Equine Gastric Ucer Syndrome (EGUS) Flashcards
Understand the anatomy of the equine stomach.
Single chamber compound stomach
Oral 1/3 lined with stratified squamous epithelium (minimal protection)
Margo plicatus
Glandular portion of stomach (2/3) formed by columnar epithelium and gastric glands containing proton pumps for acid secretion
Liquid contents reduce by half every half hour
Solid contents take 1-5 hours to empty
What are the clinical signs commonly seen with both squamous and glandular gastric ulcer disease?
Vary depending on horse - vague
Poor hair coat
Hyporexia / appetite changes
Excessive recumbency
Attitude change
Poor performance
Low level colic/pain
Describe the mechanisms of gastric injury.
Primary squamous ulceration
increased acid exposure with minimal defense systems
alteration in gastric pH gradient and content stratification
Primary glandular ulceration
acid exposure after breakdown of mucous and bicarbonate barriers
Secondary squamous ulceration
delayed gastric emptying (pyloric disease)
increased residual gastric fluid volume
dorsal movement of acid
Describe how to diagnose horses with gastric ulcers and the grading system.
History - feed, stress level
Physical exam - often normal
Gastroscopy - gold standard
Grading system 0 - 4
Describe the treatment of gastric ulcers.
Management changes and acid neutralization
Gastrogard (PPI) 30 min prior to feeding
Sucralfate for 3-5 days: helps coat ulcers while Gastrogard reaches steady state
Omeprazole for 21-28 days
*misoprostal is only used for glandular ulcers
Can repeat endoscopy to confirm healing.
