Changes

Diffuse inflammation may be the only lesion observed in foals with early GDUD.<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>  In contrast to other scoring systems,<ref>MacAllister, C.G, Andrews F.M, Deegan E, Ruoff, W, Olovson, S.G (1997) A scoring system for gastric ulcers in horses.  ''Equine Vet J'', 29:430-433.</ref> the EGUC approach does not include bleeding when assigning lesion grades.  The justification is that the 'snapshot' provided by endoscopy may by chance identify bleeding of superficial erosions whilst missing the intermittent haemorrhage of more severe lesions.<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>  Endoscopy may assist in understanding the severity of the disease and assessing the therapeutic response, but it is not without disadvantages.  Ulcer severity may be underestimated, particularly in the squamous region and glandular ulcers may be missed altogether.<ref>Andrews, F.M, Reinmeyers, C.R, McCracken, M.D, Blackford, J.T, Nadeau, J.A, Saabye, L, Sotell, M, Saxton, A (2002) Comparison of endoscopic, necropsy and histology scoring of equine gastric ulcers.  ''Equine Vet J'',34(5):475-478.</ref>  Lesions that appear grossly similar may have different grades on histopathology.<ref name="Nadeau">Nadeau, J.A, Andrews, F.M (2009) ''Science: Overviews'' Equine gastric ulcer syndrome: The continuing conundrum.  ''Equine Vet J'', 41(7):611-615.</ref>  This is important because varying lesions may have different causes, requiring a range of treatment approaches.

Diffuse inflammation may be the only lesion observed in foals with early GDUD.<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>  In contrast to other scoring systems,<ref>MacAllister, C.G, Andrews F.M, Deegan E, Ruoff, W, Olovson, S.G (1997) A scoring system for gastric ulcers in horses.  ''Equine Vet J'', 29:430-433.</ref> the EGUC approach does not include bleeding when assigning lesion grades.  The justification is that the 'snapshot' provided by endoscopy may by chance identify bleeding of superficial erosions whilst missing the intermittent haemorrhage of more severe lesions.<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>  Endoscopy may assist in understanding the severity of the disease and assessing the therapeutic response, but it is not without disadvantages.  Ulcer severity may be underestimated, particularly in the squamous region and glandular ulcers may be missed altogether.<ref>Andrews, F.M, Reinmeyers, C.R, McCracken, M.D, Blackford, J.T, Nadeau, J.A, Saabye, L, Sotell, M, Saxton, A (2002) Comparison of endoscopic, necropsy and histology scoring of equine gastric ulcers.  ''Equine Vet J'',34(5):475-478.</ref>  Lesions that appear grossly similar may have different grades on histopathology.<ref name="Nadeau">Nadeau, J.A, Andrews, F.M (2009) ''Science: Overviews'' Equine gastric ulcer syndrome: The continuing conundrum.  ''Equine Vet J'', 41(7):611-615.</ref>  This is important because varying lesions may have different causes, requiring a range of treatment approaches.

====Radiography====

====Other Imaging====

In older foals with GDUD, detection of gastric outflow obstruction via abdominal radiography is essential to treatment and prognosis.<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>  Liquid barium will demonstrate very delayed or no outflow depending on the degree of obstruction.  Without contrast medium, a large, gas filled stomach will be obvious.<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>  The need to perform contrast radiography must be weighed against the stress it would place upon the foal.

In older foals with GDUD, detection of gastric outflow obstruction via abdominal radiography is essential to treatment and prognosis.<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>  Liquid barium will demonstrate very delayed or no outflow depending on the degree of obstruction.  Without contrast medium, a large, gas filled stomach will be obvious.<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>  The need to perform contrast radiography must be weighed against the stress it would place upon the foal. If gastric rupture is suspected, abdominal ultrasound can be used to identify free fluid in the abdomen and abdominocentesis may confirm the diagnosis.<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>

====Biopsy====

====Biopsy====