0 (p = 0.046). A difference in recurrence of ESGD was present between the two common RWPs. The implications of this on the welfare of Thoroughbred racehorses warrant further discussion.
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Affiliation(s)
- Ran Shan
- Department of Veterinary Clinical Services, The Hong Kong Jockey Club, Conghua Racecourse, Guangzhou 510900, China
| | - Catherine M. Steel
- Department of Veterinary Clinical Services, The Hong Kong Jockey Club, Conghua Racecourse, Guangzhou 510900, China
| | - Ben Sykes
- School of Veterinary Sciences, Massey University, Private Bag, 11-222, Palmerston North 4442, New Zealand
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Ferlini Agne G, May BE, Lovett A, Simon O, Steel C, Santos L, Guedes do Carmo L, Barbosa B, Werner LC, Daros RR, Somogyi AA, Sykes B, Franklin S. Horse Grimace Scale Does Not Detect Pain in Horses with Equine Gastric Ulcer Syndrome. Animals (Basel) 2023; 13:1623. [PMID: 37238054 PMCID: PMC10215503 DOI: 10.3390/ani13101623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/05/2023] [Accepted: 04/27/2023] [Indexed: 05/28/2023] Open
Abstract
Equine gastric ulcer syndrome (EGUS) is a highly prevalent and presumptively painful condition, although the amount of pain horses might experience is currently unknown. The aims of this study were to determine if the Horse Grimace Scale (HGS) could identify pain behaviours in horses with and without EGUS and if severity would be positively associated with the HGS score. Horse grimace scale scores were assessed blindly using facial photographs by seven observers and involved evaluation of 6 facial action units as 0 (not present), 1 (moderately present) and 2 (obviously present). Lameness examination, serum amyloid A (SAA) measurement and gastroscopy evaluation were performed on all horses. Horses (n = 61) were divided into two and three groups based on the presence (yes, no) and severity (none, mild, moderate-severe) of EGUS, respectively. Presence of lameness and elevated SAA (≥50 µg/mL) were used as exclusion criteria. Inter-observer reliability was analyzed by intra-class correlation coefficients (ICC). HGS scores between groups were compared using Welch's and Brown Forsythe tests (p < 0.05). Overall, HGS ICC was "excellent" (0.75). No significant differences (p = 0.566) were observed in HGS scores between horses with and without gastric lesions (mean, 95% CI; 3.36, 2.76-3.95 and 3, 1.79-4.20, respectively). HGS was not influenced by the presence or severity of EGUS in this current study. Further studies investigating the use of different pain scales in horses with EGUS are needed.
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Affiliation(s)
- Gustavo Ferlini Agne
- School of Animal and Veterinary Sciences, University of Adelaide, Roseworthy Campus, Adelaide, SA 5371, Australia
| | - Bridget Eileen May
- School of Animal and Veterinary Sciences, University of Adelaide, Roseworthy Campus, Adelaide, SA 5371, Australia
| | - Amy Lovett
- School of Veterinary Medicine, Massey University, Palmerston North 4474, New Zealand
| | - Olivier Simon
- School of Animal and Veterinary Sciences, University of Adelaide, Roseworthy Campus, Adelaide, SA 5371, Australia
| | - Catherine Steel
- Department of Veterinary Clinical Services, Hong Kong Jockey Club, Sha Tin Racecourse, New Territories, Hong Kong
| | - Luiz Santos
- School of Biodiversity, One Health and Veterinary Sciences, The University of Glasgow, Bearsden, Glasgow G12 8QQ, UK
| | - Laize Guedes do Carmo
- Graduate Program in Animal Science, School of Medicine and Life Sciences, Pontifícia Universidade Católica do Paraná, Curitiba 80215-901, Brazil
| | - Bianca Barbosa
- Graduate Program in Animal Science, School of Medicine and Life Sciences, Pontifícia Universidade Católica do Paraná, Curitiba 80215-901, Brazil
| | - Laís Cristine Werner
- Graduate Program in Animal Science, School of Medicine and Life Sciences, Pontifícia Universidade Católica do Paraná, Curitiba 80215-901, Brazil
| | - Ruan R. Daros
- Graduate Program in Animal Science, School of Medicine and Life Sciences, Pontifícia Universidade Católica do Paraná, Curitiba 80215-901, Brazil
| | - Andrew A. Somogyi
- Discipline of Pharmacology, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA 5005, Australia
| | - Benjamin Sykes
- School of Veterinary Medicine, Massey University, Palmerston North 4474, New Zealand
| | - Samantha Franklin
- School of Animal and Veterinary Sciences, University of Adelaide, Roseworthy Campus, Adelaide, SA 5371, Australia
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10
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Barton MH, Hallowell GD. Current Topics in Medical Colic. Vet Clin North Am Equine Pract 2023:S0749-0739(23)00020-2. [PMID: 37169621 DOI: 10.1016/j.cveq.2023.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023] Open
Abstract
The list of medical causes of acute or chronic colic in horses is extensive. The purpose of this article is to review 4 medical causes of equine colic with a focus on newer trends in treatment. The 4 topics selected include gastric impaction, gastric glandular disease, colon displacement, and inflammatory bowel disease.
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Affiliation(s)
- Michelle Henry Barton
- College of Veterinary Medicine, University of Georgia, 2200 College Station Road, Room 1903, Athens, GA 30602, USA.
| | - Gayle D Hallowell
- IVC Evidensia, Valley View, Main Road, Upper Broughton, Nottinghamshire, UK LE14 3BG
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11
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Pratt SL, Bowen M, Hallowell GH, Shipman E, Bailey J, Redpath A. Does lesion type or severity predict outcome of therapy for horses with equine glandular gastric disease? - A retrospective study. Vet Med Sci 2022; 9:150-157. [PMID: 36495212 PMCID: PMC9857143 DOI: 10.1002/vms3.1034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Equine glandular gastric disease (EGGD) is a common condition of the horse. Misoprostol is reported to be superior to oral omeprazole and sucralfate for treatment. Long-acting intramuscular injectable omeprazole (LAIOMEP) is a novel treatment shown to be effective in a small population. OBJECTIVES This study aimed to determine LAIOMEP efficacy compared to misoprostol and oral omeprazole and identify characteristics that predict treatment outcome. METHODS All horses that underwent gastroscopy between 2012 and 2019 were reviewed. Lesions were characterised by 4 blinded observers, all of whom are diplomates in equine internal medicine, using established descriptors from the ECEIM consensus statement and subjective severity. Treatment outcome was ranked as worsened, improved or healed. Consensus lesion type, lesion severity and treatment choice were compared to outcome and data screened using univariate analysis (chi-squared) to determine whether each predicted outcome. Lesion types where univariate analysis predicted a trend (p<0.2) were included in a multiple-regression analysis to identify predictors of outcome irrespective of treatment. RESULTS Only severity significantly predicted final outcome (p = 0.025) with severe lesions being more likely to improve. Treatment choice did not significantly predict outcome. Overall healing rate was 29% (24 horses), and 43% (44 horses) improved. Treatment healing rates were 23% (10), 12% (7) and 27% (7) for LAIOMEP, misoprostol and oral omeprazole, respectively, with improvement in 69% (14), 76% (21) and 61% (9). 64% of the latter group received sucralfate. Worsening occurred in 7% (6). Treatment length varied with a median of 4 weeks (range 4-20 weeks). CONCLUSIONS This study showed poorer therapy outcome compared to previous studies. The only initial lesion descriptor to predict outcome was severity and treatment choice did not affect outcome.
