Changes

Gastric Ulceration - Horse (view source)

Revision as of 19:23, 27 July 2010

1,598 bytes added , 19:23, 27 July 2010

no edit summary

Line 31: Line 31:

*Nonracing performance horses (17% pre-competition, 56% post-competition)<ref>Hartmann, A.M, Frankeny, R.L (2003) A preliminary investigation into the association between competition and gastric ulcer formation in non-racing performance horses. ''J Equine Vet Sci'', 23:560-561. 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>

*Pleasure horses in full work ~ 60%<ref name="Bell">Bell, R.J, Mogg, T, Kingston, J.K (2007) Equine gastric ulcer syndrome in adult horses: a review. ''N Z Vet J'', 55(1):1-12).</ref>

−

*Pleasure, riding lessons, showing 37%<ref>Murray, M.J, Grodinsky, C, Anderson, C.W, Radue, P.F, Schmidt, G.R (1989) Gastric ulcers in horses: a comparison of endoscopic findings in horses with and without clinical signs. ''Equine Vet J Suppl'', 7:68-72.</ref>

+

*Pleasure, riding lessons, showing 37%<ref name="Murray 1989">Murray, M.J, Grodinsky, C, Anderson, C.W, Radue, P.F, Schmidt, G.R (1989) Gastric ulcers in horses: a comparison of endoscopic findings in horses with and without clinical signs. ''Equine Vet J Suppl'', 7:68-72.</ref>

*Foals ~25-57%<ref>Wilson, J.H (1986) Gastric and duodenal ulcers in foals: a retrospective study. ''Proc Equine Colic Res Symp 2nd:126-128.</ref><ref>Murray, M.J, Grodinsky, C, Cowles, R.R, ''et al.''(1990) Endoscopic evaluation of changes in gastric lesions of Thoroughbred foals. ''J Am Vet Med Assoc'', 196:1623-1627.</ref><ref>Murray, M.J (1989) Endoscopic appearance of gastric lesions in foals: 94 cases (1987-1988). ''J Am Vet Med Assoc'', 195:1135-1141.</ref>, the incidence increases dramatically in foals with clinical signs, especially gastrointestinal signs.<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>

Line 45: Line 45:

==Clinical syndrome==

−

The clinical signs associated with gastric ulcers are often very non-sepcific, difficult to document and at times only subjective.<ref name="Orsini">Orsini, J (2000) Tutorial Article Gastric ulceration in the mature horse: a review. ''Equine Vet Educ'', 12(1):24-27.</ref> In addition, there appears to be a poor correlation between the severity of endoscopic lesions and the clinical presentation.(~~Murray et al~~ 1989 in ~~Orsini)~~ The significance of gastric ulceration in horses thus remains questionable. However, there have been instances in which ulcer treatment has preceded an improvement in clinical status and/or racing perfomance, suggesting that in some horses, ulcers are a considerable burden.<ref name="Orsini">Orsini, J (2000) Tutorial Article Gastric ulceration in the mature horse: a review. ''Equine Vet Educ'', 12(1):24-27.</ref> Cases gastric ulceration are often asymptomatic, but signs that have been attributed to these lesions in mature horses include:

+

The clinical signs associated with gastric ulcers are often very non-sepcific, difficult to document and at times only subjective.<ref name="Orsini">Orsini, J (2000) Tutorial Article Gastric ulceration in the mature horse: a review. ''Equine Vet Educ'', 12(1):24-27.</ref> In addition, there appears to be a poor correlation between the severity of endoscopic lesions and the clinical presentation.<ref name="Murray 1989">Murray, M.J, Grodinsky, C, Anderson, C.W, Radue, P.F, Schmidt, G.R (1989) Gastric ulcers in horses: a comparison of endoscopic findings in horses with and without clinical signs. ''Equine Vet J Suppl'', 7:68-72.</ref> The significance of gastric ulceration in horses thus remains questionable. However, there have been instances in which ulcer treatment has preceded an improvement in clinical status and/or racing perfomance, suggesting that in some horses, ulcers are a considerable burden.<ref name="Orsini">Orsini, J (2000) Tutorial Article Gastric ulceration in the mature horse: a review. ''Equine Vet Educ'', 12(1):24-27.</ref> Cases gastric ulceration are often asymptomatic, but signs that have been attributed to these lesions in mature horses include:

