Gastric Ulcers In Horses Research Articles

The effect of a natural-source mineral supplement on gastric ulceration in horses

The effect of a natural-source mineral supplement on gastric ulceration in horses

The Effect of Serum-Based Bioactive Proteins for the Prevention of Squamous Gastric Ulcers in Horses

The objective of this study was to determine the effects of serum-based bioactive proteins on the prevention of squamous gastric ulcer formation in horses in moderate exercise programs over a 21-day period. Horses without ulcers were identified and randomly assigned to treatment or control group. Horses were subjected to a training program which induced squamous gastric ulceration in control horses. In horses treated with 210-g bioactive proteins, the incidence of squamous ulcers was significantly reduced (P = .0001) compared to control horses. In horses treated with 80-g bioactive proteins, 66.67% (10/15) of the control horses developed squamous gastric ulceration compared to 33.55% (5/15) of those administered bioactive proteins. In conclusion, dosing horses with bioactive proteins derived from serum was effective for preventing gastric ulcers in horses experiencing stress from exercise or training.

Occurrence of gastric ulcers in horses exercised on a treadmill

ABSTRACT: The most frequently causes of gastric ulcers in horses are fasting, feeding type and management, as well as administration of certain medications. More recently, exercise has also been identified as an important factor in the development of gastric lesions in athlete horses. The purpose of the present study was to assess whether treadmill exercise predisposes the horses to the occurrence of gastric ulcers. Five Arabian horses underwent a twelve-week training period on a treadmill and a gastroscopic evaluation before and after the training period. All animals showed gastric lesions after the training period. Based on these results, it is concluded that Arabian horses undergoing exercise on a treadmill may develop gastric lesions varying in number and severity.

A Comparison Between Omeprazole and a Dietary Supplement for the Management of Squamous Gastric Ulceration in Horses

Although several studies have assessed the short-term effect of dietary supplements on the treatment and prevention of gastric ulceration in horses, few have assessed the response over a duration of more than 30 days. A blinded randomized noninferiority clinical trial was conducted using 42 Thoroughbred horses in race training with squamous ulceration of ≥ grade 2/4, randomly assigned to one of two treatment groups for a period of 90 days: omeprazole at the full label dose of 4 mg/kg or the Succeed digestive conditioning supplement. Noninferiority analyses and Wilcoxon sign rank tests were used to analyze the data. At day 90, Succeed was noninferior to 4 mg/kg omeprazole administered daily in terms of the proportion of horses with complete resolution of squamous ulceration. At day 30, Succeed was found to be inferior to omeprazole in terms of the proportion of horses with grade ≤1/4 squamous ulceration. The proportion of horses with reducing squamous ulcer score (compared with day 0) was statistically significant for both treatments at days 30 and 60. At day 90 of the 17 horses on Succeed, nine had a reducing squamous ulcer score (P value = .049), and of the 19 horses on omeprazole, 10 had a reducing squamous ulcer score at day 90 (P value = .091). The noninferiority of Succeed compared to omeprazole at 90 days for the complete resolution of squamous ulceration and the reduced efficacy of omeprazole following 90 days of treatment are likely to be of interest to practitioners managing gastric ulceration in performance horses.

The influence of feeding a high calcium, algae supplement on gastric ulceration in adult horses

SummaryCalcium is considered important in buffering excess stomach acid in mammals, including horses. Control of stomach acid is important in preventing the development of ulcers within the stomach lining, which, in horses, are considered to be caused by acid splashing. Algae supplements contain various minerals which are in natural form, as seen in all plant and feedstuffs. The current trial was conducted to examine if a high calcium algae supplement had any impact on gastric ulceration in horses, which may be due to buffering stomach acid, reducing the pH in a gradual manner, without resorting to medication. Ten horses, of either thoroughbred, standardbred or sport horse breed, were selected on the basis of the presence of ulcers in their stomach, as ascertained by endoscopy. The average ulceration score before algae supplementation was 2.2 ± 0.75 according to the EGUC scoring system. The horses were then maintained on their normal diet (unchanged from the initial ulcer scoring) by the owner with the addition of 40 g per day of the high calcium, algae based Maxia Complete® (Seahorse Supplements Ltd, Christchurch, NZ) for thirty days (T30). All horses were then re endoscoped to assess any change in ulceration score. All horses showed a significant improvement in ulcer score, with seven having a score of zero (fully healed, no evidence of further ulceration) and two with a score of one (some residual inflammation or keratinosis in areas of healed ulcers). This resulted in a mean score of 0.3 ± 0.48 (P < 0.0001: T0 versus T30) at the end of the study. This trial demonstrated that feeding an organic form of high calcium from algae reduced ulceration in horses.