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Affiliation(s)
- S. L. Pratt
- School of Veterinary Medicine and ScienceUniversity of NottinghamSutton BonningtonUK
| | | | | | - E. Shipman
- School of Veterinary Medicine and ScienceUniversity of NottinghamSutton BonningtonUK
| | - J. Bailey
- School of Veterinary Medicine and ScienceUniversity of NottinghamSutton BonningtonUK
| | - A. Redpath
- School of Veterinary Medicine and ScienceUniversity of NottinghamSutton BonningtonUK
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Pratt S, Bowen I, Hallowell G, Shipman E, Redpath A. Assessment of agreement using the equine glandular gastric disease grading system in 84 cases. Vet Med Sci 2022; 8:1472-1477. [PMID: 35412651 PMCID: PMC9297748 DOI: 10.1002/vms3.807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Introduction Equine glandular gastric disease (EGGD) is a common condition causing signs of gastric pain although lesions are highly variable in their appearance. The only definitive method to diagnose EGGD ante‐mortem is gastroscopy. The current recommended method for describing these lesions is the European College of Equine Internal Medicine (ECEIM) guidelines; however, repeatability between users is variable. This study aimed to validate the reliability of lesion descriptions using ECEIM consensus guidelines, using four blinded equine internal medicine diplomates. Methods Ninety‐two horses with EGGD with pre‐ and post‐treatment gastroscopy images were identified using the electronic record at a UK equine hospital between 2012 and 2019. Eight horses were excluded due to non‐diagnostic images. Four blinded observers used the recommended grading system to describe images and outcomes. Intraclass correlation coefficients and Krippendorff's alpha were used to determine reliability and agreement, respectively. Results Intraclass correlation coefficient for severity was 0.782 (95% confidence interval [CI] 0.722–0.832), for distribution was 0.671 (95% CI 0.540–0.763), for the descriptor raised was 0.635 (95% CI 0.479–0.741), fibrinosuppurative was 0.745 (95% CI 0.651–0.812), haemorrhagic was 0.648 (95% CI 0.513–0.744), hyperaemic was 0.389 (95% CI 0.232–0.522) and for outcome was 0.677 (95% CI 0.559–0.770). Krippendorff's alpha for severity was 0.466 (95% CI 0.466–0.418), for distribution was 0.304 (95% CI 0.234–0.374), for the descriptor raised was 0.268 (95% CI 0.207–0.329), fibrinosuppurative was 0.406 (95% CI 0.347–0.463), haemorrhagic was 0.287 (95% CI 0.229–0.344), hyperaemic was 0.112 (95% CI 0.034–0.188) and for outcome was 0.315 (95% CI 0.218–0.408). There was moderate reliability determined between observers using intra‐class correlation coefficients and unacceptable agreement determined between observers using Krippendorff's alpha. Discussion These results suggest that the current grading system is not comparable between observers, indicating the need to review the grading system or define more robust criteria.
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Affiliation(s)
- Stefanie Pratt
- School of Veterinary Medicine and Science, University of Nottingham, Nottingham, UK
| | - Ian Bowen
- School of Veterinary Medicine and Science, University of Nottingham, Nottingham, UK
| | - Gayle Hallowell
- School of Veterinary Medicine and Science, University of Nottingham, Nottingham, UK
| | - Emma Shipman
- School of Veterinary Medicine and Science, University of Nottingham, Nottingham, UK
| | - Adam Redpath
- School of Veterinary Medicine and Science, University of Nottingham, Nottingham, UK
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13
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Equine gastric ulcer syndrome in adult horses. Vet J 2022; 283-284:105830. [DOI: 10.1016/j.tvjl.2022.105830] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 03/01/2022] [Accepted: 04/21/2022] [Indexed: 01/10/2023]
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14
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Gough S, Hallowell G, Rendle D. Evaluation of the treatment of equine glandular gastric disease with either long-acting-injectable or oral omeprazole. Vet Med Sci 2022; 8:561-567. [PMID: 35167731 PMCID: PMC8959258 DOI: 10.1002/vms3.728] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Background Equine glandular gastric disease (EGGD) is common in domesticated horses and can be challenging to treat. Oral omeprazole (ORLO) is used widely but the clinical response is frequently poor. Objectives To compare rates of EGGD healing and improvement between ORLO and a long‐acting injectable omeprazole preparation (LAIO). Study design Retrospective clinical study. Methods The case records and gastroscopy images of horses presenting to masked for peer review over a 12‐month period were reviewed, with images blindly assessed by one of the authors. Treatment responses to 4 mg/kg LAIO administered every 7 days for 2 and 4 weeks were compared with ORLO 4 mg/kg PO q24hrs for 4 weeks. Data were compared using a Mann‐Whitney U test with post‐hoc Dunn's test, Chi‐squared test and a Fisher's exact test. Results Thirty‐three horses that received LAIO and 12 that received ORLO were identified. Nine horses in the LAIO had received other treatments previously. The groups were comparable in signalment and EGGD lesion severity. Long‐acting injectable omeprazole was found to be non‐inferior to ORLO. LAIO was associated with better healing rates than ORLO at 4 weeks (LAIO‐80%; ORLO‐42%; p = 0.02), and reduction in lesion severity at 2 and 4 weeks in the LAIO group but not in the ORLO group at 4 weeks. Eighteen percent of horses in the LAIO group and 50% in the ORLO group did not heal at 4 weeks. There was no association between rate of healing or improvement and resolution or improvement of clinical signs. Six localised and self‐limiting injection site reactions were identified in 4 horses treated with LAIO (6.7%). Main limitations Retrospective design, small numbers and the use of other treatments prior to use of LAIO. Conclusions LAIO was found to be non‐inferior to oral omeprazole for EGGD. Larger blinded randomised clinical trials are justified. Equine glandular gastric disease (EGGD) is common in domesticated horses and can be challenging to treat. Long‐acting injectable omeprazole was found to be non‐inferior to ORLO. LAIO was associated with better healing rates than ORLO at 4 weeks (LAIO‐80%; ORLO‐42%; p = 0.02), and reduction in lesion severity at 2 and 4 weeks in the LAIO group but not in the ORLO group at 4 weeks.
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Affiliation(s)
- Sarah Gough
- Rainbow Equine Hospital, Malton, North Yorkshire, YO17 6SG
| | - Gayle Hallowell
- School of Veterinary Medicine and Science, University of Nottingham, Nottingham, United Kingdom
| | - David Rendle
- Rainbow Equine Hospital, Malton, North Yorkshire, YO17 6SG
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15
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Phytotherapy compared to omeprazol therapy in equine gastric ulcers. ACTA VET BRNO 2022. [DOI: 10.2754/avb202291040309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The aim of this study was to offer an alternative therapy for gastric ulcers in horses as the interest in natural products is growing not only among practicioners but also horse owners. We compared the treatment of equine gastric squamous mucosa ulcers by omeprazol and by nutraceutical herbal mixture PREVUL (Dzsar Ltd., FitoCavallo, Hungary). A total of 36 horses, 18 geldings, 15 non-pregnant mares and 3 stallions were diagnosed with Equine Squamous Gastric Disease (ESGD) by gastroscopy. Horses were randomly divided into three groups. The first group was treated with 4 mg/kg omeprazole paste (Peptizole, Norbrook, United Kingdom) per os once daily on empty stomach for 28 days. The second group received 20 g of pulverized herbal mixture PREVUL twice daily in cracked oats for 28 days. The third experimental group received 2 mg/kg omeprazole per os once daily on empty stomach followed by 15 g of PREVUL mixed with cracked oats twice daily for 28 days. Ten healthy horses were used as control to evaluate the palatability and voluntary intake of PREVUL. Control gastroscopy was performed afted 30 days. The use of PREVUL alone P < 0.05 or in combination with omeprazole paste P < 0.01 appears to improve the healing of gastric ulcers in horses.
