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Vokes J, Lovett A, Sykes B. Equine Gastric Ulcer Syndrome: An Update on Current Knowledge. Animals (Basel) 2023; 13:1261. [PMID: 37048517 PMCID: PMC10093336 DOI: 10.3390/ani13071261] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/14/2023] [Accepted: 03/29/2023] [Indexed: 04/08/2023] Open
Abstract
Equine Gastric Ulcer Syndrome (EGUS) is a term that has been used since 1999, initially being used to describe all gastric mucosal disease in horses. Since this time, the identification of two distinct main disease entities of the equine gastric mucosa have been described under the umbrella of EGUS; these are Equine Squamous Gastric Disease (ESGD) and Equine Glandular Gastric Disease (EGGD). In 2015 the European College of Equine Internal Medicine (ECEIM) released a consensus statement defining these disease entities. This document highlighted the lack of evidence surrounding EGGD compared to ESGD, and identified knowledge gaps for further research to be directed. Subsequently, many studies on EGGD have been published, especially on pathophysiology, diagnosis, and treatment. This article updates current knowledge on both ESGD and EGGD as understanding has evolved since the last large-scale review.
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Affiliation(s)
- Jessica Vokes
- Equine Veterinary Clinic, School of Veterinary Sciences, Massey University, Palmerston North 4474, New Zealand
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Orr EL, Staniar WB, Smarsh DN. A Survey of Pennsylvania Horse Management: Part One-Nutrition. J Equine Vet Sci 2022; 119:104140. [PMID: 36244609 DOI: 10.1016/j.jevs.2022.104140] [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: 07/25/2022] [Revised: 10/04/2022] [Accepted: 10/10/2022] [Indexed: 11/05/2022]
Abstract
Various aspects of nutritional management can impact both a horse's gastrointestinal (GI) health and caretaker costs. The objective of this study was to characterize the feeding management and GI issues of horses in Pennsylvania (PA). An online survey was distributed from February 27th to August 31st, 2020. Kruskal-Wallis and Mann-Whitney tests were used to analyze the data. Nonparametric statistics were used when data were not normally distributed. From 470 responses collected, the average horse age was 15.7 ± 7.5 years, and the most common breeds were the Quarter Horse and Thoroughbred. Of the 345 horses who received premixed feed, 81% were fed on a volume basis. Most horses (95%) received hay on a volume basis, and 57% of horses were fed hay on the ground rather than in a feeder. No difference was detected in the number of scoops of premixed feed (median = 2; P = .284) or the flakes of hay per day (median = 5.7; P = .765) between horses in different exercise categories. The frequency of reported GI issues was 10% (46/470). Owner perceived, veterinary perceived, and veterinary diagnosed ulcers were found in 2.3%, 4%, and 2.3% of horses, respectively. No statistical difference was detected in the number of scoops of premixed feed fed per day between horses with or without GI issues (P = .536). Horses were provided the same amount of premixed feed and forage regardless of reported exercise category. Most equine caretakers fed concentrates on volume rather than weight, a common practice despite most feeding requirements being based on feed weights.
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Affiliation(s)
- Erin L Orr
- Pennsylvania State University, University Park, PA 16802
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Lo Feudo CM, Stucchi L, Conturba B, Stancari G, Zucca E, Ferrucci F. Equine Gastric Ulcer Syndrome affects fitness parameters in poorly performing Standardbred racehorses. Front Vet Sci 2022; 9:1014619. [PMID: 36504861 PMCID: PMC9732101 DOI: 10.3389/fvets.2022.1014619] [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: 08/08/2022] [Accepted: 11/11/2022] [Indexed: 11/27/2022] Open
Abstract
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.
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Affiliation(s)
- Chiara Maria Lo Feudo
- Equine Sports Medicine Laboratory “Franco Tradati”, Department of Veterinary Medicine and Animal Sciences, Università Degli Studi di Milano, Lodi, Italy
| | - Luca Stucchi
- Veterinary Teaching Hospital, Department of Veterinary Medicine and Animal Sciences, Università Degli Studi di Milano, Lodi, Italy,*Correspondence: Francesco Ferrucci
| | - Bianca Conturba
- Veterinary Teaching Hospital, Department of Veterinary Medicine and Animal Sciences, Università Degli Studi di Milano, Lodi, Italy
| | - Giovanni Stancari
- Veterinary Teaching Hospital, Department of Veterinary Medicine and Animal Sciences, Università Degli Studi di Milano, Lodi, Italy
| | - Enrica Zucca
- Equine Sports Medicine Laboratory “Franco Tradati”, Department of Veterinary Medicine and Animal Sciences, Università Degli Studi di Milano, Lodi, Italy
| | - Francesco Ferrucci
- Equine Sports Medicine Laboratory “Franco Tradati”, Department of Veterinary Medicine and Animal Sciences, Università Degli Studi di Milano, Lodi, Italy,Luca Stucchi
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Gunes V, Onmaz AC, Pavaloiu A, Kaya Karasu G, van den Hoven R. A retrospective study of gastrointestinal disorders in a predominantly Austrian leisure horse referral hospital population. EQUINE VET EDUC 2022. [DOI: 10.1111/eve.13500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- V. Gunes
- Department of Internal Medicine Faculty of Veterinary Medicine University of Erciyes Kayseri Turkey
| | - A. C. Onmaz
- Department of Internal Medicine Faculty of Veterinary Medicine University of Erciyes Kayseri Turkey
| | - A. Pavaloiu
- Department of Internal Medicine and Clinical Laboratory University of Agricultural Sciences and Veterinary Medicine Cluj‐Napoca Cluj‐Napoca Romania
