eqine gastric disease

Question 1

what are the clinical signs of gastric disease?

Answer 1

• Colic signs (particularly after eating)
• Weight loss
• Bucking/rearing under saddle
• Resentment of girthing and leg aid
• Poor performance
• Changes in temperament

Question 2

what are the risk factors for squamous gastric disease?

Answer 2

• lack of access to forage
• lack of access to water
• high carbohydrate diets
• high stress environments/individuals
• Other focuses of pain?
  ◦ think about in non-responsive cases

Question 3

what is done to diagnose gastric disease? explain the process adn steps of this?

Answer 3

endoscopy:

Patient preparation:
* Horses must have food withheld for at least 12 hours
* Water removed ~4 hours before?
* Grazing muzzle for horses which eat bedding!

Restraint
Chemical restraint:
* Sedation with an alpha-2 agonist and an opiate
◦ Detomidine:
◦ Butorphanol:

Physical restraint:
* At least three personnel
◦ One person to restrain the horse
◦ One person to pass the endoscope
◦ One person to control the endoscope

Nose twitching
* Useful additional restraint in some cases
* Often only required for the first 20s as you pass through nasal passages

Question 4

where is squamous disease often founds? how is it graded?

Answer 4

Lesser curvature is a common area for squamous disease

Question 5

what is glandular disease described? where is the most common place to find glandular lesions?

Answer 5

• Mild/moderate/severe
• Focal/multifocal/diffuse
• Raised/flat/depressed
• Hyperaemic?
• Haemorrhagic?
• Fibrinosupprative? (yellow)

glandlular lesions are most commonly found in the plylorus

Question 6

what is the first line treatment for gastric disease? both squamous and glandular, and additional treatments

Answer 6

(oral omeprazole needs to be given on an empty stomach)
(sucralfate coats the stomach and helps aid the mucosu layer can be used fromthe start or added later on)

Question 7

Glandular disease takes longer to treat than squamous disease, therefore horse is scoped every 4 weeks to look for imporvement.

what are the second line treatments (4 options) for glandular disease?

Answer 7

Question 8

what is the management and maintenance of glandular disease?

Answer 8

Husbandry and management changes:
* Feed roughage ad lib, especially during the day (no starvation)
* Reduce stressful stimuli
* Eliminate carbohydrates from the horses diet
◦ Replace with oils in cases where calories are needed

Feed supplements:
* Limited evidence for many – buffers of little use clinically
* Growing evidence for the use of pectin and lecithin
◦ Consider sugar beet pulp as a source of pectin

Maintenance medication:
* Oral omeprazole licensed for long term use at 1mg/kg orally once daily
◦ Can be targeted to high risk periods
◦ Consider competition legality – prohibited by the BHA