ImproWin® in the treatment of gastric ulceration of the squamous mucosa in trotting racehorses

Equine Gastric Ulcer Syndrome affects fitness parameters in poorly performing Standardbred racehorses

Introduction

Equine Gastric Ulcer Syndrome (EGUS) is a highly prevalent disorder in horses, which can be classified, based on the localization of the lesions, as Equine Squamous Gastric Disease (ESGD) or Equine Glandular Gastric Disease (EGGD). Although EGUS is recognized as a common cause of poor performance in racehorses, objective investigations about its relation with athletic capacity are lacking. Therefore, the present retrospective study aims to evaluate the associations between EGUS severity and some fitness parameters measured during an incremental treadmill test in Standardbred racehorses in training.

Methods

With this aim, data from 87 Standard bred racehorses which underwent a complete diagnostic evaluation for poor performance was reviewed. During gastroscopic examination, a 0-4 score was assigned to ESGD, while EGGD was evaluated for absence/presence; a total EGUS score was obtained by adding 1 point to ESGD score in horses showing concomitant EGGD. Fitness parameters obtained during incremental treadmill test included speed at a heart rate of 200 bpm (V200), speed and heart rate at a blood lactate of 4 mmol/L (VLa4, HRLa4), peak lactate, lactate and heart rate at 30 minutes post-exercise, maximum speed, minimum pH and maximum hematocrit. The associations between fitness parameters and EGUS and ESGD scores were evaluated by Spearman correlation, while Mann-Whitney test was used to compare them between horses with or without EGGD. Statistical significance was set at p<0.05.

Results

EGUS grade was inversely correlated with V200 (p = 0.0025) and minimum pH (p = 0.0469); ESGD grade was inversely correlated with V200 (p = 0.0025) and VLa4 (p = 0.0363). Although a trend was observed, no significant differences in V200 were observed between horses with or without EGGD (p = 0.073); horses with EGGD reached a lower minimum pH (p = 0.0087).

Discussion

These results show a negative association between aerobic capacity and EGUS, in particular ESGD. Although different hypotheses have been proposed, including abdominal pain and decreased appetite due to lactate accumulation, the underlying mechanisms are still unknown, and it is not clear whether EGUS represents a cause or a consequence of an early lactate accumulation and post-exercise acidosis.

Effects of a nutraceutical supplement in the management of mild equine squamous gastric disease in endurance horses

INTRODUCTION

Equine squamous gastric disease (ESGD) may require prolonged treatments with acid suppressants; therefore, interest in nutraceutical supplements with anti-ulcerogenic properties has increased. This study aims to investigate the efficacy of Trophogast pellet for the treatment of ESGD in endurance horses.

MATERIAL AND METHODS

Fifteen endurance horses were included based on their gastroscopic examination and randomly assigned to a treatment group, receiving Trophogast pellet for 30 days together with management changes, or to a control group, only subjected to management modifications. At the end of treatment, gastroscopy was repeated. Scores were assigned according to the Equine Gastric Ulcer Council scoring system. All horses were weighed at the beginning and at the end of the study. ESGD grades and weight before and after treatment were compared.

RESULTS

At enrolment, median ESGD score in the treatment group was 2, while in the control group it was 1. After the treatment period, a significant decrease in ESGD grade was observed in the treatment group (median 1, p = 0.0078), while there was no change in the control group (median 2). No significant weight change was observed in either group.

CONCLUSION

Trophogast pellet was effective at promoting healing of mild ESGD in endurance horses.

Establishment of a risk assessment system for peptic ulcer recurrence and its value in individualized intervention

OBJECTIVE

To investigate the establishment of a risk assessment system for peptic ulcer (PU) recurrence and implement an individualized intervention for PU patients with a moderate to high recurrence risk to reduce the recurrence of PU in patients with a moderate to high recurrence risk.

METHODS

The factors for PU recurrence were collected through consulting the literature, and a risk prediction model for PU recurrence was established using the univariate binary and multivariate multinomial Logistic stepwise regression analysis. According to the model, a total of 235 PU patients were divided into patients with high, moderate and low recurrence risks. A total of 71 PU patients with moderate to high recurrence risks were selected as the study subjects, and further divided into the control group (n=35) and the experimental group (n=36). The control group was not treated with intervention, while the experimental group was treated with individualized intervention. The PU recurrence, adverse emotions and changes of pain degree were assessed in the two groups at 3, 6, 9 and 12 months after intervention.

