GI

Question 1

What are the most commonly used NSAID in post-operative colic patient ?
And what are the 3 most important factors to consider for NSAID discontinuation ?

Answer 1

Flunixin and phenylbutazone
Important factor to consider when deciding the timepoint for NSAID discontinuation following colic surgery : absence of active colic sign, pain score evaluation and absence of fever.

A survey of non-steroidal anti-inflammatory drug use in the post-operative period following equine colic surgery
eve 2023

Question 2

What is the Leaky Gut Syndrome (LGS) ?
What are the risk factors for developing LPS ?

Answer 2

Leaky gut syndrome (LGS) is an idiopathic disorder characterised by weakening of tight junction proteins (such as zonulin) in the gastrointestinal epithelium. The resulting hyperpermeability of the GI tract can trigger aberrant systemic inflammatory responses.
Combined transport and exercise increases gastrointestinal permeability and systemic SAA and LPS.

The combination of trailer transport and exercise increases gastrointestinal permeability and markers of systemic inflammation in horses
EVJ 2023

Question 3

Which of the following statements best summarizes the findings and clinical implications of the study on ischaemic postconditioning (IPoC) in equine jejunal ischaemia?

A) Ischaemic postconditioning significantly reduced epithelial denudation and paracellular permeability after reperfusion, but had no effect on intestinal microperfusion or tight junction protein levels.

B) Ischaemic postconditioning reduced epithelial denudation, lowered paracellular permeability, and prevented the reduction of tight junction proteins like claudin-1, claudin-2, and occludin, showing potential protective effects against ischaemia-reperfusion injury.

C) Ischaemic postconditioning led to increased intestinal microperfusion and oxygen saturation during reperfusion, resulting in a higher rate of tissue recovery and greater expression of tight junction proteins.

D) The study concluded that ischaemic postconditioning had no significant effect on reducing ischaemia-reperfusion injury, as it failed to improve histomorphology, permeability, or tight junction protein levels compared to the control group.

Answer 3

Correct Answer:

B) Ischaemic postconditioning reduced epithelial denudation, lowered paracellular permeability, and prevented the reduction of tight junction proteins like claudin-1, claudin-2, and occludin, showing potential protective effects against ischaemia-reperfusion injury.

Justifications:

A) is incorrect because IPoC did reduce intestinal microperfusion during clamping cycles, and it also prevented the reduction in tight junction protein levels during reperfusion, indicating protective effects on the intestinal barrier.

B) is correct. This statement accurately summarizes the key findings: IPoC reduced epithelial denudation, lowered paracellular permeability, and prevented the reduction of important tight junction proteins, showing potential protective effects during reperfusion.

C) is incorrect. While IPoC did reduce epithelial damage and permeability, it did not increase microperfusion or oxygen saturation during the reperfusion phase; in fact, saturation was only affected during the first clamping cycle.

D) is incorrect because the study did find significant benefits of IPoC, particularly in reducing villus denudation, decreasing permeability, and maintaining tight junction proteins, suggesting it has protective potential against ischaemia-reperfusion injury.

The effect of ischaemic postconditioning on mucosal integrity and function in equine jejunal ischaemia.
2021 EVJ

Question 4

Which of the following best summarizes the findings and clinical implications of the study on the inflammatory response in horses undergoing colic surgery using quantitative real-time PCR?

A) The study found that inflammatory genes such as IL-1β, IL-6, TNF, and CCL2 were significantly upregulated in both the mucosa and muscularis externa in colic cases compared to controls, with higher TNF expression linked to the development of post-operative reflux (POR).

B) Horses undergoing colic surgery had reduced gene expression of IL-1β, IL-6, and TNF in both the mucosa and muscularis externa, indicating a lack of inflammatory response.
C) Inflammatory gene expression was consistent between colic cases and controls, with no significant difference in the presence of post-operative reflux (POR).

D) Horses that developed post-operative reflux (POR) had significantly lower TNF expression in the mucosa, suggesting that lower levels of inflammation protect against this complication.

