Changes

===NSAIDs===

===NSAIDs===

As in [[Gastric Ulceration - all species|other species]], nonsteroidal anti-inflammatory drugs (NSAIDs) have been shown to cause gastric ulcers in horses. Typicaly this is associated with high doses or frequent administration of phenylbutazone or flunixin meglumine.  However, although there is evidence to the contrary,<ref>Andrews, F.M, Reinemeyer, C.R, Longhofer, S.L (2009) Effects of top-dress formulations of suxibuzone and phenylbutazone on development of gastric ulcers in horses. ''Vet Ther'', 10(3):113-20.</ref>therapeutic doses of NSAIDs may be sufficient to induce EGUS.  Other studies have suggested that suxibuzone causes significantly less ulcerogenic effects than phenylbutazone when administered orally(Monreal et al. 2004) and that combination treatment with phenylbutazone and flunixin meglumine may be more risky than phenylbutazone alone.(Reed et al. 2006)  The ulcers produced by NSAIDs are unusual in that they have a predilection for the glandular mucosa(MacAllister et al. 1993 in Jonssen)(Furr and Murray 1989; Kuinaran and Bhuvanakumar 1994 In: Vatistas, N.J, Sifferman, R.L, Holste, J, Cox, J.L, Pinalto, G, Schultz, K.T (1999) Induction and maintenance of gastric ulceration in horses in simulated race training.  ''Equine Vet J Suppl'', 29:40-44</ref>, they may look different endoscopically from ulcers that occur naturally,(Jonssen 2006) and they appear to heal spontaneously.(Jones 1983; MacAllister and Sangiah 1993 in Vatisats 2 1999)  Despite the well-established link bewteen NSAIDs and ulcers, NSAIDs are rarely responsible for the lesions in horses in race training.(Vatistas et al. 3994b; Murray et al. 1996; Vatistas 1998 In: Vatistas, N.J, Sifferman, R.L, Holste, J, Cox, J.L, Pinalto, G, Schultz, K.T (1999) Induction and maintenance of gastric ulceration in horses in simulated race training.  ''Equine Vet J Suppl'', 29:40-44</ref>

As in [[Gastric Ulceration - all species|other species]], nonsteroidal anti-inflammatory drugs (NSAIDs) have been shown to cause gastric ulcers in horses. Typicaly this is associated with high doses or frequent administration of phenylbutazone or flunixin meglumine.  However, although there is evidence to the contrary,<ref>Andrews, F.M, Reinemeyer, C.R, Longhofer, S.L (2009) Effects of top-dress formulations of suxibuzone and phenylbutazone on development of gastric ulcers in horses. ''Vet Ther'', 10(3):113-20.</ref>therapeutic doses of NSAIDs may be sufficient to induce EGUS.  Other studies have suggested that suxibuzone causes significantly less ulcerogenic effects than phenylbutazone when administered orally(Monreal et al. 2004) and that combination treatment with phenylbutazone and flunixin meglumine may be more risky than phenylbutazone alone.(Reed et al. 2006)  The ulcers produced by NSAIDs are unusual in that they have a predilection for the glandular mucosa(MacAllister et al. 1993 in Jonssen)(Furr and Murray 1989; Kuinaran and Bhuvanakumar 1994 In: Vatistas, N.J, Sifferman, R.L, Holste, J, Cox, J.L, Pinalto, G, Schultz, K.T (1999) Induction and maintenance of gastric ulceration in horses in simulated race training.  ''Equine Vet J Suppl'', 29:40-44</ref>, they may look different endoscopically from ulcers that occur naturally,<ref name="Jonsson">Jonsson, H, Egenvall, A (2006) Prevalence of gastric ulceration in Swedish Standardbreds in

race training.  ''Equine Vet J'', 38(3):209-213.</ref> and they appear to heal spontaneously.(Jones 1983; MacAllister and Sangiah 1993 in Vatisats 2 1999)  Despite the well-established link bewteen NSAIDs and ulcers, NSAIDs are rarely responsible for the lesions in horses in race training.(Vatistas et al. 3994b; Murray et al. 1996; Vatistas 1998 In: Vatistas, N.J, Sifferman, R.L, Holste, J, Cox, J.L, Pinalto, G, Schultz, K.T (1999) Induction and maintenance of gastric ulceration in horses in simulated race training.  ''Equine Vet J Suppl'', 29:40-44</ref>

===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).  The physiological and psychological stresses of training, housing, boredom, travel, mixing, hospitalisation and entering new environments<ref name="Vatistas 2">Vatistas, N.J, Sifferman, R.L, Holste, J, Cox, J.L, Pinalto, G, Schultz, K.T (1999) Induction and maintenance of gastric ulceration in horses in simulated race training.  ''Equine Vet J Suppl'', 29:40-44</ref> may increase the risk of developing EGUS.  In foals hypoxia may also be a risk factor.

A nervous disposition has been linked with gastric ulcers<ref>McClure, S.R, Glickman, L.T, Glickman, N.W (1999) Prevalence of gastric ulcers in show horses.  ''J Am Vet Med Ass 215:1130-1133.  In: In: Jonsson, H, Egenvall, A (2006) Prevalence of gastric ulceration in Swedish Standardbreds in race training.  ''Equine Vet J'', 38(3):209-213.</ref>but the same association was not seen in another study.<ref>Vatistas, N.J, Snyder, J.R, Carlson, G, Johnson, B, Arthur, R.M, Thurmond, M, Zhou, H, Lloyd, L.K (1999) Cross-sectional study of gastric ulcers of the squamous mucosa in Thoroughbred racehorses.  ''Equine Vet J Suppl'', 29:34-39.  In: Jonsson, H, Egenvall, A (2006) Prevalence of gastric ulceration in Swedish Standardbreds in race training.  ''Equine Vet J'', 38(3):209-213.</ref> The physiological and psychological stresses of training, housing, boredom, travel, mixing, hospitalisation and entering new environments<ref name="Vatistas 2">Vatistas, N.J, Sifferman, R.L, Holste, J, Cox, J.L, Pinalto, G, Schultz, K.T (1999) Induction and maintenance of gastric ulceration in horses in simulated race training.  ''Equine Vet J Suppl'', 29:40-44</ref> may increase the risk of developing EGUS.  In foals hypoxia may also be a risk factor.

==Clinical syndrome==

==Clinical syndrome==