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16
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Hwang H, Dong HJ, Han J, Cho S, Kim Y, Lee I. Prevalence and treatment of gastric ulcers in Thoroughbred racehorses of Korea. J Vet Sci 2022; 23:e19. [PMID: 35187877 PMCID: PMC8977533 DOI: 10.4142/jvs.21247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 10/20/2021] [Accepted: 12/07/2021] [Indexed: 12/03/2022] Open
Abstract
Background 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. Objectives 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 gastroscopy was performed within two days after racing. Twelve horses with a sum grade of five or higher were randomly assigned to two treatment groups. Seven horses were administered ranitidine, and five horses were administered omeprazole. Follow-up gastroscopy was scheduled within one to five days after finishing the treatment. Results The prevalence of gastric ulcer in Korean Thoroughbred racehorses after racing was 100%, and the grade was more severe in the non-glandular region than in the pyloric region. There was no correlation between the severity of gastric ulcer in the two regions. Omeprazole had a greater therapeutic effect than ranitidine. Conclusions This study shows the importance of recognizing gastric ulcers as an important factor, and omeprazole as a possible treatment option in Korea, as it has been removed from the list of prohibited substances for racehorses. Thus, the use of omeprazole is currently recommended until one day before the race.
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Affiliation(s)
- Hyeshin Hwang
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Seoul National University, Seoul 08826, Korea
| | - Hee-Jin Dong
- Department of Veterinary Pathobiology and Preventive Medicine, BK21 PLUS Program for Creative Veterinary Science Research, Research Institute for Veterinary Science and College of Veterinary Medicine, Seoul National University, Seoul 08826, Korea
| | - Janet Han
- College of Veterinary Medicine, Western University of Health Sciences, Pomona, CA 91766, USA
| | - Seongbeom Cho
- Department of Veterinary Pathobiology and Preventive Medicine, BK21 PLUS Program for Creative Veterinary Science Research, Research Institute for Veterinary Science and College of Veterinary Medicine, Seoul National University, Seoul 08826, Korea
| | - Yongbaek Kim
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Seoul National University, Seoul 08826, Korea
| | - Inhyung Lee
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Seoul National University, Seoul 08826, Korea
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Hewetson M, Tallon R. Equine Squamous Gastric Disease: Prevalence, Impact and Management. VETERINARY MEDICINE (AUCKLAND, N.Z.) 2021; 12:381-399. [PMID: 35004264 PMCID: PMC8725839 DOI: 10.2147/vmrr.s235258] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 12/07/2021] [Indexed: 12/12/2022]
Abstract
This narrative review explores the etiopathogenesis, clinical signs, diagnosis and treatment of ESGD (equine squamous gastric disease) and discusses the impact of this commonly encountered condition on the equine industry. ESGD refers specifically to peptic injury of the squamous mucosa of the stomach. Prevalence is highest in performance horses, but the disease has been documented across many breeds and ages, including in feral horses and foals. The pathogenesis of ESGD is well understood. Intensive management and exercise are important factors that contribute to a disruption of the normal stratification of gastric pH. This results in exposure of the vulnerable squamous mucosa to acid, leading to ulceration. Clinical signs are variable and there is little evidence to support a direct association between reported signs and the presence or absence of lesions seen on gastroscopy. Management is aimed at acid suppression and mitigation of known risk factors.
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Affiliation(s)
- Michael Hewetson
- Department of Clinical Science and Services, The Royal Veterinary College, North Mymms, Hertfordshire, UK
| | - Rose Tallon
- Department of Clinical Science and Services, The Royal Veterinary College, North Mymms, Hertfordshire, UK
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18
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Bishop RC, Kemper AM, Wilkins PA, McCoy AM. Effect of omeprazole and sucralfate on gastrointestinal injury in a fasting/NSAID model. Equine Vet J 2021; 54:829-837. [PMID: 34719063 DOI: 10.1111/evj.13534] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 09/10/2021] [Accepted: 10/18/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Equine gastric ulcer syndrome (EGUS) is a common and significant cause of morbidity in horses, with a range of clinical signs, including inappetence, colic and poor performance. Hospitalised horses are exposed to factors that may induce EGUS, including fasting and nonsteroidal anti-inflammatory drug (NSAID) administration, and may be at risk for development of squamous (ESGD) and glandular gastric disease (EGGD). Prophylactic anti-ulcer medication is often prescribed for these patients, but drug selection is complicated by different aetiology and response to treatment of ESGD and EGGD. OBJECTIVES To establish the efficacy of sucralfate or omeprazole used prophylactically in horses exposed to a combined feed-fast and NSAID administration EGUS induction protocol. We hypothesised that these drugs would be equally effective for prevention of gastric lesions in the experimental cohort. STUDY DESIGN Randomised crossover experimental design. METHODS Horses (n = 14) received either omeprazole (1 mg/kg PO q24h) or sucralfate (20 mg/kg PO q8h) while undergoing the feed-fast/NSAID protocol, allowed an 8-week washout period, and then administered the alternate treatment. Serial gastroscopy, ultrasound and haematology documented treatment effects. RESULTS ESGD and EGGD score increased over time under both treatments. There was a significant effect of treatment on EGGD scores (P < .001), with post-treatment EGGD scores higher for horses receiving sucralfate (median 3; IQR 2.25,3) than omeprazole (1; 1,1). The effect of treatment on ESGD scores just achieved significance (P = .05), with post-treatment ESGD scores higher for sucralfate (4; 3,4) than omeprazole (2; 2,3). MAIN LIMITATIONS This study was performed in healthy horses, and response to treatment may differ in horses with clinical illness. Additional investigation in a larger population may be required to detect significant differences in other clinical parameters. CONCLUSIONS Omeprazole was superior to sucralfate for mitigating gastric lesion severity in healthy horses exposed to a feed-fast/NSAID model.
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Affiliation(s)
- Rebecca C Bishop
- Department of Veterinary Clinical Medicine, University of Illinois, Urbana, Illinois, USA
| | - Ann M Kemper
- Department of Veterinary Clinical Medicine, University of Illinois, Urbana, Illinois, USA
| | - Pamela A Wilkins
- Department of Veterinary Clinical Medicine, University of Illinois, Urbana, Illinois, USA
| | - Annette M McCoy
- Department of Veterinary Clinical Medicine, University of Illinois, Urbana, Illinois, USA
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19
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Lehman ML, Bass L, Gustafson DL, Rao S, O’Fallon ES. Clinical efficacy, safety and pharmacokinetics of a novel long‐acting intramuscular omeprazole in performance horses with gastric ulcers. EQUINE VET EDUC 2021. [DOI: 10.1111/eve.13546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- M. L. Lehman
- Department of Clinical Sciences Colorado State University College of Veterinary Medicine and Biomedical Sciences Fort Collins Colorado USA
| | - L. Bass
- Department of Clinical Sciences Colorado State University College of Veterinary Medicine and Biomedical Sciences Fort Collins Colorado USA
| | - D. L. Gustafson
- Department of Clinical Sciences Colorado State University College of Veterinary Medicine and Biomedical Sciences Fort Collins Colorado USA
| | - S. Rao
- Department of Clinical Sciences Colorado State University College of Veterinary Medicine and Biomedical Sciences Fort Collins Colorado USA
| | - E. S. O’Fallon
- Department of Clinical Sciences Colorado State University College of Veterinary Medicine and Biomedical Sciences Fort Collins Colorado USA
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20
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Paul LJ, Ericsson AC, Andrews FM, Keowen ML, Morales Yniguez F, Garza F, Banse HE. Gastric microbiome in horses with and without equine glandular gastric disease. J Vet Intern Med 2021; 35:2458-2464. [PMID: 34351018 PMCID: PMC8478018 DOI: 10.1111/jvim.16241] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 07/23/2021] [Accepted: 07/27/2021] [Indexed: 01/04/2023] Open
Abstract
Background The role of the gastric microbiome in development or persistence of equine glandular gastric disease (EGGD) remains to be investigated. Hypothesis/Objectives The objective was to characterize the glandular mucosal and gastric fluid microbiomes of horses with and without EGGD. It was hypothesized that differences in the mucosal microbiome are associated with EGGD. Animals Twenty‐four horses were enrolled. Methods Gastroscopy was performed and EGGD scores recorded (score 0, n = 6; score 1, n = 8; score ≥2, n = 10). Gastric fluid and pinch biopsies of healthy glandular mucosa and EGGD lesions were collected via gastroscope. 16S rRNA amplicon sequencing of the gastric fluid and glandular mucosal biopsies was performed. Relationships between gastric fluid and mucosal microbial community composition were evaluated among EGGD score groups (EGGD 0‐BX, EGGD 1‐BX, EGGD ≥2‐BX) and among endoscopic appearances: controls from horses without EGGD and normal areas, hyperemic areas, and lesions from horses with EGGD. Results Microbial community structure of mucosal biopsies differed among EGGD score groups (Jaccard similarity index; P = .009). Principal coordinate analysis showed separate clusters for EGGD 0‐BX and EGGD ≥2‐BX. Conclusions and Clinical Importance A modest difference was detected in the community structure of the gastric glandular mucosal microbiome in association with EGGD score.
