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Presumptive on clinical signs and response to treatment (Sanchez)
Presumptive on clinical signs and response to treatment (Sanchez)
Definitive diagnosis requires endoscopy (cannot do in foals as need to starve prior to exam)
Definitive diagnosis requires endoscopy (cannot do in foals as need to starve prior to exam)
==Endoscopy==
===Endoscopy===
Performed under mild sedation in standing horse or foal (Sanchez)
Performed under mild sedation in standing horse or foal (Sanchez)
Duodenoscopy is most specific diagnostic method but is technically me chanllenegng than gastrocopy
Duodenoscopy is most specific diagnostic method but is technically me chanllenegng than gastrocopy
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)
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==
===Biopsy===
A transendoscopic gastric biopsy technique was recently validated for obtaining samples from the gastric glandular mucosa in the live horse.<ref>Rodrigues, N.L, Dore, M, Doucet, M.Y (2009) Validation of a transendoscopic glandular and nonglandular gastric biopsy technique in horses. ''Equine Vet J'', 41(7):631-5.</ref>Unfortunately this technique failed to produce samples of squamous mucosa that would be suitable for histopathological analysis.
===Laboratory tests===
The detection of occult blood in faeces has proven unreliable in the horse and currently, useful laboratory markers for EGUS are lacking.<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> Tests that require further analysis for sensitivity and specificity<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> include:
*Urine (93) and blood (94) sucrose absorption as an assay of gastric mucosal permeability<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>
*Serum alpha1-antitrypsin which has been detected more frequently in foals with gastric ulceration (95)
===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). Expensive and not absorbed in foas with diarrhoea
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). Expensive and not absorbed in foas with diarrhoea