1,406
edits
Changes
→Endoscopy
Oesophagogastroscopy or duodenoscopy can be performed under mild sedation (e.g. 0.6-0.8mg/kg xylazine(Orsini)) in the standing horse. Of these, duodenoscopy is the more specific but more technically demanding method(Sanchez). Endoscopic examination requires preparatory starving of the patient for 6-8hours (Orsini), eliciting a certain degree of stress. As such, it is preferable not to carry out this technique in foals. In adult horses, a minimum endoscope length of two metres is essential to visualize the gastric body and fundus.(Sanchez) A 2.8-3.0 metre endoscope is needed to observe the gastric antrum, pylorus and proximal dudoenum.(Sanchez) In either case, fibreoptic or videoendoscopic equipment can be used.(EGUC)
Oesophagogastroscopy or duodenoscopy can be performed under mild sedation (e.g. 0.6-0.8mg/kg xylazine(Orsini)) in the standing horse. Of these, duodenoscopy is the more specific but more technically demanding method(Sanchez). Endoscopic examination requires preparatory starving of the patient for 6-8hours (Orsini), eliciting a certain degree of stress. As such, it is preferable not to carry out this technique in foals. In adult horses, a minimum endoscope length of two metres is essential to visualize the gastric body and fundus.(Sanchez) A 2.8-3.0 metre endoscope is needed to observe the gastric antrum, pylorus and proximal dudoenum.(Sanchez) In either case, fibreoptic or videoendoscopic equipment can be used.(EGUC)
Based on a consensus, the Equine Gastric Ulcer Council (EGUC) publised an EGUS Lesion Scoring System which they claimed to be simple and applicable to both regions of the equine gastric mucosa(EGUC). This last point has been debated, since most of the acquired data on gastric lesions refers only to the squamous mucosa(Merritt). At the time of writing however, the EGUC system appears to be the most well established and useful in practice:
Based on a consensus, the Equine Gastric Ulcer Council (EGUC) published an EGUS Lesion Scoring System which they claimed to be simple and applicable to both regions of the equine gastric mucosa(EGUC). This last point has been debated, since most of the acquired data on gastric lesions refers only to the squamous mucosa(Merritt). At the time of writing however, the EGUC system appears to be the most well established and useful in practice:
{|cellpadding="10" cellspacing="0" border="1"
{|cellpadding="10" cellspacing="0" border="1"
|}
|}
Diffuse inflammation may be the only lesion observed in foals with early GDUD.(Sanchez) In contrast to other scoring systems(MacAllistaer et al 1997), 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.(EGUC) 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 altoghether(Andrews 2002). Lesions that appear grossly similar may have different grades on histopathology(Martineau 2009). This is important as 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.(Sanchez) In contrast to other scoring systems(MacAllistaer et al 1997), 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.(EGUC) 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(Andrews 2002). Lesions that appear grossly similar may have different grades on histopathology(Martineau 2009). This is important as varying lesions may have different causes, requiring a range of treatment approaches.
===Radiography===
===Radiography===