Answer 4

Correct Answer:
A) The study found that inflammatory genes such as IL-1β, IL-6, TNF, and CCL2 were significantly upregulated in both the mucosa and muscularis externa in colic cases compared to controls, with higher TNF expression linked to the development of post-operative reflux (POR).

Justifications:

A) is correct. This option accurately captures the study’s main findings: key inflammatory markers such as IL-1β, IL-6, TNF, and CCL2 were upregulated, and higher TNF expression in the mucosa was associated with the development of post-operative reflux (POR), a complication linked to POI.

B) is incorrect because the study found increased expression of inflammatory genes, not reduced, in horses undergoing colic surgery, indicating a significant inflammatory response.

C) is incorrect because there was a significant difference in inflammatory gene expression between colic cases and controls, particularly in horses with POR.

D) is incorrect because horses with POR actually had higher TNF expression, indicating more inflammation, not less.

Use of quantitative real-time PCR to determine the local inflammatory response in the intestinal mucosa and muscularis of horses undergoing small intestinal resection.
EVJ. Lisowski1 et al. 2021

Question 5

Which of the following best summarizes the findings of the study on Equine Omega Complete (EOC) supplementation in preventing gastric ulcers and increasing alpha-tocopherol concentrations in horses?

A) EOC supplementation effectively prevented gastric ulcer formation, similar to omeprazole, and significantly increased alpha-tocopherol levels compared to the control group.
B) EOC supplementation did not prevent gastric ulcer formation, and although it increased alpha-tocopherol concentrations, the increase was not significantly different from the control group.
C) Omeprazole had no effect on gastric ulcer prevention, while EOC effectively reduced ulcer formation and improved alpha-tocopherol concentrations.
D) EOC and omeprazole both failed to prevent gastric ulcer formation, and neither treatment had an effect on alpha-tocopherol concentrations.

Answer 5

Correct Answer:
B) EOC supplementation did not prevent gastric ulcer formation, and although it increased alpha-tocopherol concentrations, the increase was not significantly different from the control group.

Justifications:

A) is incorrect because EOC did not prevent ulcer formation, and the increase in alpha-tocopherol was not significantly different from the control group.
B) is correct. The study found that EOC did not prevent ulcers, and while it increased alpha-tocopherol, the change was not significant.
C) is incorrect because omeprazole was effective in preventing ulcers, while EOC was not.
D) is incorrect because omeprazole did successfully prevent gastric ulcer formation.

Efficacy of the oral supplement, Equine Omega Complete, for the prevention of gastric ulcers and alpha-tocopherol supplementation in horses
2023 JVIM

Question 6

What are the clinical effects of transportation on gastric pH and gastric ulceration in mares ?

Answer 6

Transportation is associated with increased gastric squamous ulceration and with increased pH of gastric fluid.
These findings may be a csq of impaired gastric emptying and reflux of alkaline small intestinal content, with factors such as duodenal bile salts and short-chain fatty acids mediating mucosal injury.

Effects of transportation on gastric pH and gastric ulceration in mares
jvim 2020

Question 7

Is Serum Amyloid A elevated in horses with equine gastric ulcer syndrome?

Answer 7

No association was found between SAA concentrations and the presence or degree of squamous or glandular EGUS.

Is Serum Amyloid A elevated in horses with equine gastric ulcer syndrome?
eve 2020

Question 8

What are the effects of PBZ on gastric ulcers, intestinal permeability and fecal microbiota in horses ?
A- PBZ induces impaired barrier function and increased gastric ulceration score, but does not induce specific changes in the microbiota
B- PBZ induces impaired barrier function, increased gastric ulceration score, and induced specific changes in the microbiota
C- PBZ induces increased gastric ulceration score, but does not alter barrier function and specific changes in the microbiota.
D- PBZ induces increased gastric ulceration score and specific changes in the microbiota, but does not alter barrier function.

Answer 8

B- PBZ induces impaired barrier function, increased gastric ulceration score, and induced specific changes in the microbiota.

Effects of phenylbutazone alone or in combination with a nutritional therapeutic on gastric ulcers, intestinal permeability, and fecal microbiota in horses
jvim 2021

Question 9

Can omeprazole be use to prevent PBZ-induced EGUS ?

