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→Risk Factors
==Risk Factors==
==Risk Factors==
===Exercise===
===Exercise===
There appears to be a high prevalence of gastric ulcers in horses performing in most disciplines including racing, endurance, show jumping, dressage and western performance.(Hartmann and Frankeny 2003)in (Nadeau 2009). Although this may be related to exercise, other confounding factors associated with these disciplines such as travel, diet, feeding regime, NSAIDs and stress may be significant. However, Vatistas et al (2 1999) were able to induce and maintain EGUS in racehorses in fast work without the use of NSAIDs or fasting before exercise (Vatistas et al 2 1999). There is also evidence that training for just 8 days is suffcient to induce gastric ulcers.<ref>White, G, McClure, S.R, Siifferman, R, Holste, J.E, Fleishman, C, Murray, M.J, Cramer, L.G (2007) Effects of short-term light to heavy exercise on gastric ulcer development in horses and efficacy of omeprazole paste in preventing gastric ulceration. ''J Am Vet Med Assoc'', 230(11):1680-2.</ref> Furthermore, the higher prevalence of gastric ulcers at post mortem in racehorses in training compared to those in retirement adds weight to the hypothesis that exercise is an important risk factor for EGUS.(Hammond et al. (1986)It is thought that exercise increases the exposure of the squamous mucosa to acid as the stomach is compressed by the abdominal viscera and diaphragm during excessive movement (Lorenzo-Figueras and Merritt 2002).
There appears to be a high prevalence of gastric ulcers in horses performing in most disciplines including racing, endurance, show jumping, dressage and western performance.(Hartmann and Frankeny 2003)in (Nadeau 2009). Although this may be related to exercise, other confounding factors associated with these disciplines such as travel, diet, feeding regime, NSAIDs and stress may be significant. However, Vatistas et al (2 1999) were able to induce and maintain EGUS in racehorses in fast work without the use of NSAIDs or fasting before exercise (Vatistas et al 2 1999). There is also evidence that training for just 8 days is suffcient to induce gastric ulcers.<ref>White, G, McClure, S.R, Siifferman, R, Holste, J.E, Fleishman, C, Murray, M.J, Cramer, L.G (2007) Effects of short-term light to heavy exercise on gastric ulcer development in horses and efficacy of omeprazole paste in preventing gastric ulceration. ''J Am Vet Med Assoc'', 230(11):1680-2.</ref> Furthermore, the higher prevalence of gastric ulcers at post mortem in racehorses in training compared to those in retirement adds weight to the hypothesis that exercise is an important risk factor for EGUS.(Hammond et al. (1986) Strenuous exercise is known to stimulate gastrin release which has effects on HCl secretion, gastric emptying, gastric blood flow. It is also thought that exercise increases the exposure of the squamous mucosa to acid as the stomach is compressed by the abdominal viscera and diaphragm during excessive movement (Lorenzo-Figueras and Merritt 2002).
===Housing and Transport===
===Housing and Transport===
===Diet===
===Diet===
'''Feed deprivation''' encourages gastric ulceration in two ways: (1) it precludes the buffering capacity of protein leading to a reduced gastric pH (Murray and Schusser 1993) (2) it empties the stomach and exposes the squamous mucosa to the more mobile gastric juice.(Sandin 2000) It is predictable, therefore, that an alternating feed-fast protocol produces a consistent model of ulcer induction in the equine squamous mucosa (36, 37, 66 in Sanchez). Despite this, feed deprivation is not a prerequisite for gastric ulceration in the horse(Vatistas 1998). Diets that are plentiful in roughage prolong the mastication process and the production of salivary bicarbonate that protects the gastric mucosa. A diet of '''high grain and low roughage''' thus predisposes to EGUS. (Nadeau 2009). This sort of diet is commonly fed to racehorses but dietary components have also been shown to influence EGUS risk in nonracehorses<ref>Luthersson, N, Nielson, K.H, Harris, P, Parkin, T.D (2009) Risk factors associated with equine gastric ulceration syndrome (EGUS) in 201 horses in Denmark. ''Equine Vet J'', 41(7):625-30.</ref> Ponies fed a '''concentrate diet''' had a greater prevalence of gastric ulcers than ponies fed hay alone.(Vatisats 2 1999) '''High starch meals''' are also a risk because they are fermented to volatile fatty acids (VFAs) and lactic acid and are emptied from the stomach relatively slowly (Metayer et al. 2004)(Taharaguchi et al. 2004; Boswinkel et al. 2007)(Nadeau 2009)
'''Feed deprivation''' encourages gastric ulceration in two ways: (1) it precludes the buffering capacity of protein leading to a reduced gastric pH (Murray and Schusser 1993) (2) it empties the stomach and exposes the squamous mucosa to the more mobile gastric juice.(Sandin 2000) It is predictable, therefore, that an alternating feed-fast protocol produces a consistent model of ulcer induction in the equine squamous mucosa (36, 37, 66 in Sanchez). Despite this, feed deprivation is not a prerequisite for gastric ulceration in the horse(Vatistas 1998). Diets that are plentiful in roughage prolong the mastication process and the production of salivary bicarbonate that protects the gastric mucosa. A diet of '''high grain and low roughage''' thus predisposes to EGUS. (Nadeau 2009). This sort of diet is commonly fed to racehorses but dietary components have also been shown to influence EGUS risk in nonracehorses<ref>Luthersson, N, Nielson, K.H, Harris, P, Parkin, T.D (2009) Risk factors associated with equine gastric ulceration syndrome (EGUS) in 201 horses in Denmark. ''Equine Vet J'', 41(7):625-30.</ref> Ponies fed a '''concentrate diet''' had a greater prevalence of gastric ulcers than ponies fed hay alone(Vatisats 2 1999) and this may be because grain and pelleted feeds are asssociateds with increased serum gastrin.(Smyth et al 1988) '''High starch meals''' are also a risk because they are fermented to volatile fatty acids (VFAs) and lactic acid and are emptied from the stomach relatively slowly (Metayer et al. 2004)(Taharaguchi et al. 2004; Boswinkel et al. 2007)(Nadeau 2009)
===Other ailments===
===Other ailments===
===Temperament===
===Temperament===
A nervous disposition has been linked with gastric ulcers (McClure et al. 1999) but the same association was not seen in another study (Vatistas et al. 1999a)(Jonssen 2006).
A nervous disposition has been linked with gastric ulcers (McClure et al. 1999) but the same association was not seen in another study (Vatistas et al. 1999a)(Jonssen 2006). The physiological and psychological stresses of training, housing, boredom, travel, mixing, hospitalisation and entering new environments (Vatistas 2 1999) may increase the risk of developing EGUS. In foals hypoxia may also be a risk factor.
The results of our study suggest that, rather than training itself, the most stressful event may have been when horses entered their new environment..(Vatistas 2 1999)
==Clinical syndrome==
==Clinical syndrome==