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|'''Gastroduodenal ulceration<br>
|'''Gastroduodenal ulceration<br>
'''Equine Gastric Ulcer Syndrome<br>
'''Equine Gastric Ulcer Syndrome<br>
'''Peptic ulcer disease<br>
'''Equine Gastric Ulcer'''
'''Equine Gastric Ulcer'''
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*Excessive recumbency
*Excessive recumbency
*Bruxism (in foals only and almost pathognomonic)
*Bruxism (in foals only and almost pathognomonic)
Foals with outflwo obstruction will dveelop reflux after suckling or marked reflux even with limited to no sukcling if the duodenal obstruction is distal to the common biel duct.(Sanhcez)
==Diagnosis==
==Diagnosis==
Definitive diagnosis requires gastroscopy (cannot do in foals as need to starve prior to exam)
Presumptive on clinical signs and response to treatment (Sanchez)
Definitive diagnosis requires endoscopy (cannot do in foals as need to starve prior to exam)
==Laboratory tests==
==Laboratory tests==
No known laboratory markers, attempts to detect occult blood in faeces unreliable in horse
No known laboratory markers, attempts to detect occult blood in faeces unreliable in horse. Other tests need further evaulationfor senstivty and sepcificity (Sanchez):
Urine (93) and blood (94) sucrose absorption testing have been evauated a sameasure of gastric mucosal permeability (Sanchez)
Serum alpha1-antitrypsin was detectable more frequnetly infoals with gastrci ulceration (95 in Sanchez)
==Endoscopy==
==Endoscopy==
EGUS Lesion Scoring System (2 in Sanchez)
Performed under mild sedation in standing horse or foal (Sanchez)
Duodenoscopy is most specific diagnostic method but is technically me chanllenegng than gastrocopy
EGUS Lesion Scoring System publsihed based on consens by Equine Gastric Ulcer Council(2 in Sanchez)
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Minimum endoscope length of two metres and 2.8-3.0 metre instruments are reuired for duodenoscopy
Diffuse reddeing or inflammation may be only lesion seen in cases of early duodenal disease
In older foals with GDUD, detection ofgastrci outflow obsturction is critical to therapeutic plan and appropriate prognosis (Sanchez)
Minimum endoscope length of two metres and 2.8-3.0 metre instruments are required for duodenoscopy
A 3 mtre endoscope allows visualization of stomach, pyrlorus and proximal duodenum (Sanchez)
Shorter scopes permit investigation fo gastric body and fundus only (Sanchez)
Maximum external diameter of 9mm for neonates (Sanchez)
Foals - lesions mainly in glandular epithelium
Foals - lesions mainly in glandular epithelium
Adults - margo plicatus and squamous epithelium
Adults - margo plicatus and squamous epithelium
Abdominal radiography without contrast in foals with outflow obsturction typically rveeals very disticnt enlarged, gas-filled stomach. Liquid barium contrast will either have markedly delayed (with incomplete obstruction) oir no (complete onsbtruction) outflow. (Sanchez)
==Pathology==
==Pathology==