Answer 9

Administration of omeprazole ameliorated PBZ-induced EGGD, but was associated with an increase in intestinal complications. Caution should be exercised when co-prescribing NSAIDs and omeprazole in horses, particularly in association with change in management.

Impact of concurrent treatment with omeprazole on phenylbutazone-induced equine gastric ulcer syndrome (EGUS)
evj 2021

Question 10

Which fatty acid to choose to prevent the most severe gastric ulcers?

Answer 10

Long-chain polyunsaturated fatty acid supplementation (omega 3, omega 6) was associated positively with prevention or resolution of severe squamous gastric ulceration.

Long-chain polyunsaturated fatty acid supplementation increases levels in red blood cells and reduces the prevalence and severity of squamous gastric ulcers in exercised Thoroughbreds
javma 2022

Question 11

Are gastric ulcers a pathology reserved for sport and race horses?

Answer 11

An abattoir study found EGGD in 30% of feral horses demonstrating that these do not only occur in domesticated equids.

Equine gastric ulcer syndrome in adult horses (Review)
Vet J 2022

Question 12

What is the pathophysiology of ESGD and the associated risk factors ? (4 points)

Answer 12

Squamous ulceration is caused by exposure of the gastric mucosa to acid, mainly hydrochloric acid (HCl), volatile fatty acids (VFA’s) and bile acids.
Risk factors:
- High starch intake, probably because starch leads to increased production of VFA’s that reduce mucosal integrity → increased serum gastrin concentrations
- Periods of forage deprivation >6 h
- Stress → Cribbing and other stereotypies are associated with ESGD and considered to be coping mechanisms, suggesting a link with stress
- Intensity of exercise → During exercise intra-abdominal pressure increased, pushing the acidic gastric contents up against the squamous mucosa.

Equine gastric ulcer syndrome in adult horses (Review)
Vet J 2022

Question 13

What is the pathophysiology of EGGD and the associated risk factors ? (3 points)

Answer 13

EGGD is thought to be related to compromise of mucosal defence mechanisms. Histological examination of glandular gastric lesions showed a lack of ulcerative pathology, but rather of inflammation.
Risk factors :
- NSAID at inappropriate doses, mediated mainly by effects on mucosal blood flow, caused by prostaglandin inhibition. Normal use of NSAIDs does not appear to cause EGGD under field conditions and preventive use of omeprazole is not considered necessary. Reminder: caution should be exercised when co-prescribing NSAIDs and omeprazole in horses
- Stress → Both trainer and the number of caretakers were shown to increase the prevalence of EGGD in riding horses.
- Frequency of exercise → Exercising during 5 or more days per week also considerably increased the risk of horses developing EGGD and may be related to altered gastric blood flow or (physiological) stress.

Equine gastric ulcer syndrome in adult horses (Review)
Vet J 2022

Question 14

What is the correlation between endoscopic findings and histology for EGUS ?

Answer 14

When results of endoscopy, necropsy and histology were compared it became obvious that endoscopy may underestimate ulcer number and severity.

Equine gastric ulcer syndrome in adult horses (Review)
Vet J 2022

Question 15

What is the clinical relevance of sucrose permeability testing in the diagnosis of EGUS ?

Answer 15

Sucrose permeability testing is based on the fact that sucrose cannot cross the healthy gastrointestinal mucosa, but when the epithelium is injured.
Blood sucrose testing had a high sensitivity for the detection of gastric ulcers in weanling foals but the specificity was low.
And it was found to be neither sensitive nor specific in adult horses with EGUS.

Equine gastric ulcer syndrome in adult horses (Review)
Vet J 2022

Question 16

What is the clinical relevance of fecal occult blood test in the diagosis of EGUS ?

Answer 16

The fecal occult blood test also has a low sensitivity for detecting EGUS.

Equine gastric ulcer syndrome in adult horses (Review)
Vet J 2022

Question 17

What is the reliability of EGUC ordinal grading system (0-4) for EGGD in horses ?

Answer 17

Inter- and intra-observer reliability were substantial for glandular mucosa using the EGUC scale.
Current recommendations are to use descriptive terminology for EGGD (Consensus 2015), but further refinement seems desirable.

Equine gastric ulcer syndrome in adult horses (Review)
Vet J 2022
Interobserver and intraobserver reliability for 2 grading systems for gastric ulcer syndrome in horses
jvim 2021

Question 18

Which prophylactic treatment for EGUS is preferable between omeprazole (1 mg/kg q24h) and sucralfate (20 mg/kg q8h) in horses exposed to a combined feed-fast and NSAID administration ?

Answer 18

Omeprazole was superior to sucralfate for mitigating gastric lesion severity in healthy horses exposed to a feed-fast/NSAID model.

Effect of omeprazole and sucralfate on gastrointestinal injury in a fasting/NSAID model
evj 2022

Question 19

Does curcumin extract or Harpagophytum species result in gastric ulceration ?

Answer 19

Supplements containing turmeric (Curcuma longa) and devil’s claw (Harpagophytum species) did not cause or worsen gastric ulcers or alter health parameters after 28 days of feeding.

Effect of an oral supplement containing curcumin extract (Longvida) on lameness due to osteoarthritis and gastric ulcer scores
eve 2022
Effects of supplements containing turmeric and devil’s claw on equine gastric ulcer scores and gastric juice pH
eve 2022

Question 20

What is the clinical efficacy and safety of a long-acting IM omeprazole in EGUS ?

Answer 20

5 mg/kg bwt intramuscular injection of LAO-USA once a week for four doses
Both ESGD and EGGD improved within 28 days, but injection reactions included oedema, heat and pain at the injection site. The number of injection site reactions increased following each dose.

Clinical efficacy, safety and pharmacokinetics of a novel long-acting intramuscular omeprazole in performance horses with gastric ulcers
eve 2022

Question 21

What is the potential clinical efficacy of porcine hydrolysed collagen (PHC) on gastric ulcer scores, gastric juice pH, and gastrin concentration in horses ?

Answer 21

The PHC fed to horses enhanced the effects of omeprazole on increased gastric juice pH, inhibited gastrin secretion after feeding and resulted in fewer nonglandular ulcers after long-term feeding (56 days) in stall-confined horses undergoing intermittent feeding.
EGGD ?

The effect of porcine hydrolysed collagen on gastric ulcer scores, gastric juice pH, gastrin and amino acid concentrations in horses
eve 2022

Question 22

What is the clinical impact of partial substitution of concentrates by dehydrated alfalfa ?

Answer 22

Feeding pelleted dehydrated alfalfa could help to reduce the incidence and severity of EGGD.

Effect of diet composition on glandular gastric disease in horses
jvim 2023

Question 23

Is it important to use tapering protocols of omeprazole in horses ? And why ?

Answer 23

• Serum gastrin concentrations increased in response to omeprazole treatment but returned to baseline within 2 to 4 days after the last dose of omeprazole.
• No effect of treatment or discontinuation was seen in serum chromogranin A concentrations.
• Rebound gastric hyperacidity seems unlikely in horses and our results do not support the use of tapering protocols in horses.

Evaluation of the effects of medium-term (57-day) omeprazole administration and of omeprazole discontinuation on serum gastrin and serum chromogranin A concentrations in the horse
jvim 2023

Question 24

What is the best dosing intervals of extended-release injectable omeprazole in the treatment of ESGD and EGGD ?

Answer 24

• The proportions of horses with EGGD healing in association with ERIO used at 5-day intervals were higher than associated with treatment at 7-day intervals.
• For ESGD, there was no significant difference between the 2 protocols.
• The use of ERIO at 5-day intervals might be more appropriate than the 7-day interval that is used currently.
• Prevalence of injection-site reaction → 1%

Five- versus seven-day dosing intervals of extended-release injectable omeprazole in the treatment of equine squamous and glandular gastric disease
evj 2024

Question 25

Is oral esomeprazole more protent than omeprazole in horses ?

Answer 25

Oral-buffered esomeprazole was a more effective treatment for ESGD (and concurrent EGGD) than oral-buffered omeprazole.

Comparison of oral esomeprazole and oral omeprazole in the treatment of equine squamous gastric disease
evj 2024

Question 26

In horses diagnosed with gastric impactions, which of the following is true regarding the prognosis and management of lone gastric impactions (LGI)?

A) LGI are less likely to require long-term dietary management compared to CGI.
B) LGI resolves more quickly compared to CGI, with shorter hospital stays.
C) LGI horses are more likely to experience gastric rupture and require long-term dietary changes.
D) LGI horses show more acute clinical signs compared to CGI.

Answer 26

Answer: C

Justifications:

A): Incorrect. Horses with LGI were significantly more likely to require long-term dietary management (72.7%) compared to CGI (25%)​.

B): Incorrect. LGI resolves more quickly (median 2 days) compared to CGI (median 4 days), but there is no significant difference in hospital stay​.

C): Correct. LGI horses were more likely to experience gastric rupture (29.6%) and required long-term dietary management more often​.

D): Incorrect. LGI horses had longer-lasting clinical signs, while CGI cases showed more acute onset​.

Clinical presentation and outcome of gastric impactions with or without concurrent intestinal lesions in horses. 2023

Question 27

In the study on plasma concentrations of serum amyloid A (SAA) and lipopolysaccharide-binding protein (LBP) in horses with laminitis caused by hindgut acidosis (HGA), which of the following statements are clinically accurate?

A. Horses fed a high-forage diet (70:30 forage-to-concentrate ratio) showed significant increases in laminitis severity, LBP, and SAA levels by Day 20.
B. Horses fed a high-concentrate diet (30:70 forage-to-concentrate ratio) showed significant increases in plasma LBP and SAA concentrations, along with laminitis severity scores, particularly by Day 20.
C. The study suggests that LBP may be a more sensitive marker than SAA for the early identification of HGA and laminitis in horses on high-carbohydrate diets.
D. Cecal pH and volatile fatty acids (VFA) levels remained stable across both diet groups, with no significant changes due to diet composition.
E. The increase in LBP observed in horses with HGA may be due to endotoxins released from gram-negative bacteria as a result of decreased cecal pH.

Answer 27

Correct answer: 2. B, C, E

Explanation:

A is incorrect: Horses on the high-concentrate (30:70) diet, not the high-forage (70:30) diet, exhibited significant increases in laminitis severity, LBP, and SAA levels.

B is correct: Horses on the 30:70 diet showed notable increases in plasma LBP, SAA concentrations, and laminitis severity, especially by Day 20.
“On day 20, a significant increase in the concentration of SAA was observed in horses fed a high-concentrate diet, in contrast to the initial stage of the study. LBP levels in the plasma were significantly elevated on days 10 and 20 in horses fed a high-concentrate diet. Based on our findings, it is recommended that the evaluation of plasma LBP concentrations is more effective than SAA for the early identification of HGA in horses fed a high-grain diet.”

C is correct: The study suggests that LBP could be a more sensitive marker than SAA for early detection of HGA and laminitis in horses on high-carbohydrate diets.

D is incorrect: Cecal pH and VFA levels showed significant changes, particularly in horses on the high-concentrate diet.

E is correct: The increase in LBP is likely due to endotoxins from gram-negative bacteria as a result of decreased cecal pH, consistent with the study’s findings.

Plasma concentration of serum amyloid A and lipopolysaccharide binding protein in horses with laminitis resulted from hindgut acidosis 2024

Question 28

In a study on the effects of intravenous ascorbic acid (AA) on oxidative stress in healthy adult horses, which of the following statements accurately summarize the findings?

A. All doses of AA (25, 50, and 100 mg/kg) significantly reduced plasma dROM levels at 2 and 6 hours post-administration.
B. Only the 100 mg/kg dose of AA significantly reduced dROM levels at 2 hours, with levels returning to baseline by 6 hours.
C. Plasma antioxidant capacity (PAC) and reactive oxygen species (ROS) levels in neutrophils and erythrocytes were unaffected by AA at any dose.
D. Plasma AA concentrations increased in a dose-dependent manner and remained elevated at 6 hours.
E. The study recommends 50 mg/kg AA for reducing oxidative stress due to its effects on ROS in neutrophils.

Answer 28

Correct Answer: 2. B, C, D

Explanation:

B is correct: Only the 100 mg/kg dose reduced dROM levels, and effects were temporary (baseline levels by 6 hours).
C is correct: PAC and ROS in neutrophils and erythrocytes were unaffected by any AA dose.
D is correct: Plasma AA concentrations rose in a dose-dependent manner and remained elevated at 6 hours.
A is incorrect because not all doses impacted dROM.
E is incorrect as the study did not recommend the 50 mg/kg dose for reducing oxidative stress.

2023 Effects of intravenous administration of ascorbic acid (vitamin C) on oxidative status in healthy adult horses

Question 29

In a 12-year-old Quarter Horse gelding with chronic colic and weight loss due to lymphocytic myenteric ganglionitis (MG) associated with equine herpesvirus infection, which of the following statements is TRUE regarding diagnosis and management?

A. Myenteric ganglionitis can be reliably diagnosed in horses through partial-thickness intestinal biopsies.
B. Treatment options for Chronic Intestinal Pseudo-Obstruction (CIPO) in horses are generally successful, with long-term survival expected.
C. Full-thickness biopsies provide greater diagnostic value in cases of suspected myenteric ganglionitis in horses.
D. Neuronal degeneration in CIPO cases is primarily managed with surgical removal of affected intestinal sections in horses, with successful long-term outcomes.

Answer 29

Correct Answer: C. Full-thickness biopsies provide greater diagnostic value in cases of suspected myenteric ganglionitis in horses.

Explanation:

Option A: False. Partial-thickness biopsies are often limited in diagnosing myenteric ganglionitis effectively, as shown in equine cases where full-thickness biopsies are recommended to better capture enteric neuropathy characteristics.
Option B: False. The prognosis for CIPO in horses is typically poor, as even with prokinetics, dietary management, and corticosteroids, recurrence of symptoms and complications such as intestinal rupture often lead to euthanasia.
Option C: True. Full-thickness biopsies are indeed more reliable for identifying myenteric ganglionitis, especially in cases involving recurrent intestinal impactions.
Option D: False. Surgical interventions in horses with CIPO, including resection, have not shown successful long-term outcomes due to the disease’s complex and recurrent nature.

2023 Lymphocytic myenteric ganglionitis associated with equine herpesvirus infection: A cause of chronic intestinal pseudo-obstruction and recurrent colic in an adult horse

Question 30

Based on the study’s findings, which of the following diets is most likely to result in spontaneous healing of severe Equine Gastric Ulcer Syndrome (EGUS) in horses?

A. Whole oat grains at 2 g starch/kg body weight per meal with hay ad libitum (OS2)
B. Pasture turnout (PST)
C. Whole oat grains at 1 g starch/kg body weight per meal with hay ad libitum (OS1)
D. Hay fed ad libitum (HAY)

Answer 30

Correct Answer: B. Pasture turnout (PST)

Justification:

Option A (OS2): Horses fed 2 g starch/kg body weight per meal had an increased risk of ulceration and a higher likelihood of acute gastritis.
Option B (PST) is correct: The study showed that pasture turnout provided the best outcomes, with spontaneous healing of severe EGUS, particularly in the squamous mucosa.
Option C (OS1): This low-starch diet still posed some risk for EGUS, with increased ulceration in the antrum.
Option D (HAY): Ad libitum hay showed positive results but was less effective than pasture turnout for spontaneous healing of severe EGUS.

Equine gastric ulcer syndrome in horses fed hay, hay plus different amounts of oats or with pasture turnout

Question 31

A 10-year-old gelding used in a university teaching program undergoes monthly gastroscopies as part of a study. The horse shows mild girthing pain but no other clinical signs. Based on the findings of this study, which of the following statements is most likely to be true?
A) The horse’s ESGD and EGGD lesions will remain stable over the three-month period without treatment.
B) If the horse has ESGD, it will definitely worsen without acid suppressive treatment.
C) The horse’s ESGD or EGGD lesions may improve or deteriorate within a month without treatment.
D) Girthing pain is a definitive indicator of severe EGUS in teaching horses.

Answer 31

Correct answer: C) The horse’s ESGD or EGGD lesions may improve or deteriorate within a month without treatment.

Justification:
The study found that “Both ESGD and EGGD lesions can improve or deteriorate in a month’s time, without acid suppressive treatment.”
The researchers observed that ESGD grades changed in 5/13 horses between the first and second gastroscopies, and in 4/13 horses between the second and third gastroscopies, without any treatment.
EGGD classifications also changed in 5/12 horses between the first and second gastroscopies, and in 2/13 horses between the second and third gastroscopies.
The study suggests that management factors and stress from handling by multiple people during teaching may contribute to EGUS development, which could explain the fluctuations in lesion severity.

A 3 month longitudinal evaluation of the prevalence of ESGD and EGGD in a group of teaching horses

Question 32

According to the study, which of the following is TRUE regarding the treatment of Equine Glandular Gastric Disease (EGGD) in horses with concurrent Inflammatory Bowel Disease (IBD)?

A. Horses with IBD showed significant improvement in EGGD lesion scores when treated with intramuscular omeprazole (IMOM).
B. The presence of IBD tends to reduce the effectiveness of EGGD treatment, and some horses with IBD had worsened EGGD scores after IMOM treatment.
C. Oral omeprazole alone is equally effective for EGGD in horses with or without IBD.
D. Intramuscular omeprazole is not recommended for EGGD treatment due to its lack of efficacy across all cases.

Answer 32

Correct Answer: B. The presence of IBD tends to reduce the effectiveness of EGGD treatment, and some horses with IBD had worsened EGGD scores after IMOM treatment.

Justification:

Option A is incorrect: Horses with concurrent IBD did not show significant improvement in EGGD lesion scores with IMOM; in fact, some cases worsened.
Option B is correct: The study found that IBD may negatively impact the treatment outcome for EGGD, with some horses experiencing worsened scores post-IMOM.
Option C is incorrect: Oral omeprazole alone was less effective for EGGD, particularly in horses with IBD (difference with injectable omeprazole thatn is effective for both EGUS)
Option D is incorrect: Intramuscular omeprazole is generally effective for EGGD but may be less so in cases with concurrent IBD.

Retrospective comparison of different treatments of EGUS and the inflluence of IBD

Question 33

In a study comparing the fecal microbiota of healthy horses to horses with colitis, which of the following findings was observed regarding horses with colitis and their survival outcomes?

A. The microbiota composition was identical between surviving and non-surviving colitis horses.
B. Non-surviving colitis horses showed an enrichment of Enterobacteriaceae, Pseudomonas, Streptococcus, and Enterococcus.
C. Colitis horses that developed laminitis showed no enrichment of specific bacterial groups compared to healthy horses.
D. Differences in the fecal microbiota were more pronounced between laminitis and non-laminitis colitis horses than between survivors and non-survivors.

Answer 33

Correct Answer: B. Non-surviving colitis horses showed an enrichment of Enterobacteriaceae, Pseudomonas, Streptococcus, and Enterococcus.

A is incorrect: The study found that non-surviving colitis horses had distinct microbiota, particularly with an enrichment of certain bacterial groups.
B is correct: Non-surviving colitis horses had significant enrichment of Enterobacteriaceae, Pseudomonas, Streptococcus, and Enterococcus.
C is incorrect: Horses with laminitis were also enriched in specific bacterial groups, such as Enterobacteriaceae, Streptococcus, and Lactobacillus, though the overall microbiota composition was not significantly different from non-laminitis horses.
D is incorrect: Microbiota differences were more prominent between healthy and colitis horses than between laminitis and non-laminitis or survivor and non-survivor subgroups.

Fecal microbiota of horses with colitis and its association with laminitis and survival during hospitalization 2022