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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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| |} | | |} |
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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== |