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Affiliation(s)
- Linda J Paul
- Louisiana State University, Veterinary Clinical Sciences, Equine Health Studies Program, Baton Rouge, Louisiana, USA
| | - Aaron C Ericsson
- Metagenomics Center, Equine Gut Group, University of Missouri, Columbia, Missouri, USA
| | - Frank M Andrews
- Louisiana State University, Veterinary Clinical Sciences, Equine Health Studies Program, Baton Rouge, Louisiana, USA
| | - Michael L Keowen
- Louisiana State University, Veterinary Clinical Sciences, Equine Health Studies Program, Baton Rouge, Louisiana, USA
| | - Francisco Morales Yniguez
- Louisiana State University, Veterinary Clinical Sciences, Equine Health Studies Program, Baton Rouge, Louisiana, USA
| | - Frank Garza
- Louisiana State University, Veterinary Clinical Sciences, Equine Health Studies Program, Baton Rouge, Louisiana, USA
| | - Heidi E Banse
- Louisiana State University, Veterinary Clinical Sciences, Equine Health Studies Program, Baton Rouge, Louisiana, USA
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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; 32:27-30. [PMID: 34220268 PMCID: PMC8240527 DOI: 10.1294/jes.32.27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 03/31/2021] [Indexed: 11/05/2022] Open
Abstract
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; minimum, 1) than before
administration (median, 4; maximum, 4; minimum, 3) in the rice fermented extract group
(P<0.05). In conclusion, the administration of a rice fermented extract for one month
improves gastric mucosal lesions in Thoroughbreds with gastric ulcers.
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Affiliation(s)
- Naoki Sasaki
- Department of Clinical Veterinary Science, Joint Faculty of Veterinary Medicine, Yamaguchi University, Yamaguchi 753-8515, Japan
| | - Yasunobu Nishi
- Department of Clinical Veterinary Science, Joint Faculty of Veterinary Medicine, Yamaguchi University, Yamaguchi 753-8515, Japan
| | - Yumi Fujiwara
- Department of Clinical Veterinary Science, Joint Faculty of Veterinary Medicine, Yamaguchi University, Yamaguchi 753-8515, Japan
| | - Tetsuya Takeyama
- Department of Clinical Veterinary Science, Joint Faculty of Veterinary Medicine, Yamaguchi University, Yamaguchi 753-8515, Japan
| | - Hayata Kumagai
- Department of Clinical Veterinary Science, Joint Faculty of Veterinary Medicine, Yamaguchi University, Yamaguchi 753-8515, Japan
| | - Samantha Senarathna
- Department of Clinical Veterinary Science, Joint Faculty of Veterinary Medicine, Yamaguchi University, Yamaguchi 753-8515, Japan
| | | | | | | | | | | | | | | | | | | | - Yasuho Taura
- Department of Clinical Veterinary Science, Joint Faculty of Veterinary Medicine, Yamaguchi University, Yamaguchi 753-8515, Japan
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Hewetson M. Managing glandular gastric disease in horses. IN PRACTICE 2021. [DOI: 10.1002/inpr.40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Wise JC, Hughes KJ, Edwards S, Jacobson GA, Narkowicz CK, Raidal SL. Pharmacokinetic and pharmacodynamic effects of 2 registered omeprazole preparations and varying dose rates in horses. J Vet Intern Med 2020; 35:620-631. [PMID: 33340169 PMCID: PMC7848319 DOI: 10.1111/jvim.15971] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 11/02/2020] [Accepted: 11/10/2020] [Indexed: 12/02/2022] Open
Abstract
Background Omeprazole preparations vary in bioavailability in horses. Hypothesis/Objectives 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). Animals 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 larger dose administered, Cmax (median, 1032 ng/mL; range, 576‐1766) and AUC0‐24 (median, 63.9 μg/mL*min; range, 42.4‐152.4) were greater after single oral administration of NOV than REF (282.7 ng/mL; range, 94.8‐390.2, and 319 23.8 μg/mL*min; range, 8.2‐42.3, respectively; both P = .004). No differences were observed between products for absolute oral bioavailability (NOV 55% range, 15‐88; REF 17% range, 10‐77; P = .25). Treatment with both preparations was associated with reduced gastric squamous ulcer scores and increased pH of gastric fluid. Bioequivalence was demonstrated for pharmacodynamic measures with the exception of % time pH <4, despite differences in dose rate and subsequent plasma omeprazole concentrations. Conclusions and Clinical Importance The findings of this study indicate that the NOV product would be a suitable alternative to the reference product, and confirm that plasma concentrations of omeprazole and omeprazole dose do not predict drug pharmacodynamics in horses.
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Affiliation(s)
- Jessica C Wise
- School of Animal and Veterinary Sciences, Charles Sturt University, Wagga Wagga, New South Wales, Australia
| | - Kristopher J Hughes
- School of Animal and Veterinary Sciences, Charles Sturt University, Wagga Wagga, New South Wales, Australia
| | - Scott Edwards
- School of Animal and Veterinary Sciences, Charles Sturt University, Wagga Wagga, New South Wales, Australia
| | - Glenn A Jacobson
- School of Pharmacy and Pharmacology, University of Tasmania, Hobart, Tasmania, Australia
| | - Christian K Narkowicz
- School of Pharmacy and Pharmacology, University of Tasmania, Hobart, Tasmania, Australia
| | - Sharanne L Raidal
- School of Animal and Veterinary Sciences, Charles Sturt University, Wagga Wagga, New South Wales, Australia
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24
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Wise JC, Wilkes EJA, Raidal SL, Xie G, Crosby DE, Hale JN, Hughes KJ. Interobserver and intraobserver reliability for 2 grading systems for gastric ulcer syndrome in horses. J Vet Intern Med 2020; 35:571-579. [PMID: 33284465 PMCID: PMC7848314 DOI: 10.1111/jvim.15987] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 11/12/2020] [Accepted: 11/20/2020] [Indexed: 11/29/2022] Open
Abstract
Background Grading of equine gastric ulcer syndrome (EGUS) is undertaken in clinical and research settings, but the reliability of EGUS grading systems is poorly understood. Hypothesis/Objectives Investigate interobserver and intraobserver reliability of an established ordinal grading system and a novel visual analog scale (VAS), and assess the influence of observer experience. Animals Sixty deidentified gastroscopy videos. Methods Six observers (3 specialists and 3 residents) graded videos using the EGUS Council (EGUC) system and VAS. Observers graded the videos three 3 for each system, using a cross‐over design with at least 1 week between each phase. The order of videos was randomized for each phase. Methods Interobserver and intraobserver reliability were estimated using Gwet's agreement coefficient with ordinal weights applied (AC2) for the EGUC system and the intraclass correlation coefficient (ICC) for the VAS. Results Using the EGUC system, interobserver reliability was substantial for squamous (AC2 = 0.69; 95% confidence interval [CI], 0.57‐0.80) and glandular mucosa (AC2 = 0.72; 95% CI, 0.70‐0.75), and intraobserver reliability was substantial for squamous (AC2 = 0.80; 95% CI, 0.71‐0.90) and glandular mucosa (AC2 = 0.80; 95% CI, 0.74‐0.86). Interobserver reliability using the VAS was moderate for squamous (ICC = 0.64; 95% CI, 0.31‐0.96) and poor for glandular mucosa (ICC = 0.35; 95% CI, 0.06‐0.64), and intraobserver reliability was moderate for squamous (ICC = 0.74; 95% CI, 0.62‐0.86) and glandular mucosa (ICC = 0.56; 95% CI, 0.39‐0.72). Conclusions and Clinical Importance The EGUC system had acceptable intraobserver and interobserver reliability and performed well regardless of observer experience. Familiarity and observer experience improved reliability of the VAS.