| | | | - R. van den Hoven
- Department for Small Animals and Horses Equine Clinic Section Internal Medicine and Infectious Diseases University of Veterinary Medicine Vienna Austria
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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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Stewart HL, Engiles JB, Stefanovski D, Southwood L. Clinical and intestinal histologic features of horses treated for recurrent colic: 66 cases (2006-2015). J Am Vet Med Assoc 2019; 252:1279-1288. [PMID: 29701532 DOI: 10.2460/javma.252.10.1279] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To describe gastrointestinal histologic findings for horses with recurrent colic and evaluate possible associations between initial clinical signs, biopsy method, histologic diagnosis, and outcome 1 year after hospital discharge. DESIGN Retrospective case series. ANIMALS 66 horses with a history of recurrent colic for which gastrointestinal specimens had been submitted for histologic examination. PROCEDURES Histologic diagnosis was categorized as inflammatory, neoplastic, ischemic, other, and undiagnosed. Relationships among initial clinical features, biopsy method, histologic diagnosis, and outcome 1 year after hospital discharge (ie, alive vs dead and persistent recurrent colic [yes vs no]) and between corticosteroid treatment and outcome were investigated. Odds ratios and hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated. RESULTS Inflammatory disease (36/66 [55%]) was the most common histologic diagnosis. Horses undergoing rectal biopsy alone were significantly (OR, 14.4; 95% Cl, 2.7 to 76.1) more likely to not have a histologic diagnosis than were horses in which other biopsy methods were used. In multivariable modelling, persistence of recurrent colic (HR, 15.2; 95% Cl, 1.9 to 121.2) and a history of weight loss (HR, 4.9; 95% Cl, 1.4 to 16.5) were significantly associated with outcome (alive vs dead) 1 year after surgery. Corticosteroid treatment was not significantly associated with either outcome. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that a high proportion (36/66 [55%]) of horses with recurrent colic had inflammatory gastrointestinal disease. Use of rectal biopsy alone to obtain biopsy specimens was more likely to result in no histologic diagnosis. Use of corticosteroids in horses with inflammatory gastrointestinal disease was not associated with outcome but warrants further investigation.
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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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Freeman DE. Fifty years of colic surgery. Equine Vet J 2018; 50:423-435. [DOI: 10.1111/evj.12817] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 12/05/2017] [Accepted: 01/10/2018] [Indexed: 12/21/2022]
Affiliation(s)
- D. E. Freeman
- Department of Large Animal Clinical Sciences; College of Veterinary Medicine; University of Florida; Gainesville Florida USA
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Diseases of the Alimentary Tract. Vet Med (Auckl) 2017. [PMCID: PMC7167529 DOI: 10.1016/b978-0-7020-5246-0.00007-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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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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Cook VL, Blikslager AT. The use of nonsteroidal anti-inflammatory drugs in critically ill horses. J Vet Emerg Crit Care (San Antonio) 2014; 25:76-88. [PMID: 25521286 DOI: 10.1111/vec.12271] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Accepted: 09/15/2014] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To review the physiology of the cyclooxygenase (COX) enzymes with reference to the beneficial effects of nonsteroidal anti-inflammatory drugs (NSAIDs) related to their analgesic and antiendotoxic properties as well as the mechanisms responsible for adverse gastrointestinal, renal, and coagulation effects. DATA SOURCES Human and veterinary peer reviewed literature VETERINARY DATA SYNTHESIS NSAIDs are frequently administered to critically ill horses for their analgesic and anti-inflammatory effects. However, NSAIDs have significant side effects principally on the gastrointestinal mucosa and kidneys. These side effects may be exacerbated in critically ill horses if they have gastrointestinal damage or are volume depleted CONCLUSIONS This review provides important information for equine veterinarians and criticalists on the advantages and disadvantages of using traditional NSAIDs and newer equine COX-2 selective NSAIDs for the management of different conditions in critically ill horses.
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Affiliation(s)
- Vanessa L Cook
- From the Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI (Cook); and
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Assessment of Gastric Ulceration and Gastrin Response in Horses with History of Crib-Biting. J Equine Vet Sci 2013. [DOI: 10.1016/j.jevs.2012.12.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Videla R, Sommardahl C, Elliott S, Vasili A, Andrews F. Effects of Intravenously Administered Esomeprazole Sodium on Gastric Juice pH in Adult Female Horses. J Vet Intern Med 2011; 25:558-62. [DOI: 10.1111/j.1939-1676.2011.0716.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Affiliation(s)
- J A Nadeau
- Department of Animal Science, University of Connecticut, Storrs, Connecticut 06269, USA
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Videla R, Andrews FM. New Perspectives in Equine Gastric Ulcer Syndrome. Vet Clin North Am Equine Pract 2009; 25:283-301. [DOI: 10.1016/j.cveq.2009.04.013] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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