References

Andrews F, Bernard W, Byars D Recommendations for the diagnosis and treatment of equine gastric ulcer syndrome (EGUS). Equine Vet Educ. 1999; 11:(5)262-272

Andrews FM, Buchanan BR, Smith SH, Elliott SB, Saxton AM. In vitro effects of hydrochloric acid and various concentrations of acetic, propionic, butyric or valeric acids on bioelectrical properties of equine gastric squamous mucosa. Am J Vet Res. 2006; 67:(11)1873-1882 https://doi.org/10.2460/ajvr.67.11.1873

Andrews FM, Larson C, Harris P. Nutritional management of gastric ulceration. Equine Vet Educ. 2017; 29:(1)45-55 https://doi.org/10.1111/eve.12495

Argenzio RA. Comparative pathophysiology of nonglandular ulcer disease: a review of experimental studies. Equine Vet J Suppl. 1999; 29:19-23 https://doi.org/10.1111/j.2042-3306.1999.tb05163.x

Aristizabal F, Nieto J, Yamout S, Snyder J. The effect of a hay grid feeder on feed consumption and measurement of the gastric pH using an intragastric electrode device in horses: a preliminary report. Equine Vet J. 2013; 46:(4)484-487 https://doi.org/10.1111/evj.12175

Banse HEMH, Crosby C, Windeyer MC. Prevalence of and risk factors for equine glandular and squamous disease in polo horses. Can Vet J. 2018; 59:(8)880-884

Banse HE, Andrews FM. Equine glandular gastric diseases: prevalence, impact and management strategies. Vet Med (Auckl). 2019; 10:69-76 https://doi.org/10.2147%2FVMRR.S174427

Bass L, Swain E, Santos H, Hess T, Black J. Effect of feeding frequency using a commercial automated feeding device on gastric ulceration in exercised quarter horses. J Equine Vet Sci. 2018; 64:96-100 https://doi.org/10.1016/j.jevs.2018.02.005

Bäuerlein V, Sabban C, Venner M, Vervuert I. Effects of feeding alfalfa hay in comparison to meadow hay on the gastric mucosa in adult Warmblood horses. Pferdeheilkunde. 2020; 35:(1)29-36 https://doi.org/10.21836/PEM20200105

Begg LM, O'Sullivan CB. The prevalence and distribution of gastric ulceration in 345 racehorses. Aust Vet J. 2003; 81:(4)199-201 https://doi.org/10.1111/j.1751-0813.2003.tb11469.x

Bell RJW, Kingston JK, Mogg TD, Perkins NR. The prevalence of gastric ulceration in racehorses in New Zealand. N Z Vet J. 2007; 55:(1)12-18 https://doi.org/10.1080/00480169.2007.36729

British Equine Trade Association. BETA Feed Approval Mark for products suitable for horses prone to equine gastric ulcer syndrome. 2022. https://www.beta-uk.org/pages/feed-safety/beta-feed-approval-mark-for-products-suitable-for-horses-prone-to-equine-gastric-ulcer-syndrome.php (Accessed 6 April 2022)

Bruynsteen L, Moons CPH, Janssens GPJ Level of energy restriction alters body condition score and morphometric profile in obese Shetland ponies. Vet J. 2015; 206:(1)61-66 https://doi.org/10.1016/j.tvjl.2015.06.006

Camacho-Luna P, Buchanan B, Andrews F M. Advances in diagnostics and treatments in horses and foals with gastric and duodenal ulcers. Vet Clin North Am Equine Pract. 2018; 34:(1)97-111 https://doi.org/10.1016/j.cveq.2017.11.007

Cargile JL, Burrow J A, Kim I, Cohen N D, Merritt A M. Effect of dietary corn oil supplementation on equine gastric fluid acid, sodium, and prostaglandin E2 content before and during pentagastrin infusion. J Vet Intern Med. 2004; 18:545-549 https://doi.org/10.1892/0891-6640(2004)18%3C545:eodcos%3E2.0.co;2

