Changes

===Housing and Transport===

===Housing and Transport===

Housing in '''stables''' has been proposed as a risk factor for gastric ulcers, with more lesions being found in confined horses compared to those out at grass.<ref>Murray, M.J, Eichorn, E.S (1996) Effects of intermittent feed deprivation, intermittent feed deprivation with ranitidine administration, and stall

Housing in '''stables''' has been proposed as a risk factor for gastric ulcers, with more lesions being found in confined horses compared to those out at grass.<ref>Murray, M.J, Eichorn, E.S (1996) Effects of intermittent feed deprivation, intermittent feed deprivation with ranitidine administration, and stall

confinement with ''ad libitum'' access to hay on gastric ulceration in horses.  ''Am J Vet Res'', 57:1599-1603.</ref>  However, when comparing solitary stable confinement with stabling next to a companion, and finally turn out in a paddock, Husted and colleagues found that the environmental situation had no effect on mucosal acid exposure in the equine stomach.<ref>Husted, L, Sanchex, L.C, Olsen, S.N, Baptiste, K.E, Merritt, A.M (2008) Effect of paddock vs. stall housing on 24 hour gastric pH within the proximal and ventral equine stomach.  ''Equine Vet J'', 40(4):337-41.</ref>  '''Transport''' has also been shown to induce squamous mucosal ulceration in horses.<ref>McClure, S.R, Carithers, D.S, Gross, S.J, Murray, M.J (2005) Gastric ulcer development in horses in a simulated show or training environment.  ''J Am Vet Med Assoc'', 227:775-777.</ref>

confinement with ''ad libitum'' access to hay on gastric ulceration in horses.  ''Am J Vet Res'', 57:1599-1603.</ref>  However, when comparing solitary stable confinement with stabling next to a companion, and finally turn out in a paddock, Husted and colleagues (2008) found that the environmental situation had no effect on mucosal acid exposure in the equine stomach.<ref>Husted, L, Sanchex, L.C, Olsen, S.N, Baptiste, K.E, Merritt, A.M (2008) Effect of paddock vs. stall housing on 24 hour gastric pH within the proximal and ventral equine stomach.  ''Equine Vet J'', 40(4):337-41.</ref>  '''Transport''' has also been shown to induce squamous mucosal ulceration in horses.<ref>McClure, S.R, Carithers, D.S, Gross, S.J, Murray, M.J (2005) Gastric ulcer development in horses in a simulated show or training environment.  ''J Am Vet Med Assoc'', 227:775-777.</ref>

===Diet===

===Diet===

'''Feed deprivation''' encourages gastric ulceration in two ways: (1) it precludes the buffering capacity of protein leading to a reduced gastric pH (Murray and Schusser 1993) (2) it empties the stomach and exposes the squamous mucosa to the more mobile gastric juice.(Sandin 2000)  It is unsurprising, therefore, that an alternating feed-fast protocol would produce a consistent model of ulcer induction in the equine squamous mucosa.(36, 37, 66 in Sanchez)  Despite this, feed deprivation is not a prerequisite for gastric ulceration in the horse.(Vatistas 1998)  Diets that are plentiful in roughage prolong the mastication process and the production of salivary bicarbonate that protects the gastric mucosa.  A diet of '''high grain and low roughage''' thus predisposes to EGUS. (Nadeau 2009)  This sort of diet is commonly fed to racehorses but dietary components have also been shown to influence EGUS risk in nonracehorses.<ref>Luthersson, N, Nielson, K.H, Harris, P, Parkin, T.D (2009) Risk factors associated with equine gastric ulceration syndrome (EGUS) in 201 horses in Denmark.  ''Equine Vet J'', 41(7):625-30.</ref>  Ponies fed a '''concentrate diet''' had a greater prevalence of gastric ulcers than ponies fed hay alone(Vatisats 2 1999) and this may be because grain and pelleted feeds are asssociated with increased serum gastrin.(Smyth et al 1988)  '''High starch meals''' are also a risk because they are fermented to volatile fatty acids (VFAs) and lactic acid and are emptied from the stomach relatively slowly.(Metayer et al. 2004)(Taharaguchi et al. 2004; Boswinkel et al. 2007)(Nadeau 2009)