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Affiliation(s)
- Jessica C Wise
- School of Animal and Veterinary Sciences, Charles Sturt University, Wagga Wagga, New South Wales, Australia
| | - Edwina J A Wilkes
- School of Animal and Veterinary Sciences, Charles Sturt University, Wagga Wagga, New South Wales, Australia
| | - Sharanne L Raidal
- School of Animal and Veterinary Sciences, Charles Sturt University, Wagga Wagga, New South Wales, Australia
| | - Gang Xie
- Quantitative Consultant Unit, Charles Sturt University, Wagga Wagga, New South Wales, Australia
| | - Danielle E Crosby
- School of Animal and Veterinary Sciences, Charles Sturt University, Wagga Wagga, New South Wales, Australia
| | - Josephine N Hale
- School of Animal and Veterinary Sciences, Charles Sturt University, Wagga Wagga, New South Wales, Australia
| | - Kristopher J Hughes
- School of Animal and Veterinary Sciences, Charles Sturt University, Wagga Wagga, New South Wales, Australia
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25
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Camacho‐Luna P, Andrews FM, Keowen ML, Garza F, Liu C‐C, Lamp B, Olijve J. The effect of porcine hydrolysed collagen on gastric ulcer scores, gastric juice pH, gastrin and amino acid concentrations in horses. EQUINE VET EDUC 2020. [DOI: 10.1111/eve.13409] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- P. Camacho‐Luna
- Equine Health Studies Program Department of Veterinary Clinical Sciences School of Veterinary Medicine Louisiana State University Baton Rouge LouisianaUSA
| | - F. M. Andrews
- Equine Health Studies Program Department of Veterinary Clinical Sciences School of Veterinary Medicine Louisiana State University Baton Rouge LouisianaUSA
| | - M. L. Keowen
- Equine Health Studies Program Department of Veterinary Clinical Sciences School of Veterinary Medicine Louisiana State University Baton Rouge LouisianaUSA
| | - F. Garza
- Equine Health Studies Program Department of Veterinary Clinical Sciences School of Veterinary Medicine Louisiana State University Baton Rouge LouisianaUSA
| | - C. ‐C. Liu
- Department of Veterinary Clinical Sciences School of Veterinary Medicine Louisiana State University Baton Rouge LouisianaUSA
| | - B. Lamp
- Sonac‐Darling Ingredients International Mukwonago Wisconsin USA
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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; 6:235-241. [PMID: 31945806 PMCID: PMC7196684 DOI: 10.1002/vms3.220] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 10/03/2019] [Accepted: 10/26/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Equine squamous gastric disease (ESGD) is a highly prevalent disease in horses, particularly in elite athletes. Some horses respond slowly, or fail to respond, to the licensed treatment, oral omeprazole (ORLO). OBJECTIVES To compare rates of ESGD healing and improvement between ORLO and a long-acting injectable omeprazole preparation (LAIO). STUDY DESIGN Retrospective clinical study. METHODS The case records and gastroscopy images of horses presenting to Rainbow Equine Hospital over a 12-month period were reviewed, with images being reviewed blind by one of the authors (David Rendle). Treatment responses were compared between horses that received 2 or 4 injections of 4 mg/kg LAIO at weekly intervals, and horses that received ORLO at 4 mg/kg PO SID for 4 weeks. Data were compared using a Mann-Whitney test with post hoc Dunn's test, chi-squared test or Fisher's exact test. RESULTS Fifty-six horses met the inclusion criteria: 29 received LAIO and 27 received ORLO. Treatment groups were comparable in terms of signalment and ESGD lesions. There was a difference in rate of healing when LAIO and ORLO treatment groups were compared at 28 days (LAIO-97%; ORLO-67%; p = .005; OR = 14(1.8-158)), but no difference between LAIO at 14 days and ORLO at 28 days (LAIO-86%; ORLO-67%; p = .12; OR = 3.1 (0.9-10)). Five localised and self-limiting injection site reactions were identified in 3 horses out of 98 injections (5.1%). MAIN LIMITATIONS The study was limited by its retrospective nature, absence of randomisation and limited numbers. CONCLUSIONS Four weeks of treatment with LAIO resulted in better rates of ESGD healing than 4 weeks of ORLO. Larger more robust studies of LAIO are warranted.
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Affiliation(s)
- Sarah Gough
- Rainbow Equine HospitalMaltonNorth YorkshireUnited Kingdom
| | - Gayle Hallowell
- School of Veterinary Medicine and ScienceUniversity of NottinghamNottinghamUnited Kingdom
| | - David Rendle
- Rainbow Equine HospitalMaltonNorth YorkshireUnited Kingdom
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Liu W, Liu G, Liu J. Effects of astragaloside IV on the pharmacokinetics of omeprazole in rats. PHARMACEUTICAL BIOLOGY 2019; 57:449-452. [PMID: 31290355 PMCID: PMC6691885 DOI: 10.1080/13880209.2019.1636828] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Revised: 06/14/2019] [Accepted: 06/22/2019] [Indexed: 05/20/2023]
Abstract
Context: Omeprazole and astragaloside IV (AS-IV) are widely used for the treatment of gastric ulcers in China clinics. Objective: This study investigates the effects of AS-IV on the pharmacokinetics of omeprazole in rats. Materials and methods: The pharmacokinetics of orally administered omeprazole (2 mg/kg), with or without AS-IV (100 mg/kg/day for 7 days) pretreatment, were investigated in male Sprague-Dawley rats (two groups of six animals each) using LC-MS/MS. A Caco-2 cell transwell model and rat liver microsome incubation systems were also used to support the in vivo pharmacokinetic data and investigate its potential mechanism. Results: The results indicated that co-administration of AS-IV could decrease the systemic exposure of omeprazole significantly (p < 0.05), including AUC0-t (717.20 ± 177.63 vs. 1166.25 ± 186.65 ng h/mL) and Cmax (272.35 ± 25.81 vs. 366.34 ± 32.57 ng/mL). The t1/2 of omeprazole also decreased significantly (1.78 ± 0.15 vs. 2.23 ± 0.27 h, p < 0.05). The efflux ratio of omeprazole across the Caco-2 cell transwell model increased significantly from 1.73 to 2.67 (p < 0.05), and the metabolic stability of omeprazole was decreased from 42.6 ± 7.8 to 26.2 ± 5.1 min with the pretreatment of AS-IV (p < 0.05). Discussion and conclusions: AS-IV could decrease the systemic exposure of omeprazole in rats when AS-IV and omeprazole were co-administered, and it might exert these effects through decreasing the absorption of omeprazole by inducing P-gp, or through accelerating the metabolism of omeprazole in rat liver by inducing the activity of CYP3A4.
