Gastric Ulcers: How to Tell if Your Horse Has One, and What to Do if it Does
My Horse University and eXtension’s HorseQuest welcome you to this live Webcast. Gastric Ulcers in Horses: How to Tell if Your HorseHas One, and What do Do if it Does Dr. Jenifer Nadeau University of Connecticut
Meet our presenter: Dr. Jenifer Nadeau Associate Professor & Equine Extension Specialist University of Connecticut
Prevalence of Equine Gastric Ulcer Syndrome (EGUS)• 60% to 93% in • 11% in lesson horses performance horses • 66.6% in pregnant• 40% to 58% of show broodmares horses • 75.9% in non pregnant• 25% to 50% in foals broodmares • 37-53% pleasure horsesMurray et al, Equine Vet J, 1996; Murray, JAVMA, 1989; Murray,AAEP, 1997; Bertone 2000; McClure et al. 1999.
Stomach Anatomy• Non-glandular region• Margo plicatus• Glandular region
Causes• Diet especially hydrochloric acid and volatile fatty acids• Bile acids• Bacterial contamination, including H. pylori• Non-steroidal anti-inflammatory drugs (NSAIDs)• Exercise
Causes of EGUS• Damage occurs when aggressive factors overpower defenses of gastric mucosa• Squamous mucosal lesions (80%) result from increased acids• Glandular mucosal lesions (20%) result from impaired mucosal protection
Previous Study (Dietary Factors) (Nadeau, Andrews, Mathew et al, AJVR, 2000) 1.5 Gastric Lesion Number and Severity 1 b 0.5 bChange in score 0 NG Lesion# G Lesion# NG Severity G Severity Alfalfa/grain -0.5 Bromegrass -1 a -1.5 a -2 -2.5
ConclusionsHigh lipid solubility Ability to remain undissociated at low pH Cell Acidification, Damage to Sodium Transport Cell Swelling Necrosis and Ulceration
Risk Factors• Age, breed, gender• Exercise• Fasting• Pasture turnout• Starch intake• Forage feeding and type of forage• Water intake• NSAIDs
Clinical Signs• Acute and recurrent colic• Poor body condition• Poor appetite• Grinding of teeth
Diagnosis• Endoscopy• Clinical signs & response to treatment
Medical Management• Antacids• Histamine type 2 receptor antagonists – Ranitidine/Cimetidine• Omeprazole – Gastrogard• Coating or binding agents – Sucralfate/bismuth subsalicylate
Prevention and Management• Roughage – as much as possible – at least 1-1.5 kg/100 kg BW – at least 75% roughage – Give high protein (17-20% CP) or high calcium (6-14 mg/g feed) forage• Avoid feeding sweet feeds – <1 g/kg BW starch meal – <2 g/kg BW starch/day• If giving concentrates, feed more frequently• Provide pasture turnout whenever possible or frequent forage (4-6 meals/day)
Prevention and Management• Provide fresh, clean water continuously• Whenever possible, avoid stressful situations – Long distance travel – Changing environments – Long periods of confinement – Avoid leaving horses >6 hours without forage during transport – Consider giving antiulcer medicine before transport• Use minimal effective dose for NSAIDs, treat with antiulcer medicine simultaneously
Prevention and Management• Racehorses – Prior to racing, give normal ration – Give forage up to 3 hrs prior to workout or race – Do not feed hay or concentrates within 3 hrs of workout or race – After the workout or race, forages can again be offered – Do not feed concentrates until at least 2 hrs after exercise – Water can be offered free choice after exercise but should initially drink slowly
Summary• Multifactorial, many causes• Long list of potential risk factors• Important to evaluate horse’s diet and daily management to prevent them• By following these recommendations, may be possible to prevent or reduce the risk of gastric ulceration• Feeding and management practices must change to prevent recurrence!
Resources• Nadeau, Jenifer & Luthersson, Nanna. Effect of Nutrition on Gastric Ulceration. In:Equine Applied and Clinical Nutrition Book Editor(s): Ray Geor, Pat Harris and Manfred Coenen• Hepburn, Richard. Gastric ulceration in horses. March 2011. Equine Practice. 33:116-124.
Acknowledgments• Nanna Luthersson• Dr. Frank Andrews• Dr. Richard Hepburn
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