Final Exam - EGUS

Question 1

what cells produce hydrochloric acid?

Answer 1

parietal cells

Question 2

what is EGUS?

Answer 2

all encompassing term to describe erosive & ulcerative diseases of the stomach

Question 3

what is ESGD? what is EGGD?

Answer 3

equine squamous gastric disease

equine glandular gastric disease

Question 4

what breeds are most affected by equine squamous gastric disease?

Answer 4

thorough bred race horses, show/sport horses, some pasture pets

Question 5

where are most lesions in ESGD?

Answer 5

margo plicatus

Question 6

where are the majority of lesions in EGGD?

Answer 6

pyloric antrum

Question 7

what breeds are commonly affected by EGGD?

Answer 7

race horses, stressed horses

Question 8

majority of lesions in foals are located where?

Answer 8

glandular or duodenal

Question 9

why do foals have a high prevalence of gastric ulcers?

Answer 9

rapid decrease in gastric pH after birth, increased time between meals, decreased milk intake, hypoxia, high perforation risk

Question 10

what are some decreased nutritional risks for EGUS?

Answer 10

pasture turnout, free access to fibrous feed or frequent forage feeding, alfalfa hay for increased gastric pH, <6 hours between feedings, & free access to water

Question 11

what are some increased nutritional risks for EGUS?

Answer 11

non-exercising animals eating grain/high starch, beginning of training/stabling/stress, intermittent water access, fasting, exceeding 2g/kg BW starch intake a day, removal from pasture & going onto grain only

Question 12

why are horses unique with respect to the formation of gastric ulcers?

Answer 12

continuous acid producers

Question 13

what is the pathophysiology of squamous ulceration?

Answer 13

mucosal cells are susceptible to injury from HCl & VFA (no protection) - dependent on pH, dose, time

HCl damages the outer cell barriers - diffuses into thw straum spinosum

bacterial fermentation of starch/sugar - VFA, lactic acid, bile acid are synergistic with HCl

Question 14

what is the pathophysiology of glandular ulceration?

Answer 14

breakdown of the normal defense mechanisms to acid

Question 15

what are the 3 most common clinical signs of gastric ulcers in horses?

Answer 15

poor appetite (prefers forage), poor BCS, abdominal discomfort

Question 16

what is the only way to get a definitive diagnosis of a gastric ulcer? what do you do in preperation?

Answer 16

gastroscopy

fast at least 16 hours, remove water 1 hour before, sedate with alpha 2s & torb, pass scope to stomach, inflate with air, remove air when done

Question 17

what grade of ESGD means there is one ulcer present?

Answer 17

grade II

Question 18

what is different about the EGGD grading system?

Answer 18

anatomic location & description of the lesion

Question 19

what is the best treatment for gastric ulcers (ESGD & EGGD) in horses?

Answer 19

omeprazole - proton pump inhibitor, impairs the HKATPase pump that secretes HCL with new pumps needing to be made before acid production resumes

Question 20

T/F: EGGD is trickier to treat than ESGD

Answer 20

true - some don’t respond to omeprazole

Question 21

how can you prevent gastric ulcers?

Answer 21

omeprazole, avoid NSAIDS, avoid stress

Question 22

what are some ways to nutritionally manage EGUS?

Answer 22

> 50% diet = forage

alfalfa hay, minimal grain, free choice water, good quality gras pasture

Question 23

NSAIDS can cause what gi problem?

Answer 23

right dorsal colitis - decreased PGE2 = decreased mucosal blood flow = loss of mucosal barrier function

Question 24

what is the median age of horses affected by NSAID toxicity?

Answer 24

6 years old

Question 25

what are some clinical signs associated with NSAID toxicity?

Answer 25

colic, diarrhea, weight loss, PLE, edema, fever

Question 26

how is right dorsal colitis diagnosed?

Answer 26

history, clin path - hypoalbuminemia, mild anemia, hypocalcemia

ultrasound - colonic wall thickness > 0.6cm wall + edema

Question 27

how is right dorsal colitis treated?

Answer 27

NSAIDs discontinued, oncotic support, pain meds (opioids & lidocaine), sucralfate, & dietary management

Question 28

what is the gold standard medical therapy for gastric ulcers in horses?

Answer 28

omeprazole