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Affiliation(s)
- Wei Liu
- Department of Pediatric Medicine, Yidu Central Hospital of Weifang, Weifang, China
- CONTACT Wei Liu Department of Pediatric Medicine, Yidu Central Hospital of Weifang, No.4138, South Linglongshan Road, Shandong 262500, China
| | - Guozhi Liu
- Department of Neonatology, Yidu Central Hospital of Weifang, Weifang, China
| | - Jing Liu
- Department of Pediatric Medicine, Yidu Central Hospital of Weifang, Weifang, China
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Bezdekova B, Wohlsein P, Venner M. Chronic severe pyloric lesions in horses: 47 cases. Equine Vet J 2019; 52:200-204. [PMID: 31390081 DOI: 10.1111/evj.13157] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 07/25/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND The clinical findings and outcome associated with chronic severe equine pyloric lesions have not been well described previously. OBJECTIVES To describe the history, clinical signs, endoscopic and ultrasound results, laboratory data, treatment, pathological findings and survival of horses with chronic severe pyloric lesions. STUDY DESIGN Retrospective case series. METHODS Medical records from horses treated at clinics in Czech Republic and Germany in which chronic severe pyloric lesions were confirmed endoscopically and/or on post-mortem examination were reviewed. RESULTS Forty-seven horses were identified, median age 3 years (range 0.8-16 years). There were 3 geldings, 23 mares and 19 stallions and the majority were Warmbloods (60%). The most common presenting signs were poor body condition (40; 87%), slow eating (39; 83%), recurrent colic (35; 74%) and selective appetite (30; 64%). The most consistent laboratory abnormality was hypoalbuminaemia (10; 36%). Slow gastric emptying was confirmed in 29 individuals during gastroscopy and/or ultrasonography. Endoscopy revealed distal oesophagitis in 9 of 47 horses, and severe equine squamous gastric disease in all cases. Pyloric lesions were depressed, flat or raised fibrinosuppurative pyloric ulcers and were seen in 45 (2 pylori were not seen endoscopically). Thirty-two cases were treated, with 28 responding well initially. All treated cases received anti-ulcer medication and four underwent gastrojejunostomy. Clinical signs recurred after medical treatment in at least 11 cases. Only 18 of 44 cases (41%) survived long term (3 were lost to follow-up). Horses diagnosed at 3 years of age or younger were significantly less likely to survive more than 6 months than older horses (27.8% vs. 72.2%, P<0.001). MAIN LIMITATIONS The study is retrospective, some records were incomplete and case identification was subjective. CONCLUSIONS Chronic severe pyloric lesions can be associated with delayed gastric emptying identified with ultrasonography and/or endoscopy. The prognosis is poor in young horses.
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Affiliation(s)
- B Bezdekova
- Equine Medical, Skalice nad Svitavou, Czech Republic
| | - P Wohlsein
- Department for Pathology, School of Veterinary Medicine of Hannover, Hannover, Germany
| | - M Venner
- Equine Clinic Destedt, Destedt, Germany
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Banse HE, Andrews FM. Equine glandular gastric disease: prevalence, impact and management strategies. VETERINARY MEDICINE (AUCKLAND, N.Z.) 2019; 10:69-76. [PMID: 31406687 PMCID: PMC6642651 DOI: 10.2147/vmrr.s174427] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 03/26/2019] [Indexed: 12/13/2022]
Abstract
Equine glandular gastric disease (EGGD) is an increasingly recognized disease of the glandular mucosa of the equine stomach. Diagnosis is confirmed by gastric endoscopy and scored based upon one of several different endoscopic scoring systems. Prevalence appears to be variable, depending upon breed and discipline. Primary identified risk factors include exercise frequency, and stress; therefore, management strategies are focused on reducing exercise and stress. Limiting grain intake and increasing pasture turnout may also be helpful preventative measures. Pharmacologic treatment consists primarily of an approved omeprazole product with or without misoprostol or sucralfate. Further research into the pathophysiology of EGGD may allow for identification of other targeted treatments.
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Affiliation(s)
- Heidi E Banse
- Equine Health Studies Program, Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton RougeLA, USA
| | - Frank M Andrews
- Equine Health Studies Program, Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton RougeLA, USA
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Effect of Changing Diet on Gastric Ulceration in Exercising Horses and Ponies After Cessation of Omeprazole Treatment. J Equine Vet Sci 2019; 83:102742. [PMID: 31791527 DOI: 10.1016/j.jevs.2019.05.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 05/02/2019] [Accepted: 05/06/2019] [Indexed: 11/23/2022]
Abstract
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. Omeprazole (4 mg/kg per os SID) was given to all ES pairs for 4 weeks. Gastroscopies were scored, without dietary knowledge, after 4 and 10 weeks (Scopes 2 and 3). Workloads remained similar throughout. McNemar's tests identified any changes in ESGD grade. Within the EM group, DC had no additional effect. For the ES group remaining on their original diet, there was significant improvement in ESGD grade from Scopes 1 to 2 (P < .001) but a worsening between Scopes 2 and 3 (P = .005), with Scope 3 being no different from Scope 1 (P = .08) reflecting no apparent long-term medication benefit. For the DC group, there was significant improvement in ESGD grade from Scopes 1 to 2 (P < .001) and between Scopes 1 and 3 (P = .003); In addition, there was no significant difference between Scopes 2 and 3 (P = .32). Although limited by the small number of pairs evaluated, this study provides evidence that appropriate DCs can be a beneficial management strategy for ESGD.
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Varley G, Bowen IM, Habershon‐Butcher JL, Nicholls V, Hallowell GD. Misoprostol is superior to combined omeprazole‐sucralfate for the treatment of equine gastric glandular disease. Equine Vet J 2019; 51:575-580. [DOI: 10.1111/evj.13087] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 02/23/2019] [Indexed: 12/20/2022]
Affiliation(s)
| | - I. M. Bowen
- School of Veterinary Medicine and Science University of Nottingham Loughborough UK
| | | | - V. Nicholls
- School of Veterinary Science University of Liverpool Leahurst UK
| | - G. D. Hallowell
- School of Veterinary Medicine and Science University of Nottingham Loughborough UK
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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 2018; 33:233-240. [PMID: 30499188 PMCID: PMC6335573 DOI: 10.1111/jvim.15350] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 10/02/2018] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND To date, risk factors for equine glandular gastric disease (EGGD) have not been described in Thoroughbred racehorses. OBJECTIVES To determine management factors associated with EGGD, identify clinical signs in affected horses, and compare these to equine squamous gastric disease (ESGD). ANIMALS The study was carried out on 109 Thoroughbred racehorses from 8 training yards (3 in the United Kingdom and 5 in Australia). METHODS Gastroscopic examination alongside a questionnaire regarding management, feeding, exercise, and health. RESULTS Management factors and clinical signs were different for EGGD versus ESGD. Exercising ≥5 days per week was associated with a 10.4 times (95% CI [confidence interval]: 1.34-26.9) increased risk of EGGD. Horses racing below expectation were 3.7 times (95% CI: 1.1-16.7) more likely to have EGGD. Trainer was also identified as a risk factor for EGGD. Time in work ≤6 weeks was associated with a decreased risk of ESGD (odds ratio [OR] 0.3; 95% CI: 0.1-0.99). Horses aggressive to humans were less likely to have ESGD (OR 0.12; 95% CI: 0.03-0.54). Horses with stereotypies were more likely to have ESGD (OR 5.0; 95% CI: 1.6-15.9). CONCLUSIONS AND CLINICAL IMPORTANCE The findings of our study further support the notion that EGGD should be considered as a distinct disease entity to ESGD. Exercising ≤4 days per week could reduce the risk of EGGD. Horses with EGGD are more likely to perform below expectation and, as such, EGGD might be performance limiting in some affected individuals. Stress minimization could reduce the risk of EGGD.