−

*Poor appetite (particularly decreased consumption of concentrates)(~~Sanchez~~)

+

*Poor appetite (particularly decreased consumption of concentrates)<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>

*Poor condition

*Rough hair coat

*Weight loss

−

*Excessive recumbency (~~EGUC~~)

+

*Excessive recumbency<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>

*Mild to severe colic

**Mild, recurrent colic signs post-prandially<ref>Videla, R, Andrews, F.M (2009) New perspectives in equine gastric ulcer syndrome. ''Vet Clin North Am Equine Pract'', 25(2):283-301.</ref>

Line 64: Line 64:

Neonatal foals

−

Many are asymptomatic and some only exhibit signs when ulceration has become severe. Glandular ulcers are considered the most significant(~~Sanchez~~)

+

Many are asymptomatic and some only exhibit signs when ulceration has become severe. Glandular ulcers are considered the most significant<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>

*Poor appetite

*Diarrhoea

Line 70: Line 70:

*Frequent dorsal recumbency

−

Sucklings and weanlings (~~Sanchez~~)

+

Sucklings and weanlings<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>

Diarrhoea

Poor appetite (off suck or partially off suck)

Line 82: Line 82:

Dorsal recumbency

−

Signs of gastroduodenal ulcer disease (GDUD)(~~Sanchez~~):

+

Signs of gastroduodenal ulcer disease (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>:

Bruxism

Colic

−

Ptyalism (top DDx, secondary to gastric outflow obstruction and gastroesophageal reflux, DDx esophageal obstruction and Candida infection (Merck))

+

Ptyalism (top DDx, secondary to gastric outflow obstruction and gastroesophageal reflux, DDx esophageal obstruction and Candida infection<ref name="Merck">Merck & Co (2008) The Merck Veterinary Manual (Eighth Edition), Merial</ref>)

Diarrhoea

−

Gastrooesophageal reflux after suckling (in foals with outflow obstruction, marked reflux may be seen even with limited to no suckling if the duodenal obstruction is distal to the common bile duct.) (~~Sanchez~~)

+

Gastrooesophageal reflux after suckling (in foals with outflow obstruction, marked reflux may be seen even with limited to no suckling if the duodenal obstruction is distal to the common bile duct.)<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>

5 syndromes in foals: silent, active with clinical signs, perforated, gastric and duodenal stenosis, general malaise and low grade colic

−

Sudden gastric perforation without prior signs occurs sporadically in foals.(Merck)

+

Sudden gastric perforation without prior signs occurs sporadically in foals.<ref name="Merck">Merck & Co (2008) The Merck Veterinary Manual (Eighth Edition), Merial</ref>

−

Complications related to gastric ulcers are most frequent and severe in foals and include perforation, delayed gastric emptying, gastroesophageal reflux and esophagitis, and megaesophagus secondary to chronic gastroesophageal reflux. Ulcers in the proximal duodenum or at the pylorus can cause fibrosis and stricture. The latter complication is seen in both foals and adult horses. In rare cases, severe gastric ulceration causes fibrosis and contracture of the stomach. (Merck)

+

Complications related to gastric ulcers are most frequent and severe in foals and include perforation, delayed gastric emptying, gastroesophageal reflux and esophagitis, and megaesophagus secondary to chronic gastroesophageal reflux. Ulcers in the proximal duodenum or at the pylorus can cause fibrosis and stricture. The latter complication is seen in both foals and adult horses. In rare cases, severe gastric ulceration causes fibrosis and contracture of the stomach.<ref name="Merck">Merck & Co (2008) The Merck Veterinary Manual (Eighth Edition), Merial</ref>

==Diagnosis==

Nmr28

1,406

edits