'''Feed deprivation''' encourages gastric ulceration in two ways: (1) it precludes the buffering capacity of protein leading to a reduced gastric pH<ref>Murray, M.J, Schusser, G.F (1993) Measurement of 24-h gastric pH using an indwelling pH electrode in horses unfed, fed and treated with ranitidine.  ''Equine Vet J'', 25:417-421.  In: Sandin, A, Skidell, J, Haggstrom, J, Nilsson, G (2000) ''Postmortem'' findings of gastric ulcers in Swedish horses older than age one year: a retrospective study of 3715 horses (1924–1996).  ''Equine Vet J'', 32(1):36-42.</ref> and (2) it empties the stomach and exposes the squamous mucosa to the more mobile gastric juice.<ref name="Sandin">Sandin, A, Skidell, J, Haggstrom, J, Nilsson, G (2000) ''Postmortem'' findings of gastric ulcers in Swedish horses older than age one year: a retrospective study of 3715 horses (1924–1996).  ''Equine Vet J'', 32(1):36-42.</ref> It is unsurprising, therefore, that an alternating feed-fast protocol would produce a consistent model of ulcer induction in the equine squamous mucosa.<ref>Murray, M.J, Schusser, G.F (1993) Measurement of 24-h gastric pH using an indwelling pH electrode in horses unfed, fed and treated with ranitidine.  ''Equine Vet J'', 25:417-421.  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><ref>Murray, M.J (1994) Equine model of inducing ulceration in alimentary squamous epithelial mucosa.  ''Dig Dis Sci'', 39:2530-2535.  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> Despite this, feed deprivation is not a prerequisite for gastric ulceration in the horse.(Vatistas 1998)  Diets that are plentiful in roughage prolong the mastication process and the production of salivary bicarbonate that protects the gastric mucosa.  A diet of '''high grain and low roughage''' thus predisposes to EGUS.<ref name="Nadeau"> In: Nadeau, J.A, Andrews, F.M (2009) ''Science: Overviews'' Equine gastric ulcer syndrome: The continuing conundrum.  ''Equine Vet J'', 41(7):611-615.</ref> This sort of diet is commonly fed to racehorses but dietary components have also been shown to influence EGUS risk in nonracehorses.<ref>Luthersson, N, Nielson, K.H, Harris, P, Parkin, T.D (2009) Risk factors associated with equine gastric ulceration syndrome (EGUS) in 201 horses in Denmark.  ''Equine Vet J'', 41(7):625-30.</ref>  Ponies fed a '''concentrate diet''' had a greater prevalence of gastric ulcers than ponies fed hay alone.<ref name="Vatistas 2">Vatistas, N.J, Sifferman, R.L, Holste, J, Cox, J.L, Pinalto, G, Schultz, K.T (1999) Induction and maintenance of gastric ulceration in horses in simulated race training.  ''Equine Vet J Suppl'', 29:40-44</ref> and this may be because grain and pelleted feeds are asssociated with increased serum gastrin.(Smyth et al 1988)  '''High starch meals''' are also a risk because they are fermented to volatile fatty acids (VFAs) and lactic acid and are emptied from the stomach relatively slowly.<ref>Mètayer, N, Lhôte, M, Bahr, A, Cohen, N.D, Kim, I, Rousell, A.J, Julliand, V (2004) Meal size and starch content affect gastric emptying in horses.  ''Equine Vet J'', 36:434-440.  In: Nadeau, J.A, Andrews, F.M (2009) ''Science: Overviews'' Equine gastric ulcer syndrome: The continuing conundrum.  ''Equine Vet J'', 41(7):611-615.</ref>Taharaguchi, S, Okai, K, Orita, Y, Kuwano, M, Ueno, T, Taniyama, H (2004) Relation between amounts of concentrated feed given mares and gastric ulcers in foals.  ''J Japan Vet Med Ass'', 57:366-370.  In: Nadeau, J.A, Andrews, F.M (2009) ''Science: Overviews'' Equine gastric ulcer syndrome: The continuing conundrum.  ''Equine Vet J'', 41(7):611-615.</ref><ref>Boswinkel, A.M, Ellis, A.D, Sloet van Oldruitenborgh-Oosterbaan, M.M (2007) The influence of low versus high fibre haylage diets in combination with training or pasture rest on equine gastric ulceration syndrome (EGUS).  ''Pferdeheilkunde'', 23:123-130.  In: Nadeau, J.A, Andrews, F.M (2009) ''Science: Overviews'' Equine gastric ulcer syndrome: The continuing conundrum.  ''Equine Vet J'', 41(7):611-615.</ref>

===Other ailments===

===Other ailments===