Gastric juicepHmeasurement in horses: Three‐quarters of a century of history!

SummaryInhibition of gastric acid and increased stomachpH>4.0 is currently accepted as the mainstay of treatment for gastric ulcers in horses. Measurement of gastricpHis complicated and requires placement of a cannula and collection of gastric juice or placement ofpHelectrodes in the stomach. Since the distance from the nares to the stomach is approximately 200 cm, finding a system with apHelectrode with this length is difficult, not to mention difficult to maintain. There has been a fascination with the measurement of gastric juicepHin horses that has covered three‐quarters of a century starting with a fistula model in 1933 and culminating in a recent technique described in this issue. Placement of gastric cannulas and variouspHelectrodes have been used to measure gastric juicepHin horses in the past and present, but the future may require more sophisticated methods as we look at the efficacy of different formulations of acid suppressive drugs for treatment of equine gastric ulcer syndrome.

Short-Term Omeprazole Use Does Not Affect Serum Calcium Concentrations and Bone Density in Horses

Omeprazole is used to treat gastric ulcers in horses. In some human and experimental animal studies, proton pump inhibitor use has been associated with a change in bone density or fracture risk. This study evaluated the effects of administration of omeprazole for 60 days and its effects on serum total calcium, ionized serum calcium, bone mineral content (BMC), and bone mineral density (BMD) in horses. Blood samples and bone biopsies from the tibia were collected from 10 geldings aged 2 and 3 years old before beginning treatment. Horses were administered either 4 mg/kg omeprazole paste or an equal volume of vehicle only paste orally once per day for 60 days. Blood samples were taken at days 7, 14, 21, 28, 35, 42, 49, 56, and 60. Serum total calcium and ionized calcium were measured on all samples. Horses were euthanized on day 60, and bone was harvested from all horses from the contralateral tibia. In addition, the third metacarpal bones and proximal femurs were harvested from each subject. Bone samples were evaluated for BMD and BMC using peripheral quantitative computed tomography (pQCT). Serum total calcium and ionized calcium concentrations were not significantly different between treated and control groups. Bone density and composition were also not significantly different when compared between control and treatment groups. Short-term administration of omeprazole does not significantly affect serum total calcium and ionized serum calcium concentrations nor does it affect bone density or BMC in normal horses as measured with pQCT.

Administration of trimethoprim-sulphadimidine does not improve healing of glandular gastric ulceration in horses receiving omeprazole: a randomised, blinded, clinical study.

BackgroundInterest in Equine Gastric Ulcer Syndrome (EGUS) has recently increased in part due to a growing awareness of the differences between squamous and glandular disease. The pathophysiology and epidemiology of squamous and glandular disease are different and recently it has been shown that the response of glandular gastric ulceration to monotherapy with omeprazole is poor. Given these differences it has been recommended that specific treatment guidelines be formulated for equine glandular disease and that adjunctive therapies be investigated. Along these lines it has been suggested that the addition of antimicrobials may enhance healing. The objective of this study was to investigate whether the addition of trimethoprim-sulphadimidine to omeprazole therapy would result in superior healing of naturally occurring equine glandular ulceration compared with omeprazole monotherapy.ResultsCombination therapy of omeprazole plus trimethoprim-sulphadimidine could not be demonstrated to be superior to omeprazole monotherapy. Healing of the glandular mucosa was observed in 7/15 (47%; 95% CI 24 to 71%) and 3/13 (23%; 95% CI 7% to 50%) of horses in the TMPS and OMEP groups, respectively (OR?=?1.8; 95% CI 0.32 to 10.0; p?=?0.67). Improvement of the glandular mucosa was observed in 12/15 (80%; 95% CI 56 to 94%) and 9/13 (69%; 95% CI 42 to 89%) of horses in the TMPS and OMEP groups, respectively (OR?=?2.9; 95% CI 0.6 to 15.0; p?=?0.25).ConclusionsThe results of the present study do not support the addition of trimethoprim-sulphadimidine to therapeutic protocols for equine glandular ulceration. Several limitations were present in the study and the use of antimicrobials as an adjunctive treatment warrants further investigation. However, given the potential deleterious consequences associated with the indiscriminate use of antimicrobials, the inclusion of antimicrobials in treatment regimes for EGUS is not justified until their efficacy is further validated.