Cehak A, Krägeloh T, Zuraw A, Kershaw O, Brehm R, Breves G. Does prebiotic feeding affect equine gastric health? A study on the effects of prebiotic-induced gastric butyric acid production on mucosal integrity of the equine stomach. Res Vet Sci. 2019; 124:303-309 https://doi.org/10.1016/j.rvsc.2019.04.008

Chameroy KA, Nadeau JA, Bushmich SL, Dinger JE, Hoagland TA, Saxton AM. Prevalence of non-glandular gastric ulcers in horses involved in a university riding program. J Equine Vet Sci. 2006; 26:(5)207-211

Conover A L, Shultz A M, Wagner A L. Effects of GastroTech on equine gastric ulcer syndrome (EGUS). J Equine Vet Sci. 2015; 35:418-36

Dosi MCM, Kirton R, Hallsworth S, Keen JA, Morgan RA. Inducing weight loss in native ponies: is straw a viable alternative to hay?. Vet Rec. 2020; 187:(8) https://doi.org/10.1136/vr.105793

Ellis AD, Fell M, Luck K Effect of forage presentation on feed intake behaviour in stabled horses. Appl Anim Behav Sci. 2015a; 165:88-94 https://doi.org/10.1016/j.applanim.2015.01.010

Ellis AD, Redgate S, Zinchenko S, Owen H, Barfoot C, Harris P. The effect of presenting forage in multi-layered haynets and at multiple sites on nighttime budgets of stabled horses. Appl Anim Behav Sci. 2015b; 171:108-116 https://doi.org/10.1016/j.applanim.2015.08.012

Fedtke A, Pfaff M, Volquardsen J, Venner M, Vervuert I. Effects of feeding different roughage-based diets on gastric mucosa after weaning in Warmblood foals. Pferdeheilkunde. 2015; 31:(6)596-602 https://doi.org/10.21836/PEM20150607

Frank N, Andrews F M. Effects of dietary oils on the development of gastric ulcers in mares. Am J Vet Res. 2005; 66:(11) https://doi.org/10.2460/ajvr.2005.66.2006

Galinelli N, Wambacq W, Broeckx B, J G, Hesta M. High intake of sugars and starch, low number of meals and low roughage intake are associated with Equine Gastric Ulcer Syndrome in a Belgian cohort. J Anim Physiol Anim Nutr. 2019; 105:18-23 https://doi.org/10.1111/jpn.13215

Gehlen H, Reimer-Diesbrock S, Stockle S D. Prevalence, anatomical distribution and risk factors associated with equine gastric ulceration syndrome in American Quarter Horses. Pferdeheilkunde. 2019; 35:(5)403-415

Glunk EC, Hathaway MR, Weber WJ, Sheaffer CC, Martinson KL. The effect of hay net design on rate of forage consumption when feeding adult horses. J Equine Vet Sci. 2014; 34:(8)986-991 https://doi.org/10.1016/j.jevs.2014.05.006

Hallam S, Campbell EP, Qazamel M, Owen H, Ellis AD. Effects of traditional versus novel feeding management on 24-hour time budget of stabled horses. In: Saastamoinen M, Fradinho MJ, Santos AS, Miraglia N (eds). Wageningen: Wageningen Academic Publishers; 2012

Hammond C J, Mason D K, Watkins K L. Gastric ulceration in mature Thoroughbred horses. Equine Vet J. 1986; 18:(4)284-287

Harris PA, Ellis AD, Fradinho MJ Review: Feeding conserved forage to horses: recent advances and recommendations. Animal. 2017; 11:(6)958-967 https://doi.org/10.1017/s1751731116002469

Harris PA, Nelson S, Carslake HB Comparison on NIRS and wet chemistry methods for the nutritional analysis of haylages for horses. J Equine V Sci. 2018; 71:13-20 https://doi.org/10.1016/j.jevs.2018.08.013

