Pathology of gastritis and gastric ulceration in the horse. Part 2: a scoring system

Prevalence of squamous gastric disease in Colombian equids at slaughter: A postmortem comparative study among horses, donkeys and mules

Equine Gastric Ulcer Syndrome (EGUS) occurs with variable prevalence in horses, donkeys, and mules. Due to the particularities of the mucous membranes, the syndrome is made up of Squamous Gastric Disease (ESGD) and Glandular Gastric Disease (EGGD). Given the multifactorial nature and multiple classification systems of the syndrome, significant differences have been reported between prevalence studies performed ante mortem, which are even more remarkable when compared with postmortem evaluations. This study aimed to determine the presence and grade of squamous gastric disease in horses, donkeys and mules immediately after slaughter. The postmortem examination considered the inspection of the squamous region (cardia, dorsal fundus, and margo plicatus) and the classification of the observed lesions. The general prevalence of ESGD in the entire population of study was 83.3 % (78 %, 89 %, and 83 % for horses, donkeys, and mules, respectively), compromising the margo plicatus in all cases. 75 % had more than 5 lesions and 50 % had deep lesions, lesions of varying severity and/or evidence of recent/active bleeding. The prevalence of ESGD was similar in horses, donkeys, and mules subjected to similar handling conditions prior to slaughter, including long-distance traveling, fasting, and stress factors.

Effect of diet composition on glandular gastric disease in horses

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.

Equine glandular gastric disease: prevalence, impact and management strategies

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.

Risk Factors for Equine Gastric Glandular Disease: A Case-Control Study in a Finnish Referral Hospital Population

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.

Pathology of gastric lesions in donkeys: A preliminary study

REASONS FOR PERFORMING STUDY

Donkeys (Equus africanus asinus) are important working animals, particularly in countries where the majority of the population lives below the poverty line. Gastric ulceration has been shown to be common in British donkeys but donkeys from other parts of the world have not been as extensively researched.

OBJECTIVES

This study was performed as a preliminary overview of the severity and distribution of gastric lesions in mature donkeys and to document which parasites were present.

STUDY DESIGN

Descriptive study of pathological findings.

METHODS

Stomachs of 35 mature draught donkeys were examined grossly and histopathology samples taken from 5 regions of the gastric mucosa.

RESULTS

Gross examination revealed hyperaemia, oedema, erosions and ulcers in addition to parasitic lesions. Histopathological examination revealed hyperkeratosis, acanthosis, vacuolar degeneration of stratified squamous cells, gastritis, erosions, ulcerations, scarring, hyperactivity of mucus glands, periglandular fibroplasia and parasitic granulomes with infestation by Gasterophilus spp. larvae, Habronema spp. and Draschia megastoma.

CONCLUSIONS

In donkeys, ulceration of the nonglandular regions of the stomach is more prominent than the glandular regions and parasitic infestations were frequent.

Gizzard erosion and ulceration syndrome in chickens and turkeys: a review of causal or predisposing factors

Gizzard erosion and ulceration syndrome (GEU) was described for the first time in the 1930s. The main focus of early studies was on nutritional deficiencies and peroxidation of highly polyunsaturated fatty acids as causative factors. During the 1970s and 1980s the focus was moved towards toxic substances in the feed. Scott's review in 1985 concluded that overproduction of gastric acid induced by gizzerosine was a major cause of GEU. During the last decades, serotype 1 of fowl adenovirus A and Clostridium perfringens have been implicated as important pathogenic agents in the development of GEU in chickens. Although GEU is globally distributed and its subclinical form appears to be common in commercial poultry flocks, the condition is rarely mentioned in standard textbooks on poultry health. This regrettable fact is probably due in part to the lack of one definitive cause of the syndrome.

Pathology of gastritis and gastric ulceration in the horse. Part 1: range of lesions present in 21 mature individuals

REASONS FOR PERFORMING STUDY

Gastric ulceration is now widely recognised as an important disease in high performance horses. Little is known about gastric histopathology in healthy or diseased animals; a comprehensive assessment would enhance interpretation of gross findings through assessment of their accuracy and allow for identification of lesion variety and pathogenesis in different anatomical regions of the stomach.

OBJECTIVES

To investigate the true extent and variety of gastric lesions in a mixed population of mature horses at post mortem.

METHODS

Stomachs were removed from a mixed population of 21 horses at post mortem. Mucosal abnormalities were recorded in photographic and written form. Representative samples from all gross lesions were taken for histopathology and processed routinely. Special stains including Gram, PAS and Warthin Starry, were used when appropriate. Pathological classification of lesion type using both gross and histological appearances was performed.

RESULTS

Classification of lesions within the squamous region included hyperkeratosis, punctate scars, diffuse erosions/ ulcerations and margo injuria; and within the glandular region, hyperaemia, focal erosions and ulcerations. Glandular metaplasia was recognised for the first time in the equine stomach. No Helicobacter-like organisms were detected in association with lesion development.

CONCLUSIONS AND POTENTIAL RELEVANCE

This study used gross and histological examination to highlight the large variety of naturally occurring gastric lesions in a mixed population of horses. Analysis of the pathogenesis of lesion development is now possible. Further research regarding the range of pathology in larger, more diverse groups of horses is required.