Late winter/early spring is the time of year when those of us with the competitive urge start planning for the upcoming season of competitions. Top of mind is generally conditioning, schedule planning, and diet to ensure our horses are in peak performance shape come spring. But let’s not forget about the importance of addressing our horses from the inside out to make sure that there aren’t underlying issues that are going to rear their ugly head once competition season arrives. As many of you know, Dr. Penttila competes at a high level on her barrel horse so we’re going to share with you some tips and tricks from our veterinary team on how we keeps her horses in top form.
Equine gastric ulcer syndrome (EGUS) describes the presence of ulceration or inflammatory disease that can affect the horse stomach. The horse stomach has two portions, the squamous or non-glandular portion and the glandular portion, divided by a line called the margo plicatus. As such, horses can be affected by squamous gastric disease (ESGD), glandular gastric disease (EGGD), or both concurrently.
The diagnosis, treatment, and management of EGUS is an important aspect of veterinary care in our performance horses because it is highly prevalent. EGUS in both forms has been reported in varying amounts in horses, but on average, we can see it develop in around 50% of our horses used for pleasure, 75% of our performance horses, and up to 100% of our racing horses. The causes and risk factors for EGUS are varied depending on the type of disease present but can include being housed in busy or stressful environments, use in performance disciplines, frequent travelling, cribbing, exercising more than 5 days per week, being more inexperienced at their work, meal feeding (versus free-choice), and higher grain diets.
Figure 1: A healthy equine stomach
Though a diagnosis of EGUS may be a daunting prospect, the good news is that once recognized we have a good selection of management and treatment options to help provide affected horses comfort and improve their overall performance. You might consider booking an appointment to have your horse assessed for gastric ulcers if you notice some of the following more common signs associated with EGUS: recurrent colic, weight loss or being a “hard keeper”, poor coat condition, reduced appetite, diarrhea, hypersalivation, previous anti-inflammatory administration, behaviour changes (nervousness, aggression, girthiness, etc.), and/or poor performance.
Figure 2: Examples of severe squamous (top) and moderate glandular gastric ulcers (bottom) in the horse.
To diagnose gastric ulcers, your horse can have a gastroscopy performed under standing sedation (similar to a dental) either at the clinic or on farm. While some might feel that they would prefer to try treatment for gastric ulcers over having a gastroscopy performed, there are multiple advantages to having a gastroscopy performed prior to treatment.
- First, the risk of treating a horse that doesn’t have ulcers (and potentially wasting time and money on an unneeded therapy) is avoided when gastroscopy is performed.
- Second, when a gastroscopy is performed we can differentiate between the two different types of EGUS (ESGD and EGGD) which each have their own unique treatment and management recommendations. If you treat with oral omeprazole (Gastrogard) alone, you risk inadequate treatment for the underlying disease and a poor response to treatment then assuming your horse doesn’t have ulcers even if they did.
- Finally, an initial scope can help us gauge response to treatment over time. While healing of ESGD is expected within 4 weeks for around 80% of horses treated with Gastrogard, healing rates of EGGD are much lower with Gastrogard alone at about 25%. As such, if your horse is in the 20% of horses whose ESGD has not completely healed after 4 weeks or if they also have EGGD, an extended treatment with alternative therapies will likely be required for complete healing. Without a gastroscopy to assess response to treatment, we are unable to know how well our initial therapies worked and at risk of stopping treatment too soon.
In general, with appropriate treatment and changes to diet and management, horses who have previously been diagnosed with EGUS have a good prognosis for return to work at a high level of performance. We can help to ensure your horse is performing at their best by addressing any underlying disease early in year before the competition season demands a more stressful schedule and any mild underlying EGUS lesions get worse.
If you have any questions on EGUS or would like to book your horse in for an assessment and gastroscopy please do not hesitate to reach out to our clinic!
We hoped you enjoyed this initial summary on gastric ulcers.
References:
2. https://vmc.usask.ca/care/equine-health/resources/gastric-ulcers.php#WhatshouldIdo