Hepburn RJ. Endoscopic examination of the squamous and glandular gastric mucosa in sport and leisure horses: 684 horses (2005-2011). BMC Vet Res. 2014; 10

Hesta M, Costa M. How can nutrition help with gastrointestinal tract-based issues?. Vet Clin North Am Equine Pract. 2021; 37:(1)63-87 https://doi.org/10.1016/j.cveq.2020.12.007

Hewetson M, Tallon R. Equine squamous gastric disease: Prevalence, impact and management. Vet Med (Auckl). 2021; 12:381-399 https://doi.org/10.2147%2FVMRR.S235258

Huff NK, Auer AD, Garza F, Keowen ML, Kearney MT, McMullin RB, Andrews FM. Effect of sea buckthorn berries and pulp in a liquid emulsion on gastric ulcers scores and gastric juice pH in horses. J Vet Int Med. 2012; 26:1186-91 https://doi.org/10.1111/j.1939-1676.2012.00975.x

Husted L, Jensen TK, Olsen SN, Mølbak L. Examination of equine glandular stomach lesions for bacteria, including Helicobacter spp by fluorescence in situ hybridisation. BMC Microbiol. 2010; 10:1-8 https://doi.org/10.1186/1471-2180-10-84

Husted L, Sanchez L C, Baptiste K E, Olsen S N. Effect of a feed/fast protocol on pH in the proximal equine stomach. Equine Vet J. 2009; 41:(7)658-662 https://doi.org/10.2746/042516409x416431

Jacobs RD, Gordon MBE, Vineyard KR., Keowen ML, Garza F, Andrews FM. The effect of a seaweed-derived calcium supplement on gastric juice pH in the horse. J Equine Vet Sci. 2020; 95 https://doi.org/10.1016/j.jevs.2020.103265

Jansson A, Harris P, Davey SL, Luthersson N, Ragnarsson S, Ringmark S. Straw as an alternative to grass forage in horses – effects on post-prandial metabolic profile, energy intake, behaviour and gastric ulceration. Animals. 2021; 11:(8) https://doi.org/10.3390/ani11082197

Julliand V, De Fombelle A, Varloud M. Starch digestion in horses: The impact of feed processing. Livest Sci. 2006; 100:(1)44-52 https://doi.org/10.1016/j.livprodsci.2005.11.001

Le Jeune SS, Nieto JE, Dechant JE, Snyder JR. Prevalence of gastric ulcers in Thoroughbred broodmares in pasture: A preliminary report. Vet J. 2009; 181:(3)251-255 https://doi.org/10.1016/j.tvjl.2008.03.020

Lo Feudo CM, Stucchi L, Conturba B, Alberti E, Zucca E, Ferrucci F. Effects of a nutraceutical supplement in the management of mild equine squamous gastric disease in endurance horses. Vet Rec. 2021; 189:(11) https://doi.org/10.1002/vetr.942

Longland AC, Barfoot C, Harris PA. Effect of period, water temperature and agitation on loss of water-soluble carbohydrates and protein from grass hay: implications for equine feeding management. Vet Rec. 2014; 174:(3) https://doi.org/10.1136/vr.101820

Lorenzo-Figueras M, Merritt AM. Effects of exercise on gastric volume and pH in the proximal portion of the stomach of horses. Am J Vet Res. 2002; 63:(11)1481-1487 https://doi.org/10.2460/ajvr.2002.63.1481

Lorenzo-Figueras M, Preston T, Ott E A, Merritt A M. Meal-induced gastric relaxation and emptying in horses after ingestion of high-fat versus high-carbohydrate diets. Am J Vet Res. 2005; 66:(5) https://doi.org/10.2460/ajvr.2005.66.897