Influence of Exercise in the Occurrence of Gastric Ulcers in Horses

IntroductionThe most frequently reported causes of gastric ulcers in horses are fasting, type of feed and management, and the administration of some drugs. More recently, physical exercise has also been pointed out as an important factor in the development of gastric lesions in athletic horses. The aim of this study was to evaluate whether treadmill exercise predisposes to the occurrence of gastric ulcers in horses.MethodsFive Arabian horses were exercised on a high‐speed treadmill during twelve weeks. The animals were submitted to gastroscopy before the beginning and the end of the training period. The lesions were classified according to the method proposed by Macallister [1] that assigns scores for number and severity of injuries, with modifications to give a total score for the stomach, considering not only the presence and severity of ulcers, but also other findings as gastritis, hyperkeratosis, desquamation of the mucosa. The results obtained in the two periods were compared using the Wilcoxon test, with significance at P<0.05.ResultsIn the first gastroscopy two animals had very low scores for lesion number and severity and three horses had no injury. In contrast, in the second evaluation, all animals had higher scores. A significant difference was observed between the two periods (before and after training) considering both methods of gastric lesion classification.ConclusionsWe concluded that Arabian horses exercised on a treadmill may develop gastric lesions. The possible influence of these lesions on athletic performance and other parameters should be considered by researchers who study equine exercise physiology.Ethical Animal ResearchThis study was approved by the Ethics Committee on Animal Use (protocol number 1741). Sources of funding: FAPESP 2012/10886‐3. Competing interests: none.

Efficacy of a pectin-lecithin complex for treatment and prevention of gastric ulcers in horses

The objective of this study was to evaluate the effect of a commercial feed supplement containing pectin-lecithin on squamous mucosa ulceration in horses exposed to an experimental ulceration model. Five...

Dietary control of gastric ulcers in horses

Dietary control of gastric ulcers in horses

Dietary control of gastric ulcers in horses

Andy E Durham European Specialist in Equine Medicine, Liphook Equine Hospital, discusses potential strategies for long-term control

Efficacy of Omeprazole Powder Paste or Enteric‐Coated Formulation in Healing of Gastric Ulcers in Horses

BackgroundGastroGard, an omeprazole powder paste formulation, is considered the standard treatment for gastric ulcers in horses and is highly effective. Gastrozol, an enteric‐coated omeprazole formulation for horses, has recently become available, but efficacy data are controversial and sparse.ObjectivesTo investigate the efficacy of GastroGard and Gastrozol at labeled doses (4 and 1 mg of omeprazole per kg bwt, respectively, PO q24h) in healing of gastric ulcers.Animals40 horses; 9.5 ± 4.6 years; 491 ± 135 kg.MethodsProspective, randomized, blinded study. Horses with an ulcer score ≥1 (Equine Gastric Ulcer Council) were randomly divided into 2 groups and treated for 2 weeks each with GastroGard followed by Gastrozol (A) or vice versa (B). After 2 and 4 weeks, scoring was repeated and compared with baseline. Plasma omeprazole concentrations were measured on the first day of treatment after administration of GastroGard (n = 5) or Gastrozol (n = 5).ResultsCompared with baseline (squamous score (A) 1.65 ± 0.11, (B) 1.98 ± 0.11), ulcer scores at 2 weeks ((A) 0.89 ± 0.11, (B) 1.01 ± 0.11) and 4 weeks ((A) 1.10 ± 0.12, (B) 0.80 ± 0.12) had significantly decreased in both groups (P < .001), independent of treatment (P = .7). Plasma omeprazole concentrations were significantly higher after GastroGard compared with Gastrozol administration (AUCGG = 2856 (1405‐4576) ng/mL × h, AUCGZ = 604 (430‐1609) ng/mL × h; P = .03). The bioavailability for Gastrozol was 1.26 (95% CI 0.56–2.81) times higher than for GastroGard.Conclusions and Clinical ImportanceBoth Gastrozol and GastroGard, combined with appropriate environmental changes, promote healing of gastric ulcers in horses. However, despite enteric coating of Gastrozol, plasma omeprazole concentrations after single labeled doses were significantly higher with GastroGard.

