Bovine Gastric Ulcers

Question 1

Describe the mechanisms that are involved in the gastric protective mechanism:

Answer 1

• Mucous is a physical barrier
• Mucous contains bicarbonate → maintains the pH gradient + neutralises the acid
• High gastric blood flow → maximum production of mucous by gastric cells + carriers away back diffusing hydrogen ions

Question 2

What are the predisposing factors leading to the development of gastric ulcers in ruminants (give four)?

Answer 2

• Catecholamine release (stress induced epinephrine and norepinephrine)
• Decreased mucosal blood flow – less PGE due to NSAID’s and shock
• Sepsis – esp. gram-negative bacteria
• Increased gastrin and/or histamine release

Question 3

What is a grade 1 gastric ulcer in a ruminant?

Answer 3

Non-perforating but painful - little bleeding

Question 4

What is a grade 2 ulcer in a ruminant and what clinical signs would you expect to see?

Answer 4

Non-perforating but significant bleeding:

• Melena (very black)
• Pale mm
• Rapid HR
• Weakness
• Death with massive bleeding occurring

Question 5

What is a grade 3 perforating ulcer in ruminants?

Answer 5

Slowly perforate + adhere to parietal peritoneum simultaneously:

• TRP - adheres to the wall (peritonitis is contained → very challenging surgery)

Question 6

What is a grade 4 perforating ulcer in a ruminant?

Answer 6

• Rapid perforation + massive peritonitis, shock and death

Question 7

List four possible treatment options that you may consider for gastric ulcers in ruminants:

Answer 7

• Type 2 antihistamines – cimetidine, ranitidine, famotidine, decreased H+ secretion
• H+ blockers like omeprazole decreased acid secretion
• Oral antacids + mucosal protectants
• Mucosal protectants include sucralfate + misoprostol