Luca S, Enrica Z, Alessia S Efficacy of the administration of a natural feed supplement in the management of equine gastric ulcer syndrome in 7 sport horses: a field trial. Am J Anim Vet Sci. 2017; 12:104-110 https://doi.org/10.3844/ajavsp.2017.104.110

Luthersson N, Nielsen K, Harris P, Parkin T D H. Risk factors associated with equine gastric ulceration syndrome (EGUS) in 201 horses in Denmark. Equine Vet J. 2009; 41:(7)625-630 https://doi.org/10.2746/042516409x441929

Luthersson N, Bolger C, Fores P, Barfoot C, Nelson S, Parkin T, Harris P. Effect of changing diet on gastric ulceration in exercising horses and ponies after cessation of omeprazole treatment. J Equine Vet Sci. 2019; 83 https://doi.org/10.1016/j.jevs.2019.05.007

Malmkvist J, Poulsen J M, Luthersson N, Palme R, Christensen J W, Sondergaard E. Behaviour and stress responses in horses with gastric ulceration. App Anim Behav Sci. 2012; 142:160-167

Martínez J R, Zuluaga A M, Silveira G E. Effects of corn oil on the gastric mucosa of horses with induced ulcer. Rev Colomb Cienc Pecu. 2016; 29:138-148 https://doi.org/10.17533/udea.rccp.v29n2a07

Martinson K L, Hathaway M, Jung H, Sheaffer C. The effect of soaking on protein and mineral loss in orchardgrass and alfalfa hay. J Equine Vet Sci. 2012; 31:(12)776-782 https://doi.org/10.1016/j.jevs.2012.03.007

Metayer N, Lhote M, Bahr A, Cohen N D, Kim I, Roussel A J, Julliand V. Meal size and starch content affect gastric emptying in horses. Equine Vet J. 2004; 36:(5)436-440 https://doi.org/10.2746/0425164044868468

Morgan K, Kjellberg L, Karlsson Budde L, Kjell E, Ryman M. Pilot study on workload management and feed intake time when feeding horses with small mesh haynets. Livest Sci. 2016; 186:63-68 https://doi.org/10.1016/j.livsci.2015.06.005

Müller CE, Nostell K, Brojer J. Methods for reduction of water soluble carbohydrate content in grass forages for horses. Livest Sci. 2016; 186:46-52 https://doi.org/10.1016/j.livsci.2015.06.011

Murray MJ, Eichorn ES. 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. 1996; 57:(11)1599-1603

Murray MJ, Grady TC. The effect of a pectin-lecithin complex on prevention of gastric mucosal lesions induced by feed deprivation in ponies. Equine Vet J. 2002; 34:195-198 https://doi.org/10.2746/042516402776767268

Murray MJ, Grodinsky C, Anderson CW, Radue PF, Schmidt GR. Gastric ulcers in horses: a comparison of endoscopic findings in horses with and without clinical signs. Equine Vet J. 1989; (7)68-72 https://doi.org/10.1111/j.2042-3306.1989.tb05659.x

Murray MJ, Schusser GF. Measurement of 24-h gastric pH using an indwelling pH electrode in horses unfed, fed and treated with ranitidine. Equine Vet J. 1993; 25:(5)417-421 https://doi.org/10.1111/j.2042-3306.1993.tb02983.x

Nadeau JA, Andrews FM, Mathew AG, Argenzio RA, Blackford JT, Sohtell AM. Evaluation of diet as a cause of gastric ulcers in horses. Am J Vet Res. 2000; 61:(7)784-790 https://doi.org/10.2460/ajvr.2000.61.784

Niedźwiedź A, Kubiak K, Nicpon J. Endoscopic findings of the stomach in pleasure horses in Poland. Acta Vet Scand. 2013; 55:(1) https://doi.org/10.1186%2F1751-0147-55-45

Nieto JE, Snyder JR, Beldomenico P, Aleman M, Kerr JW, Spier SJ. Prevalence of gastric ulcers in endurance horses – a preliminary report. Vet J. 2004; 167:(1)33-37 https://doi.org/10.1016/j.tvjl.2003.09.005