Development and validation of a gas chromatography–flame ionization detection method for quantifying sucrose in equine serum

A simple and accurate method for quantifying sucrose in equine serum that can be applied to sucrose permeability testing in the horse was developed and validated using gas chromatography with flame ionization detection. The assay provided an acceptable degree of linearity, accuracy, and precision at concentrations of sucrose as low as 2.34 μmol/l and as high as 20.45 μmol/l. Percentage recovery of sucrose from serum ranged from 89% to 102%; repeatability and intermediate precision (relative standard deviation) ranged from 3.6% to 6.7% and 4.1% to 9.3%, respectively. The limit of detection was 0.73 μmol/l. No interfering peaks were observed except lactose, which gave 2 peaks, one of which overlapped partially with sucrose. To evaluate the suitability of the method for quantifying sucrose in serum samples from horses with naturally occurring gastric ulceration, 10 horses with and without naturally occurring gastric ulceration were subjected to sucrose permeability testing. All horses demonstrated an increase in serum sucrose concentration over time following oral administration of sucrose; however, the increase from baseline was significant for horses with gastric ulceration at 45 min (P = 0.0082) and 90 min (P = 0.0082) when compared with healthy horses. It was concluded that gas chromatography with flame ionization detection is a valid method for quantifying sucrose in equine serum and can be applied directly to the analysis of sucrose in equine serum as part of a larger validation study aimed at developing a blood test for the diagnosis of gastric ulcers in horses.

Pioneering research in practice

Practitioner Richard Hepburn recently completed a Masters in gastric ulceration in horses, during which he identified what he believes is a new gastric condition. He is in his first year of a PhD to continue his studies

Conceptos Generales Sobre Ulceración Gastrica De Los Caballos. Parte 2. Diagnóstico Y Tratamiento

Este trabajo propone y aborda una revisión de literatura sobre el diagnóstico y tratamiento de la ulceración gástrica de los caballos, destacando aspectos importantes y fundamentales que deben ser tenidos en cuenta durante el abordaje diagnóstico de casos clínicos y la escogencia de la alternativa terapéutica adecuada. Debido a la alta incidencia de esta patología, que en muchas ocasiones pasa por inadvertida, atribuido muy posiblemente a la variabilidad de los signos y síntomas presentes en esta enfermedad o a la falta de conocimiento y sensibilización por parte de los Médicos Veterinarios acerca de la importancia del adecuado manejo de las úlceras gástricas y sus repercusiones en la salud y el rendimiento de los caballos. El diagnóstico de la enfermedad debe basarse en la anamnesis precisa, los signos clínicos y la respuesta al tratamiento. Sin embargo, el patrón más relevante es la gastroscopia, siendo esta la manera más objetiva y precisa de diagnóstico, ya que permite el examen directo y valoración correcta de las lesiones. Las estrategias terapéuticas del síndrome de ulceración gástrica de los caballos, se fundamenta principalmente en la reducción de la acidez gástrica, el manteniendo el pH intragástrico mayor a 4, proteger o recubrir la úlcera gástrica con un agente resistente al ácido clorhídrico y por ultimo estimular la protección intrínseca de la mucosa

Behaviour and stress responses in horses with gastric ulceration

Only little is known about behaviour and stress responses in horses with gastric ulceration, despite the high prevalence of this condition. Our objectives in the present study was to (i) describe the severity of gastric ulceration in horses, housed under relatively standardised conditions, and (ii) to investigate whether horses with severe glandular gastric ulceration have increased baseline and response concentration of stress hormones and behave differently than control horses. We investigated stomachs of 96 horses at one stud, and compared an ulcer group (n=30; with severe lesions in the glandular mucosa) to paired controls (n=30; free from gastric ulcers). Baseline and response concentrations of faecal cortisol metabolites (FCM), heart rate and behaviour were measured in a novel object test (NOT, Day 1) and behaviour during postponed feeding (PF, Day 2). Glandular lesions occurred in 55.2% and non-glandular lesions in 40.6% of the horses. The amount of starch in the feed (P=0.006) and paternal stallion (P=0.031) influenced ulceration in the non-glandular region only; it should be noted that our study does not allow for separating hereditary from environmental influences, as offspring may be e.g. trained differently dependent on breeding line. Ulcer horses pawed more (P<0.001) and ate quicker (P=0.050) during PF. Although displayed by ulcers horses only during PF, we failed to demonstrate a significant association between glandular gastric ulceration and crib-biting/weaving; the total number of horses with these types of abnormal behaviour was low (n=5). Behaviour and heart rate did not differ between groups in the NOT. Baseline concentration of FCM was similar (P=0.79), however, ulcer horses responded stronger to novelty than controls (26% higher FCM; P=0.018). We conclude that the prevalence of gastric ulcers was high, and our results suggest different factors affecting ulceration in the glandular versus the non-glandular region of the horse stomach. Obvious external signs (e.g. poor body condition) identifying ulcer horses were absent. Horses with severe glandular ulcers had a higher stress hormone response to novelty, thus they were more stress sensitive. Consequently, management evoking stress in horses should be reduced to dampen the development of glandular ulceration, or to protect horses with this condition.