RESULTS

The univariate and multivariate Logistic regression analysis showed that drinking alcohol, smoking, chronic diseases, oral NSAIDS and depression were associated with the recurrence of PU. Individualized intervention improved the recurrence rate, anxiety, depression, pain degree and quality of life of patients with moderate to high PU recurrence risk.

CONCLUSION

Drinking alcohol, smoking, chronic diseases, oral NSAIDS and depression were associated with the recurrence of PU. Individualized intervention can improve the quality of prognosis and the recurrence risk of PU in patients, which has positive clinical significance.

The Safety and Efficacy in Horses of Certain Nutraceuticals that Claim to Have Health Benefits

Equine nutraceuticals are promoted as useful therapies to help optimize health and athletic performance, often without the benefit of independent research to support product efficacy and safety. This review focuses on 4 main categories of equine supplements that are frequently used as nutraceuticals: (i) supplements to support metabolic health, (ii) gastric support products, (iii) common ingredients that are included in supplements designed to support hoof health, and (iv) supplements to support joint health.

Effect of a novel fermented soy product on gastric ulcer scores in horses

Non-pharmaceutical methods are desirable to treat or prevent gastric ulceration in horses. This two-period, randomised, double-blinded placebo-controlled study was designed to evaluate the efficacy of dietary supplementation (25 g once daily in feed for 30 days) with Fermaid®Ease 187 (FE, Lallemand Australia Pty Ltd, Maroochydore, Australia) on gastric squamous and glandular mucosal ulcer scores in horses. Gastroscopy of 120 horses presented to the Veterinary Clinical Centre at Charles Sturt University (CSU; Bathurst, Australia) or at local training establishments identified 60 horses with spontaneous gastric ulcer disease (50%). Of horses eligible for inclusion, 29 horses were recruited and randomised to receive either the FE or placebo for 30 days. Effects were assessed by repeat gastroscopy (Day 31), at which time horses started the reciprocal treatment. Eleven horses successfully completed both treatment periods. Treatment with FE showed a significant decrease in squamous ulcer scores in period 1 (P=0.008), with a similar effect observed in period 2. No change was observed in squamous ulcer scores for horses receiving placebo treatment in period 1, but increased squamous scores were observed in horses receiving placebo treatment in period 2 (P=0.062). Squamous ulcer scores on Day 31 were significantly lower (P=0.005) following FE treatment than for horses receiving the placebo treatment. No effects were observed on glandular ulcer scores. This study supported the use of FE in horses predisposed to ulceration of the squamous gastric mucosa.

Mirror therapy for phantom limb and stump pain: a randomized controlled clinical trial in landmine amputees in Cambodia

Background and aims The aim of the study was to examine the effect of mirror and tactile therapy on phantom and stump pain in patients with traumatic amputations, with particular reference to amputees in low-income communities. Methods The study was conducted with an open, randomized, semi-crossover case-control design in rural Cambodia. A study sample of 45 landmine victims with trans-tibial amputations was allocated to three treatment arms; mirror therapy, tactile therapy, and combined mirror-and-tactile therapy. Non-responders from the mono-therapy interventions were crossed over to the alternative intervention. The intervention consisted of 5 min of treatment every morning and evening for 4 weeks. Endpoint estimates of phantom limb pain (PLP), stump pain, and physical function were registered 3 months after the treatment. Results All three interventions were associated with more that 50% reduction in visual analogue scale (VAS)-rated PLP and stump pain. Combined mirror-tactile treatment had a significantly better effect on PLP and stump pain than mirror or tactile therapy alone. The difference between the three treatment arms were however slight, and hardly of clinical relevance. After treatment, the reduction of pain remained unchanged for an observation period of 3 months. Conclusions The study documents that a 4-week treatment period with mirror and/or tactile therapy significantly reduces PLP and stump pain after trans-tibial amputations. Implications The article reports for the first time a randomized controlled trial of mirror therapy in a homogenous sample of persons with traumatic amputations. The findings are of special relevance to amputees in low-resource communities.