Pedersen S, Cribb A, Windeyer M, Read E, French D, Banse H. Risk factors for equine glandular and squamous gastric disease in show jumping Warmbloods. Equine Vet J. 2018; 50:747-751 https://doi.org/10.1111/evj.12949

Rendle D, McGregor Argo C, Bowen M Equine obesity: current perspectives. UK-Vet Equine. 2018; 2:(5) https://doi.org/10.12968/ukve.2018.2.S2.3

Rochais C, Henry S, Hausberger M. “Hay-Bags” and “Slow feeders”: testing their impact on horse behaviour and welfare. App Anim Behav Sci. 2018; 198:52-59 https://doi.org/10.1016/j.applanim.2017.09.019

Scheidegger M D, Gerber V, Bruckmaier RM, van der Kolk JH, Burger D, Ramseyer A. Increased adrenocortical response to adrenocorticotropic hormone (ACTH) in sport horses with equine glandular gastric disease (EGGD). Vet J. 2017; 228:7-12 https://doi.org/10.1016/j.tvjl.2017.09.002

Sykes BW, Jokisalo JM. Rethinking equine gastric ulcer syndrome: Part 1-Terminology, clinical signs and diagnosis. Equine Vet Educ. 2014; 26:(10)543-547 https://doi.org/10.1111/eve.12236

Sykes B, Jokisalo JM. Rethinking equine gastric ulcer syndrome: Part 3 – Equine glandular gastric ulcer syndrome (EGGUS). Equine Vet Educ. 2015a; 27:(7)372-375 https://doi.org/10.1111/eve.12287

Sykes B W, Jokisalo JM. Rethinking equine gastric ulcer syndrome: Part 2-Equine squamous gastric ulcer syndrome (ESGUS). Equine Vet Educ. 2015b; 27:(5)264-268 https://doi.org/10.1111/eve.12277

Sykes B W, Hewestson M, Hepburn R J, Luthersson N, Tamzali Y. European College of Equine Internal Medicine Consensus Statement – Equine gastric ulcer syndrome in adult horses. J Vet Int Med. 2015; 29:(5)1288-1299 https://doi.org/10.1111/jvim.13578

Sykes BW, Bowen M, Habershon Butcher JL, Green M, Hallowell GD. Management factors and clinical implications of glandular and squamous gastric disease in horses. J Vet Intern Med. 2019; 33:233-240 https://doi.org/10.1111/jvim.15350

Thorne J B, Goodwin D, Kennedy M J, Davidson H, P B, Harris P. Foraging enrichment for individually housed horses: Practicality and effects on behaviour. Appl Anim Behav Sci. 2005; 94:(1–2)149-164 https://doi.org/10.1016/J.APPLANIM.2005.02.002

van Erck-westergren E, Ter Woort F. Diet-induced changes in gastric and faecal microbiota in horses: association with gastric ulcer healing. Equine Vet J. 2019; 51:(S53) https://doi.org/10.1111/evj.34_13152

Vatistas NJ, Sifferman RL, Holste J, Cox JL, Pinalto G, Schultz KT. Induction and maintenance of gastric ulceration in horses in simulated race training. Equine Vet J. 1999; 29:40-44 https://doi.org/10.1111/j.2042-3306.1999.tb05167.x

Vervuert I, Stratton-Phelps M. The safety and efficacy in horses of certain nutraceuticals that claim to have health benefits. Vet Clin North Am Equine Pract. 2021; 37:(1)207-222 https://doi.org/10.1016/j.cveq.2020.11.002

Videla R, Andrews FM. New perspectives in equine gastric ulcer syndrome. Vet Clin Equine. 2009; 25:283-301 https://doi.org/10.1016/j.cveq.2009.04.013

