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Neurological Disease
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September 2002 newsletter
Equine Gastric Ulcer Syndrome
What is it and does your horse have it?
Equine Gastric Ulcer Syndrome (EGUS) is the name given to include the
many causes and severities of the changes of the equine gastric lining that
result in ulcerations. Some studies show that over 93% of horses in race
training have evidence of gastric ulcers. More recent studies show that horses
of all disciplines are being diagnosed with gastric ulceration that is affecting
their performance. Clinical signs of the disease are independent of the severity
of the ulcers. Some horses with severe ulcers show no clinical signs and some
with only mild ulcers show symptoms. Clinical signs include decreased
performance, attitude change, decreased appetite, backing off from feed,
dullness, poor body condition/weight loss, colic, pawing while eating, and many
other signs. There are no blood tests to determine if your horse has ulcers. The
only way at this time to diagnose them is via gastroscopy. A 3 meter endoscope
is passed into the horses stomach and the entire surface of the stomach and the
point at which the esophagus enters the stomach are examined. The horse is
fasted for 8-12 hours prior to the procedure so that food does not obstruct any
surface. Light sedation is used to facilitate the procedure. Most horses
tolerate the examination very well. The equine stomach is divided into an upper
squamous portion and a lower glandular portion. The line between these two areas
in called the margo plicatus. All of the digestive processes take place via the
glandular portion with digestive acids being produced constantly. The squamous
and glandular portions of the stomach have defense mechanisms to protect the
cells from the constant flow of acid, but sometimes they are overwhelmed and
ulcers result. Most ulcers appear in the squamous portion of the stomach. Ulcers
are visually graded on a scale of 0-4.
Grade 0= Normal epithelium with no reddening or hyperkeratosis (yellow
appearance and thickened).
Grade 1= Areas of reddening and hyperkeratosis.
Grade 2= Small, single, or multifocal lesions.
Grade 3= Large, single or multiple lesions, or extensive superficial
lesions.
Grade 4= Extensive lesions wath areas of apparent deep ulceration.
Treatment is based on suppressing acid production. Currently the only
approved product for treatment of EGUS is omeprazole (Gastroguard), a proton
pump inhibitor. It is administered orally once daily for 28 days and then a
maintenance dose can be given. Other acid suppressors such as ranitidine,
famotidine, and cimetidine have been used with varying success. Sucralfate acts
as a "band aid" on existing ulcers and can aid in the healing process.
Other treatments are also available depending on severity of the individual
case. None of these treatments should be given without first performing
gastroscopy to determine if a horse actually has gastric ulcers. Treatment
without an underlying problem can not only be a waste of money, but many of the
treatments can have side effects and should not be used without just cause.
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