What Are Gastric Ulcers?

Gastric ulcers can be split into two syndromes depending on the area of the stomach that is affected.

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The diagram below shows the two areas of the stomach which are divided by the margo plicatus.
Equine squamous gastric disease (ESGD) affects the upper area of the stomach called the squamous or non-glandular region. Here the stomach is less protected so any excessive acid that splashes up can cause ulcers in this area. Usually diet and management are involved in the development of ulcers in this area.

Equine glandular gastric disease (EGGD) affects the lower area of the stomach called the glandular region. The stomach acid sits in this area and it has defence mechanisms to cope with acidic conditions. However, if these mechanisms fail, then the mucosa is exposed to excess acid and glandular ulcers may occur.

What are the risk factors?

• Stress – an increased number of carers or riders
• Exercise – worked more than 4/5 days per week, high intensity exercise
• Diet – large amounts of starchy feed, long periods without forage during the day, limited turnout.

What are the clinical signs?

The clinical signs of gastric ulcers vary in severity and can also be seen with other conditions. They also do not correlate with severity of lesions seen in the stomach.

The most common signs include:

• Change in temperament – nervous, aggressive
• Changes in rideability – unwilling to go forward, bucking/ rearing, poor performance
• Weight loss, reduced appetite and poor coat condition
• Abdominal discomfort – difficulty girthing up, reaction to touching the flanks
• Mild recurrent colic
• Poor performance.

How are gastric ulcers diagnosed?

The only way to definitively diagnose gastric ulcers is via gastroscopy. Unfortunately, there are no simple tests that can be carried out on blood, faeces or urine. Your horse will need to
be starved overnight and an endoscope (camera on the end of a long tube) is used to examine the stomach for the presence of ulcers. The advantages of gastroscopy is that the severity of the lesions can be scored, appropriate treatment can be given for the type of ulcers present and a follow up scope can be used to assess whether the ulcers have healed.

Treatment

The type and length of treatment given depends on the location and severity of ulcers found during the gastroscope. As the two types of ulcers have slightly different risk factors, the treatment and management for each will be slightly different. However, for both types of ulcers the treatment focuses on acid suppression.

How can I help prevent gastric ulcers?

The type and length of treatment given depends on the location and severity of ulcers found during the gastroscope. As the two types of ulcers have slightly different risk factors, the treatment and management for each will be slightly different. However, for both types of ulcers the treatment focuses on acid suppression.

Dietary:

• Small amounts of forage little and often to help buffer the acid in the stomach
• A maximum of 2kg of concentrate in any one feed.
Management:
• Minimise management changes i.e feeding, turnout, number of handlers – if changes need to be made then do so gradually
• Allow at least 2 rest days per week
• Maximise turnout.

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