Vondran S, Venner M, Vervuert I. Effects of two alfalfa preparations with different particle sizes on the gastric mucosa in weanlings: alfalfa chaff versus alfalfa pellets. BMC Vet Res. 2016; 12:(1)1-8 https://doi.org/10.1186/s12917-016-0733-5

Vondran S, Venner M, Coenen M, Vervuert I. Effects of alfalfa chaff on the gastric mucosa in adult horses. Pferdeheilkunde. 2017; 33:66-71 https://doi.org/10.21836/PEM20170109

Ward S, Sykes BW, Brown H, Bishop A, Penaluna LA. A comparison of the prevalence of gastric ulceration in feral and domesticated horses in the UK. Equine Vet Educ. 2015; 12:(12)655-657 https://doi.org/10.1111/eve.12491

White G, McClure S R, Sifferman R Effects of short-term light to heavy exercise on gastric ulcer development in horses and efficacy of omeprazole paste in preventing gastric ulceration. J Am Vet. 2007; 230:(11)1680-1682 https://doi.org/10.2460/javma.230.11.1680

Woodward MC, Huff NK, Garza F, Keowen ML, Kearney MT, Andrews FM. Effect of pectin, lecithin, and actacid feed supplements (Egusin) on gastric ulcer scores, gastric fluid pH and blood gas values in horses. BMC Vet Res. 2014; 10:(1) https://doi.org/10.1186/1746-6148-10-s1-s4

Zavoshti FR, Andrews FM. Therapeutics for equine gastric ulcer syndrome. Vet Clin North Am Equine Pract. 2017; 33:(1)141-162 https://doi.org/10.1016/j.cveq.2016.11.004

Nutritional management of equine gastric ulcers

02 May 2022
16 mins read
Volume 6 · Issue 3

Abstract

Over the last 10 years there has been increasing awareness and subsequently recorded cases of equine gastric ulcer syndrome and with this comes an increased interest in appropriate nutrition and feed management. This review presents a systematic approach to assessing the ration of a horse at risk or diagnosed with equine gastric ulcer syndrome and demonstrates the ample evidence upon which to base nutritional recommendations for horses with equine squamous gastric disease, and to a lesser extent, equine glandular gastric disease, with an emphasis on forage. Careful selection and management of the forage ration should be the first step in designing a suitable ration, followed by selection of an appropriately low starch and sugar (less than 2g per kg body weight per day and 1g per kg body weight per meal) complementary feed. There is still more to learn about the role of supplements in the prevention and treatment of equine gastric ulcer syndrome, thus these should currently be viewed as an adjunct to an appropriate base diet and not as an isolated solution.

For over 30 years, equine gastric ulcer syndrome has been recognised as a common issue afflicting the horse (Hewetson and Tallon, 2021), describing ulcerative diseases of the stomach (Andrews et al, 1999). It has become clear that the pathophysiology differs depending on the anatomical region affected, and the terminology has been refined to describe more specific conditions including equine squamous gastric disease, pertaining to ulcers primarily affecting the non-glandular ‘unprotected’ (top) region of the stomach, and equine glandular gastric disease which describes ulcers primarily affecting the glandular region (bottom) of the stomach (Sykes and Jokisalo, 2014; 2015a; 2015b; Sykes et al, 2015; Banse and Andrews, 2019; Hewetson and Tallon, 2021).

While both forms of equine gastric ulcer syndrome can be influenced by diet and feed management, the mechanisms behind this seem to vary. This differentiation, along with ongoing advancements in our understanding of the syndrome, improves nutritional management, identification of risk factors and the ability to consider variations of these across the two conditions. The categorisation of ulcers may not only serve to enable superior management and treatment, but may also be instrumental in prevention strategies. This review collates the key advances of the past 10 years, culminating in nutrition and feeding recommendations.

Register now to continue reading

Thank you for visiting UK-VET Equine and reading some of our peer-reviewed content for veterinary professionals. To continue reading this article, please register today.