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| | ===Laboratory tests=== | | ===Laboratory tests=== |
| − | The detection of occult blood in faeces has proven unreliable in the horse and currently, useful laboratory markers for EGUS are lacking.<ref name="EGUC">The Equine Gastric Ulcer Council (1999) Tutorial Article: Recommendations for the diagnosis and treatment of equine gastric ulcer syndrome (EGUS). ''Equine Vet Educ'', 11(5):262-272.</ref> Tests that require further analysis for sensitivity and specificity<ref name="Sanchez">Sanchez, L.C (2010) 'Diseases Of The Stomach' in Reed, S.M, Bayly, W.M. and Sellon, D.C (2010) '''Equine Internal Medicine''' (Third Edition), Saunders, Chapter 15.</ref> include:
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| − | *Urine<ref>O'Connor, M.S, Steiner, J.M, Roussel, A.J, ''et al.'' (2004) Evaluation of urine sucrose concentration for detection of gastric ucleration in horses. ''Am J Vet Res'', 65:31-39. In: Sanchez, L.C (2010) 'Diseases Of The Stomach' in Reed, S.M, Bayly, W.M. and Sellon, D.C (2010) '''Equine Internal Medicine''' (Third Edition), Saunders, Chapter 15.</ref> and blood<ref>Hewetson, M, Cohen, N.D, Love, S, ''et al.'' (2006) Sucrose concentration in bood: a new method for assessment of gastric permeability in horses with gastric ulceration. ''J Vet Intern Med'', 20:388-394. In: Sanchez, L.C (2010) 'Diseases Of The Stomach' in Reed, S.M, Bayly, W.M. and Sellon, D.C (2010) '''Equine Internal Medicine''' (Third Edition), Saunders, Chapter 15.</ref> sucrose absorption as an assay of gastric mucosal permeability
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| − | *Serum alpha1-antitrypsin which has been detected more frequently in foals with gastric ulceration<ref>Taharaguchi, S, Nagano, A, Okai, K, ''et al.'' (2007) Detection of an isoform of alpha(1)-antitrypsin in serum samples from foals with gastric ulcers. ''Vet Rec'', 161:338-342. In: Sanchez, L.C (2010) 'Diseases Of The Stomach' in Reed, S.M, Bayly, W.M. and Sellon, D.C (2010) '''Equine Internal Medicine''' (Third Edition), Saunders, Chapter 15.</ref>
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| | + | Currently, useful and reliable markers for EGUS are lacking.<ref name="EGUC">The Equine Gastric Ulcer Council (1999) Tutorial Article: Recommendations for the diagnosis and treatment of equine gastric ulcer syndrome (EGUS). ''Equine Vet Educ'', 11(5):262-272.</ref> The SUCCEED Equine Faecal Blood Test uses specific equine monoclonal antibodies to albumin and haemoglobin to detect occult blood in faeces.(Carter and Pellegrini 2006; Pellegrini and Carter 2007) The test has a positive predictive value of 77% and a negative predictive value of 72% and thus cannot be relied upon alone to diagnose EGUS(Nadeau 2009). False positive results may arise from rectal trauma (e.g. recent biopsy or rectal examination) or protein losing enteropathy.(Nadeau 2009) |
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| − | In a recent study, a faecal occult blood test was found to be helpful in diagnosis of EGUS (Pellegrini 2005). The positive predictive value of the faecal occult blood test (FOBT) in horses with EGUS was 90%; however, the negative predictive value was only 17%, which suggests that a horse with a positive FOBT islikely to have a gastric ulcer. In an attempt to improve the negative predictive value of the FOBT, investigators developed another test (SUCCEED Equine Fecal Blood Test)2 that utilises specific equine monoclonal antibodies to both albumin and haemoglobin in an easy to use kit (Carter and Pellegrini 2006; Pellegrini and Carter 2007). Recent reports showed an improved predictive value of a negative test (72%), but the predictive value of a positive test was slightly lower (77%). Thus, this new test may be helpful in diagnosing EGUS in horses, but should be used as part of a complete work-up. A false positive FOBT may result if a recent rectal examination, rectal biopsy or other rectal trauma has occurred or if the horse has a protein-losing enteropathy.
| + | Tests that require further analysis for sensitivity and specificity<ref name="Sanchez">Sanchez, L.C (2010) 'Diseases Of The Stomach' in Reed, S.M, Bayly, W.M. and Sellon, D.C (2010) '''Equine Internal Medicine''' (Third Edition), Saunders, Chapter 15.</ref> include: |
| − | Furthermore, serum 1-antitrypsin was present in 44/47 foals with gastric ulcers compared to only 3/22 healthy foals (Taharaguchi et al. 2007). 1-antitrypsin may be released into serum from damaged gastric tissue, but more research is needed to validate this serum marker as a diagnostic test for EGUS.(Nadeau 2009)
| + | *Urine<ref>O'Connor, M.S, Steiner, J.M, Roussel, A.J, ''et al.'' (2004) Evaluation of urine sucrose concentration for detection of gastric ucleration in horses. ''Am J Vet Res'', 65:31-39. In: Sanchez, L.C (2010) 'Diseases Of The Stomach' in Reed, S.M, Bayly, W.M. and Sellon, D.C (2010) '''Equine Internal Medicine''' (Third Edition), Saunders, Chapter 15.</ref> and blood<ref>Hewetson, M, Cohen, N.D, Love, S, ''et al.'' (2006) Sucrose concentration in bood: a new method for assessment of gastric permeability in horses with gastric ulceration. ''J Vet Intern Med'', 20:388-394. In: Sanchez, L.C (2010) 'Diseases Of The Stomach' in Reed, S.M, Bayly, W.M. and Sellon, D.C (2010) '''Equine Internal Medicine''' (Third Edition), Saunders, Chapter 15.</ref> sucrose absorption as an assay of gastric mucosal permeability |
| | + | *Serum alpha1-antitrypsin may be released from damaged gastric tissue(Nadeau 2009) and has been detected more frequently in foals with gastric ulceration<ref>Taharaguchi, S, Nagano, A, Okai, K, ''et al.'' (2007) Detection of an isoform of alpha(1)-antitrypsin in serum samples from foals with gastric ulcers. ''Vet Rec'', 161:338-342. In: Sanchez, L.C (2010) 'Diseases Of The Stomach' in Reed, S.M, Bayly, W.M. and Sellon, D.C (2010) '''Equine Internal Medicine''' (Third Edition), Saunders, Chapter 15.</ref> |
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| − | Other diagnostic methods include measuring urine and plasma sucrose concentration (sucrose permeability tests) (O’Conner et al. 2004; Hewetson et al. 2006). However, methods for measuring sucrose require sophisticated analysis equipment, which may not be practical for clinicians in the field.
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| − | (Nadeau 2009)
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| | ===Pathology=== | | ===Pathology=== |
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