Effect of Sea Buckthorn Berries and Pulp in a Liquid Emulsion on Gastric Ulcer Scores and Gastric JuicepHin Horses

Sea buckthorn berries (Hippophae rhamnoides) are rich in vitamin C and E, carotenoids, flavonoids, fatty acids, plant sterols, lignans, and minerals. A feed supplement containing sea buckthorn berries might have efficacy in treatment and prevention of gastric ulcers in horses. To test the efficacy of a commercially available formulation of sea buckthorn berries and pulp (SeaBuck SBT Gastro-Plus) for treatment and prevention of gastric ulcers in stall-confined horses. Eight Thoroughbred and Thoroughbred-cross horses (3-10 years of age, 5 geldings and 3 mares, 380-600 kg body weight). This study was a 2-period crossover in which all horses received no treatment (untreated controls; n = 8) and treatment (SeaBuckSBT Gastro-Plus, 4 ounces [35.6 g berries and pulp], twice daily; n = 8) mixed with a pelleted complete feed (18% crude fiber; 9% starch; 14% crude protein). Horses were treated for 4 weeks followed by a 1-week (d28-d35) alternating feed-deprivation period to induce or worsen existing ulcers. Gastroscopic examinations were performed on days 0, 28, and 35. Gastric juice pH was measured and gastric ulcer number and severity scores were assigned by a masked investigator. Mean nonglandular gastric ulcer scores significantly (P < .05) increased in all horses after day 28, as a result of intermittent feed deprivation. Mean nonglandular gastric ulcer number (P = .84) and severity (P = .51) were not significantly different between SBT-treated and untreated control horses. However, mean glandular ulcer number (P = .02) and glandular ulcer severity (P = .02) were significantly lower in the SBT-treated horses compared with the untreated control at week 5. SeaBuck SBT Gastro-Plus liquid fed to horses did not show efficacy in treatment or prevention of naturally occurring nonglandular ulcers in horses; however, glandular ulcer scores were significantly lower in SBT-treated horses after feed deprivation. Thus, SBT might have efficacy in prevention of glandular ulcers in horses housed in stalls and undergoing intermittent feeding.

Presencia del síndrome de úlcera gástrica en equinos de la policía militar

SUMMARY The equine gastric ulcer syndrome (EGUS) has a multifactorial nature with a high and variable prevalence in populations of horses subjected to sport activities and high physical demand. The aim of this study was to describe the frequency of presentation of gastric ulcers in horses of the military police that carried out activities of training, patrolling and inactivity. 32 Brazilian race riding horses aged between 3 and 20 years were evaluated clinically and gastroscopy, gastric lesions were located and classified by number and severity score. A 43.8% of equines showed ulcers, with 37.5% and 6.3% affecting nonglandular and glandular mucus, respectively. No association was reported between the type of activity performed by the animals and the degrees of ulceration found. These results show the presence of EGUS in this type of animals without showing clinical signs and decrease in performance.

Effects of Intravenously Administered Esomeprazole Sodium on Gastric Juice pH in Adult Female Horses

Gastric ulcers are common in horses and treatment of horses that cannot be administered oral medication can be problematic. To evaluate the efficacy of esomeprazole sodium administered intravenously on gastric juice pH and gastric ulcer scores in horses. Twelve adult female Quarter Horses. Esomeprazole sodium (0.5 mg/kg IV) was administered once daily to 8 horses (treatment group) and saline (5 mL IV) was administered to 4 horses (control group) for 13 consecutive days. Gastroscopy was performed and gastric juice pH and gastric ulcer score were recorded before and 1 hour after the administration of esomeprazole sodium or saline on days 1 and 5, then on day 14, 23 hours after the 13th daily dose of esomeprazole sodium or saline. When compared with values before treatment, gastric juice pH was higher in esomeprazole sodium-treated horses after treatment (4.25 ± 2.39 versus 6.43 ± 1.18; P = .002). Also, gastric juice pH was higher (P = .001) in esomeprazole sodium-treated horses compared with saline-treated control horses on day 5 and on day 14 values. Gastric ulcers were seen in 5/12 (43%) horses in the study. Esomeprazole sodium shows promise for treatment of gastric ulcers in horses with signs of dysphagia, gastric reflux, or other conditions that restrict oral intake of the current Federal Drug Administration-approved omeprazole paste.