Difference between revisions of "Gastric Ulceration - Horse"

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==Description==
 
==Description==
 +
==Prevalence==
 +
Racehorses 80-100%
 +
Show horses 60%
 +
Ponies 78%
 +
Endurance 67%
 
==Signalment==
 
==Signalment==
 +
Foals and young horses in training
 
==Pathophysiology==
 
==Pathophysiology==
 +
NOT associated with ''Helicobacter pylori'' and not typically associated with ''Gasterophilus''
 
==Risk Factors==
 
==Risk Factors==
 +
Housing, stress, boredom, training, diet
 +
Feeding practices:
 +
*Grain and pelleted feed asssociated with increased serum gastrin (Smyth et al 1988)
 +
*Eating behaviour (grazing vs feeds)
 +
*Feed constituents (alfalfa)
 +
*Individual variability
 +
Exercise and training
 +
*Strenuous exercise stimulates gastrin release which has effects on HCL secretion, gastric emptying, gastric blood flow
 
==Clinical syndrome==
 
==Clinical syndrome==
 +
Often asymptomatic, may see:
 +
*Poor appetite
 +
*Dullness
 +
*Change in attitude
 +
*Reduced performance
 +
*Reluctance to train
 +
*Poor condition
 +
*Weight loss
 +
*Diarrhoea
 +
*Low-grade colic
 +
*Excessive recumbency
 +
*Bruxism (in foals only)
 +
 
==Diagnosis==
 
==Diagnosis==
 +
Definitive diagnosis requires gastroscopy (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
 
==Endoscopy==
 
==Endoscopy==
 +
Minimum endoscope length of two metres and 2.8-3.0 metre instruments are reuired for duodenoscopy
 +
Foals - lesions mainly in glandular epithelium
 +
Adults - margo plicatus and squamous epithelium
 
==Pathology==
 
==Pathology==
 
==Treatment==
 
==Treatment==
 +
Proton pump inhibitors: only omeprazole (Gastroguard) is licensed for horses.  Given PO once daily (4mg/kg) for 3-4 wks, most effective drug at controlling HCl secretion (decreases basal and stimulated release)
 +
Histamine H2 receptor antagonists:
 +
*ranitidine 7mg/kg TID for 3-4wks
 +
*cimetidine 25mg/kg QID for 3-4wks
 +
Gastric protectants: sucralfate 10-20mg/kg TID for 2-4wks
 +
Antacids: magnesium and aluminium hydroxides (NOT recommended as have massive rebound effect)
 
==Prognosis==
 
==Prognosis==
 
==Prevention==
 
==Prevention==
 +
Gastroguard at lower dose (1mg/kg) daily for 3-4wks
 
==References==
 
==References==
 
<references/>
 
<references/>

Revision as of 13:15, 22 July 2010



Also known as: Gastroduodenal ulceration

Equine Gastric Ulcer Syndrome
Equine Gastric Ulcer


Description

Prevalence

Racehorses 80-100% Show horses 60% Ponies 78% Endurance 67%

Signalment

Foals and young horses in training

Pathophysiology

NOT associated with Helicobacter pylori and not typically associated with Gasterophilus

Risk Factors

Housing, stress, boredom, training, diet Feeding practices:

  • Grain and pelleted feed asssociated with increased serum gastrin (Smyth et al 1988)
  • Eating behaviour (grazing vs feeds)
  • Feed constituents (alfalfa)
  • Individual variability

Exercise and training

  • Strenuous exercise stimulates gastrin release which has effects on HCL secretion, gastric emptying, gastric blood flow

Clinical syndrome

Often asymptomatic, may see:

  • Poor appetite
  • Dullness
  • Change in attitude
  • Reduced performance
  • Reluctance to train
  • Poor condition
  • Weight loss
  • Diarrhoea
  • Low-grade colic
  • Excessive recumbency
  • Bruxism (in foals only)

Diagnosis

Definitive diagnosis requires gastroscopy (cannot do in foals as need to starve prior to exam)

Laboratory tests

No known laboratory markers, attempts to detect occult blood in faeces unreliable in horse

Endoscopy

Minimum endoscope length of two metres and 2.8-3.0 metre instruments are reuired for duodenoscopy Foals - lesions mainly in glandular epithelium Adults - margo plicatus and squamous epithelium

Pathology

Treatment

Proton pump inhibitors: only omeprazole (Gastroguard) is licensed for horses. Given PO once daily (4mg/kg) for 3-4 wks, most effective drug at controlling HCl secretion (decreases basal and stimulated release) Histamine H2 receptor antagonists:

  • ranitidine 7mg/kg TID for 3-4wks
  • cimetidine 25mg/kg QID for 3-4wks

Gastric protectants: sucralfate 10-20mg/kg TID for 2-4wks Antacids: magnesium and aluminium hydroxides (NOT recommended as have massive rebound effect)

Prognosis

Prevention

Gastroguard at lower dose (1mg/kg) daily for 3-4wks

References


Gastric Ulceration - all species

  • Affects the pars oesophagea (margo plicatus) in adults and foals.
  • Due to parasites - Gasterophilus (Bots).
  • Bots are not as common as they once were.
  • Look like big pink maggots.
  • Killed by Ivermectin.
  • Gasterophilus leave large ulcers in glandular regions of the stomach.
    • Ulcers / erosions are quite deep.
  • The parasites are believed to be non-pathogenic, but in large numbers they probably produce some discomfort and poor growth.
  • Carcinoma can also produce ulceration in the stomach of the horse as, in other species.
  • In foals, the glandular area may sometimes be affected.
    • This may be e.g. stress-related, or due to used of NSAIDs.