Changes

====Endoscopy====

====Endoscopy====

Oesophagogastroscopy or duodenoscopy can be performed under mild sedation (e.g. 0.6-0.8mg/kg xylazine<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 the standing horse.  Of these, duodenoscopy is the more specific but more technically demanding method.<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>  Endoscopic examination requires preparatory starving of the patient for 6-8hours,<ref name="Orsini">Orsini, J (2000) Tutorial Article Gastric ulceration in the mature horse: a review. ''Equine Vet Educ'', 12(1):24-27.</ref> 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.<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>  A 2.8-3.0 metre endoscope is needed to observe the gastric antrum, pylorus and proximal dudoenum.<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>  In either case, fibreoptic or videoendoscopic equipment can be used.<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>  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.<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>  This last point has been debated, since most of the acquired data on gastric lesions refers only to the squamous mucosa.<ref name="Merritt">Merritt, A M (2009) Appeal for proper usage of the term ʻEGUSʼ: Equine gastric

Oesophagogastroscopy or duodenoscopy can be performed under mild sedation (e.g. 0.6-0.8mg/kg xylazine<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 the standing horse.  Of these, duodenoscopy is the more specific but more technically demanding method.<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>  Endoscopic examination requires preparatory starving of the patient for 6-8hours,<ref name="Orsini">Orsini, J (2000) Tutorial Article Gastric ulceration in the mature horse: a review. ''Equine Vet Educ'', 12(1):24-27.</ref> eliciting a certain degree of stress.  As such, it is preferable not to carry out this technique in foals. Should endoscopy be necessary, any air introduced into the foal's stomach must be evacuated at the end of the procedure to avoid exacerbation of colic.<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> In adult horses, a minimum endoscope length of two metres is essential to visualize the gastric body and fundus.<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>  A 2.8-3.0 metre endoscope is needed to observe the gastric antrum, pylorus and proximal dudoenum.<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>  In either case, fibreoptic or videoendoscopic equipment can be used.<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>  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.<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>  This last point has been debated, since most of the acquired data on gastric lesions refers only to the squamous mucosa.<ref name="Merritt">Merritt, A M (2009) Appeal for proper usage of the term ʻEGUSʼ: Equine gastric

ulcer syndrome.  ''Equine Vet J'', 41(7):616.</ref>  At the time of writing however, the EGUC system appears to be widely used in practice:  

ulcer syndrome.  ''Equine Vet J'', 41(7):616.</ref>  At the time of writing however, the EGUC system appears to be widely used in practice: