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SPRING 2017 ISSUE
EQUINE MATTERS
10
GA S T R I C U L C E R S
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Equine Glandular Gastric Ulcer Syndrome
(EGGUS) affecting the lower, glandular part
of the stomach (including the pyloric antrum
or ‘exit’ from the stomach)
(figure 3)
.
ESGUS and EGGUS should be treated as
different problems, even when both are seen
in the same horse, as the risk factors and
treatments are different.
Does my horse need gastroscopy
or could I just give him some
medication?
Whilst ‘typical’ symptoms may lead you to
suspect EGUS in your horse, it is important
this is confirmed by gastroscopy
(figure 4)
to establish whether your horse has ESGUS,
EGGUS or both. Also, ‘trial’ treatment
with medication is costly and in some
horses affected by EGGUS symptoms will
not resolve even after a few weeks of
medication. It is also common for a horse
showing symptoms typical of EGUS to have
a different, or additional issue, such as
lameness or back pain.
Gastroscopy is useful to determine and
measure response to treatment and, should
symptoms return in the future, to confirm ulcer
type remains the same.
My horse has EGUS, what should I do?
Medication is usually necessary following
diagnosis and your vet will prescribe drugs
appropriate for your horse. It is important to
follow any directions as to how these should
be administered to ensure they are effective.
For example, you may be asked to give
medication a set time before feeding.
Nutritional and management changes are
important to aid resolution of ulcers and
reduce risk of future recurrence.
Unfortunately ulcers will return quickly if
changes cannot be implemented, resulting
in reliance on expensive medication.
Management changes alone, however, may
not lead to resolution of EGUS.
As a further prevention, your vet may also
recommend a low dose of medication
is given at times of stress, such as
transportation.
Management for ESGUS
Risk of ESGUS increases with intensity
of exercise, with ulcers often improving
during rest periods. Feeding a small,
roughage-based feed such as alfalfa chaff
approximately thirty minutes prior to exercise
is recommended.
Horses are designed to be trickle feeders,
so free access to roughage, preferably from
multiple different sources, has been shown to
be helpful. Using straw as the only roughage
source should be avoided (except in
donkeys). Alfalfa may have some beneficial
effects.
Increased time at pasture should have a
positive impact, though other ‘stressors’ may
affect this and any supplementary feed given
during turnout should also be considered.
Water should be made available at all times.
Reducing concentrate feed, and the
proportion of soluble carbohydrates within
this feed, is beneficial ensuring small, more
frequent meals. Adding roughage, e.g. chaff,
to feeds will help by encouraging chewing,
increasing saliva production which in turn
buffers stomach acid. Adding corn oil to feed
has a beneficial effect on acid production
as well as being a useful source of ‘non-
carbohydrate’ calories. Commercial feeds
are also now available for horses with
EGUS.
Feed supplements containing antacids are
widely available. Their short duration of
action does limit their usefulness but, given
regularly, they may be of benefit to horses in
regular work. These supplements are often
available in combination with mucosal
protectants such as pectin-lecithin complex
and may be useful in preventing ulcers in
some circumstances. Sugar beet is a good
source of pectins and is therefore useful to
add to the diet. Further feed supplements are
becoming available with some early positive
reports, however additional controlled
clinical studies of these products are
required to confirm their efficacy. The use of
concentrated electrolyte pastes or solutions is
not recommended in horses prone to EGUS.
Management for EGGUS
The cause of EGGUS is poorly understood
and further research is required to improve
our knowledge of this condition. In contrast
to ESGUS, exercise does not appear to be
a key factor. Whilst bacteria have been
detected in horses with ESGUS and
EGGUS they are not currently thought to
be a significant cause, though research is
ongoing.
Use of non-steroidal anti-inflammatory drugs,
such as bute, can cause issues at high
doses. However few problems are seen at
commonly used doses, particularly when
used for short periods, and these drugs are
unlikely to be a significant cause of EGGUS.
Diet may have an impact on EGGUS and
feeding recommendations for ESGUS should
also be appropriate for these horses. The use
of feed supplements may also be beneficial
but again further research is required.
Reducing social and behavioural stress is
also likely to be helpful.
Summary
●
Gastroscopy is essential for diagnosis and
monitoring of EGUS
●
There are 2 different types of EGUS
o ESGUS
o EGGUS
●
Treatment and management of these
conditions are different
●
Both medication and management
changes are necessary to reduce
recurrence of EGUS
Figure 3. Gastroscopy image from horse affected by EGGUS
Figure 4. Gastroscopy being performed at the practice