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Equine gastric ulcer syndrome and the challenges facing clinicians

01 March 2024
16 mins read
Volume 8 · Issue Sup2
Figure 2. Examples of equine glandular gastric disease. a) Mild, multi-focal, flat, hyperaemic lesions of the pyloric antrum. b) Mild, diffuse, flat, hyperaemic lesions of the pyloric antrum. c) Moderate, multi focal, raised, fibrinosuppurative lesions of the pyloric antrum.
Figure 2. Examples of equine glandular gastric disease. a) Mild, multi-focal, flat, hyperaemic lesions of the pyloric antrum. b) Mild, diffuse, flat, hyperaemic lesions of the pyloric antrum. c) Moderate, multi focal, raised, fibrinosuppurative lesions of the pyloric antrum.

Abstract

Equine gastric ulcer syndrome is the most common disease of the equine stomach. This article gives an overview of the syndrome and reviews the available literature to answer questions clinicians face when treating and managing these cases in equine practice. Equine gastric ulcer syndrome has, in recent years, been further defined into two distinct syndromes: equine squamous gastric disease and equine glandular gastric disease. Primary equine squamous gastric disease is the most common form of the disease and results from prolonged exposure of the mucosa to gastric acid in an otherwise normal gastrointestinal tract. Secondary squamous gastric disease occurs as a result of delayed gastric emptying caused by inflammatory bowel disease, pyloric stenosis, severe glandular gastric disease or gastric impaction.

Equine gastric ulcer syndrome is highly prevalent: squamous gastric disease is found in up to 93% of endurance horses during competition season and up to 100% of racehorses in training (Tamzali et al, 2011). It is described in equine athletes and pleasure horses alike and is not limited to domesticated horses – it has been reported in up to 60% of feral horses (Lamglait et al, 2017). Gastric ulcer syndrome is reported in foals with a prevalence of 22–57%, (Elfenbein and Sanchez, 2012). Glandular gastric disease has been reported in 71% of domesticated horses vs 30% of feral horses in a UK abattoir study (Ward et al, 2015). Squamous gastric disease is more prevalent in Thoroughbreds and Standardbreds, while glandular gastric disease is more prevalent in Warmbloods (Sykes et al, 2015a; Banse and Andrews, 2019). It is not known if this is a true breed predilection or reflective of the management practices typical in these breeds.

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