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Affiliation(s)
- Benjamin W Sykes
- School of Veterinary Sciences, The University of Queensland, Gatton, Queensland, Australia.,Luoda Pharma, Caringbah, New South Wales, Australia
| | - Mark Bowen
- School of Veterinary Medicine and Science, University of Nottingham, Nottingham, United Kingdom
| | | | - Martin Green
- School of Veterinary Medicine and Science, University of Nottingham, Nottingham, United Kingdom
| | - Gayle D Hallowell
- School of Veterinary Medicine and Science, University of Nottingham, Nottingham, United Kingdom
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Bass L, Swain E, Santos H, Hess T, Black J. Effects of Feeding Frequency Using a Commercial Automated Feeding Device on Gastric Ulceration in Exercised Quarter Horses. J Equine Vet Sci 2018; 64:96-100. [DOI: 10.1016/j.jevs.2018.02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 01/24/2018] [Accepted: 02/03/2018] [Indexed: 10/18/2022]
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34
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Camacho-Luna P, Buchanan B, Andrews FM. Advances in Diagnostics and Treatments in Horses and Foals with Gastric and Duodenal Ulcers. Vet Clin North Am Equine Pract 2018. [DOI: 10.1016/j.cveq.2017.11.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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35
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Viljanto M, Hillyer L, Hincks P, Pearce C, Paine SW. Re-evaluation of the regulation of omeprazole in racehorses: An evidence-based approach. J Vet Pharmacol Ther 2018; 41:469-475. [DOI: 10.1111/jvp.12491] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 01/11/2018] [Indexed: 11/30/2022]
Affiliation(s)
| | - L. Hillyer
- British Horseracing Authority; London UK
| | | | | | - S. W. Paine
- School of Veterinary Medicine and Science; University of Nottingham; Nottingham UK
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36
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Sykes BW. Courses for horses: Rethinking the use of proton pump inhibitors in the treatment of equine gastric ulcer syndrome. EQUINE VET EDUC 2018. [DOI: 10.1111/eve.12894] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- B. W. Sykes
- School of Veterinary Sciences The University of Queensland Gatton Queensland Australia
- Bova Compounding Caringbah New South Wales Australia
- Luoda Pharma Pty Ltd Caringbah New South Wales Australia
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37
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Mönki J, Hewetson M, Virtala AMK. Risk Factors for Equine Gastric Glandular Disease: A Case-Control Study in a Finnish Referral Hospital Population. J Vet Intern Med 2018; 30:1270-5. [PMID: 27461724 PMCID: PMC5108429 DOI: 10.1111/jvim.14370] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Revised: 03/23/2016] [Accepted: 06/11/2016] [Indexed: 01/29/2023] Open
Abstract
Background Equine gastric glandular disease (EGGD) is a term used to classify erosive and ulcerative diseases of the glandular mucosa of the equine stomach. Epidemiologic studies of risk factors for EGGD have not been reported. Objective To determine risk factors for EGGD. Animals Cases (n = 83) had endoscopic evidence of EGGD; controls (n = 34) included healthy horses and horses with equine squamous gastric disease (ESGD) without EGGD. Methods Retrospective case‐control study. The data were analyzed by multivariable logistic regression modeling. Analysis was performed on the full dataset. An additional analysis compared horses with glandular lesions (n = 43) against healthy horses (n = 22). Results On first analysis, Warmblood breed (OR = 13.9, 95% CI 2.2–90.9, P = .005) and an increasing number of caretakers (OR = 7.3, 95% CI 0.98–55.6, P = .053) were associated with an increased risk of EGGD. On analysis of the subset of data, Warmblood breed (OR = 28.6, 95% CI 2.96–250.0, P = .004) and increasing number of riders (OR = 12.99, 95% CI 0.94–166.7, P = .056) were risk factors. The presence of sand in the colon appeared to have a protective effect against EGGD (OR = 0.195, 95% CI 0.04–1.0, P = .051 for sand versus not having sand). Conclusions and clinical importance This study suggests that Warmbloods are predisposed to EGGD and multiple handlers/riders might increase the risk of EGGD. Identification of risk factors allows speculation on potential pathophysiological mechanisms of EGGD.
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Affiliation(s)
- J Mönki
- Veterinary Teaching Hospital, University of Helsinki, Helsinki, Finland
| | - M Hewetson
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Onderstepoort, South Africa
| | - A-M K Virtala
- Department of Veterinary Biosciences, University of Helsinki, Helsinki, Finland
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Rendle D, Bowen M, Brazil T, Conwell R, Hallowell G, Hepburn R, Hewetson M, Sykes B. Recommendations for the management of equine glandular gastric disease. ACTA ACUST UNITED AC 2018. [DOI: 10.12968/ukve.2018.2.s1.3] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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39
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40
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Bush J, van den Boom R, Franklin S. Comparison of aloe vera and omeprazole in the treatment of equine gastric ulcer syndrome. Equine Vet J 2017; 50:34-40. [DOI: 10.1111/evj.12706] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 05/16/2017] [Indexed: 11/30/2022]
Affiliation(s)
- J. Bush
- School of Animal and Veterinary Science; Adelaide South Australia Australia
| | - R. van den Boom
- School of Animal and Veterinary Science; Adelaide South Australia Australia
| | - S. Franklin
- School of Animal and Veterinary Science; Adelaide South Australia Australia
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41
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Zavoshti FR, Andrews FM. Therapeutics for Equine Gastric Ulcer Syndrome. Vet Clin North Am Equine Pract 2017; 33:141-162. [PMID: 28325176 DOI: 10.1016/j.cveq.2016.11.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Equine gastric ulcer syndrome (EGUS) is an umbrella term used to describe ulcers in the nonglandular squamous and glandular mucosa, terminal esophagus, and proximal duodenum. Gastric ulcers in the squamous and glandular regions occur more often than esophageal or duodenal ulcers and likely have a different pathogenesis. At present, omeprazole is accepted globally as the best pharmacologic therapy for both regions of the stomach; however, the addition of coating agents and synthetic prostaglandins could add to its effectiveness in treatment of EGUS. Dietary and environmental management are necessary for prevention of recurrence.
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Affiliation(s)
| | - Frank M Andrews
- Equine Health Studies Program, Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, Skip Bertman Drive, LA 70803, USA.
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Sykes BW, Kathawala K, Song Y, Garg S, Page SW, Underwood C, Mills PC. Preliminary investigations into a novel, long-acting, injectable, intramuscular formulation of omeprazole in the horse. Equine Vet J 2017; 49:795-801. [DOI: 10.1111/evj.12688] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 04/04/2017] [Indexed: 12/11/2022]
Affiliation(s)
- B. W. Sykes
- School of Veterinary Science; University of Queensland; Gatton Queensland Australia
- Luoda Pharma Pty Ltd; Caringbah New South Wales Australia
| | - K. Kathawala
- Centre for Pharmaceutical Innovation and Development; University of South Australia; Adelaide South Australia Australia
| | - Y. Song
- Centre for Pharmaceutical Innovation and Development; University of South Australia; Adelaide South Australia Australia
| | - S. Garg
- Centre for Pharmaceutical Innovation and Development; University of South Australia; Adelaide South Australia Australia
| | - S. W. Page
- Luoda Pharma Pty Ltd; Caringbah New South Wales Australia
| | - C. Underwood
- School of Veterinary Science; University of Queensland; Gatton Queensland Australia
| | - P. C. Mills
- School of Veterinary Science; University of Queensland; Gatton Queensland Australia
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43
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Arnold C, Dreher I, Grammel T, Schusser GF. Immunotherapy of a squamous cell carcinoma in the perianal region using autologous dendritic cells in a horse. EQUINE VET EDUC 2017. [DOI: 10.1111/eve.12741] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- C. Arnold
- Department of Large Animal Medicine; Faculty of Veterinary Medicine; University of Leipzig; Leipzig Germany
| | - I. Dreher
- Veterinary Hospital Dr. Thomas Grammel; Osterode am Harz Germany
| | - T. Grammel
- Veterinary Hospital Dr. Thomas Grammel; Osterode am Harz Germany
| | - G. F. Schusser
- Department of Large Animal Medicine; Faculty of Veterinary Medicine; University of Leipzig; Leipzig Germany
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44
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Hewetson M, Sykes BW, Hallowell GD, Tulamo RM. Diagnostic accuracy of blood sucrose as a screening test for equine gastric ulcer syndrome (EGUS) in adult horses. Acta Vet Scand 2017; 59:15. [PMID: 28284214 PMCID: PMC5346197 DOI: 10.1186/s13028-017-0284-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 03/05/2017] [Indexed: 12/04/2022] Open
Abstract
Background 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. Electronic supplementary material The online version of this article (doi:10.1186/s13028-017-0284-1) contains supplementary material, which is available to authorized users.
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Sykes BW, Underwood C, Mills PC. The effects of dose and diet on the pharmacodynamics of esomeprazole in the horse. Equine Vet J 2017; 49:637-642. [PMID: 28117490 DOI: 10.1111/evj.12670] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 01/18/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND Esomeprazole warrants further investigation as a treatment for equine gastric ulcer syndrome. OBJECTIVES To investigate the duration of intraday acid suppression achieved with two doses of esomeprazole under two dietary conditions. STUDY DESIGN A four way crossover design. METHODS Six adult Thoroughbreds instrumented with percutaneous gastrotomy tubes were used. Intragastric pH was measured for continuous 23 h periods (08.00-07.00 h) for 6 consecutive days (Days 0-5). Baseline data was recorded on Day 0 and esomeprazole was administered on Days 1-5. Two doses (0.5 and 2.0 mg/kg bwt/day per os once daily) and two diets (a high grain/low fibre (HG/LF) and ad libitum hay (HAY) diet) were studied. Data for the percentage of time pH was above 4 (%tpH>4) and median intraday pH was reported for two measurement points and analysed using generalised estimating equations. RESULTS An inconsistent effect of both diet and dose was evident with mean %tpH>4 and mean of the median intraday pHs typically higher at the 2.0 mg/kg bwt dose and in HG/LF diet. A cumulative effect of dosing was present with the magnitude of acid suppression observed on Day 5 consistently higher than that observed on Day 1. The magnitude of acid suppression, at measurement point 1, compared favourably with previous reports on omeprazole and exceeded human therapeutic breakpoints for the 0.5 mg/kg bwt dose in the HG/LF diet and 2.0 mg/kg bwt dose in the HAY diet. MAIN LIMITATIONS Instrumentation may have modified gastric function and horses were not fasted or exercised. CONCLUSIONS The findings of the present study suggested that both dose and diet affect the response to esomeprazole in the horse and that a cumulative effect is present over the first 5 days of treatment. Further investigation into the clinical efficacy of esomeprazole and trials directly comparing esomeprazole and omeprazole appear to be warranted.
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Affiliation(s)
- B W Sykes
- School of Veterinary Science, The University of Queensland, Gatton, Queensland, Australia.,Bova Compounding, Caringbah, New South Wales, Australia
| | - C Underwood
- School of Veterinary Science, The University of Queensland, Gatton, Queensland, Australia
| | - P C Mills
- School of Veterinary Science, The University of Queensland, Gatton, Queensland, Australia
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46
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Di Salvo A, Busechian S, Zappulla F, Marchesi MC, Pieramati C, Orvieto S, Boveri M, Predieri PG, Rueca F, della Rocca G. Pharmacokinetics and tolerability of a new formulation of omeprazole in the horse. J Vet Pharmacol Ther 2016; 40:348-355. [DOI: 10.1111/jvp.12371] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Accepted: 09/13/2016] [Indexed: 01/05/2023]
Affiliation(s)
- A. Di Salvo
- Department of Veterinary Medicine; University of Perugia; Perugia Italy
| | - S. Busechian
- Department of Veterinary Medicine; University of Perugia; Perugia Italy
| | - F. Zappulla
- Department of Veterinary Medicine; University of Perugia; Perugia Italy
| | - M. C. Marchesi
- Department of Veterinary Medicine; University of Perugia; Perugia Italy
| | - C. Pieramati
- Department of Veterinary Medicine; University of Perugia; Perugia Italy
| | - S. Orvieto
- Veterinary Practitioner; Acquasparta Terni Italy
| | - M. Boveri
- CROSS Research S.A.; Arzo Switzerland
| | | | - F. Rueca
- Department of Veterinary Medicine; University of Perugia; Perugia Italy
| | - G. della Rocca
- Department of Veterinary Medicine; University of Perugia; Perugia Italy
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47
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Sykes BW, Underwood C, Greer R, McGowan CM, Mills PC. The effects of dose and diet on the pharmacodynamics of omeprazole in the horse. Equine Vet J 2016; 49:525-531. [DOI: 10.1111/evj.12630] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Accepted: 08/19/2016] [Indexed: 12/13/2022]
Affiliation(s)
- B. W. Sykes
- School of Veterinary Science; The University of Queensland; Gatton Australia
| | - C. Underwood
- School of Veterinary Science; The University of Queensland; Gatton Australia
| | - R. Greer
- School of Veterinary Science; The University of Queensland; Gatton Australia
| | - C. M. McGowan
- Institute of Ageing and Chronic Disease; University of Liverpool; Liverpool UK
| | - P. C. Mills
- School of Veterinary Science; The University of Queensland; Gatton Australia
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48
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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 2016; 29:1288-99. [PMID: 26340142 PMCID: PMC4858038 DOI: 10.1111/jvim.13578] [Citation(s) in RCA: 168] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 05/19/2015] [Accepted: 06/10/2015] [Indexed: 12/01/2022] Open
Affiliation(s)
- B W Sykes
- BW Sykes Consultancy, Upper Orara, NSW, Australia.,School of Veterinary Sciences, The University of Queensland, Gatton, QLD, Australia
| | - M Hewetson
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Onderstepoort, South Africa
| | - R J Hepburn
- B&W Equine Hospital, Breadstone, Berkeley, Gloucestershire, UK
| | | | - Y Tamzali
- Equine Internal Medicine, Université de Toulouse, Toulouse, France
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49
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A Comparison Between Omeprazole and a Dietary Supplement for the Management of Squamous Gastric Ulceration in Horses. J Equine Vet Sci 2016. [DOI: 10.1016/j.jevs.2016.02.228] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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50
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Ward S, Sykes BW, Brown H, Bishop A, Penaluna LA. A comparison of the prevalence of gastric ulceration in feral and domesticated horses in the UK. EQUINE VET EDUC 2015. [DOI: 10.1111/eve.12491] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- S. Ward
- Oxford Brookes University; Headington UK
| | - B. W. Sykes
- The University of Queensland; Gatton Australia
- BW Sykes Consultancy; Upper Orara New South Wales Australia
| | - H. Brown
- Abingdon and Witney College; Abingdon Oxfordshire UK
| | - A. Bishop
- Abingdon and Witney College; Abingdon Oxfordshire UK
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