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Gastric Ulcers In Horses: Search For Biomarkers, Treatments Continues

Are you considering having your horse's stomach scoped again? Is there any other way to verify the presence of gastric ulcers? Right now, there isn't, but researchers are working on noninvasive ways to diagnose and monitor horses with equine gastric ulcer syndrome (EGUS).

Many performance horses have gastric ulcers, which are defects in the surface of the stomach lining that occur in either the glandular or nonglandular (squamous) regions. Thought to be largely due to management factors—stress due to training or competition, social isolation, diets high in concentrates or low in forages—gastric ulcers often cause poor performance, decreased appetite, and weight loss.

After diagnosing and grading ulcers via gastroscopy, veterinarians typically recommend treatments geared to decreasing the acidity of the stomach. Treatment plans for EGUS typically include diet modifications, management changes, and medications such as omeprazole, sucralfate, and ranitidine. Nutritional supplements designed to control the pH within the stomach could also be included.

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“Triacton supports gastric health by moderating acidity using ingredients shown to have greater buffering capacity. Those include a seaweed-derived source of calcium and several other highly bioavailable minerals,” said Catherine Whitehouse, M.S., a nutritionist for Kentucky Equine Research. “The form of calcium in Triacton offsets the negative effects of omeprazole on calcium digestibility compared to other commonly used sources of calcium in feeds and supplements.”

Because gastroscopies play a key role in ulcer management, repeated procedures are a necessary evil as horses may be resistant to treatment or the ulcers may return rapidly following cessation of pharmaceutical treatments like omeprazole.

Veterinary researchers recently suggested that identifying blood or salivary markers, or perhaps a combination of both, could help create a diagnostic panel for EGUS. This tool would screen patients for EGUS and monitor response to treatment, which would limit the frequency of gastroscopy.^*

Blood collected from eight mature geldings with gastric ulcers was evaluated for total antioxidant capacity. A moderate but significant correlation between blood and salivary antioxidant capacity was identified, potentially indicating that oxidative stress decreases as ulcers heal.

“The role of oxidative stress and antioxidants in EGUS requires further exploration, but these very preliminary findings suggest that antioxidants may play a role in the future management of this condition,” said Whitehouse.

While horse owners wait for this research to advance, Whitehouse suggested using diagnostics and treatments, including gastrointestinal buffers, currently recommended by veterinarians.

^*Svagerko, P., W. Bridges, E. Jesch, S. Pratt-Phillips, and K. Vernon. 2021. Equine gastric ulcers; a pilot study: Associated biomarkers and polysaccharide supplementation as a solution. Journal of Equine Veterinary Science 100:103518.

Reprinted courtesy of Kentucky Equine Research. Visit ker.com for the latest in equine nutrition and management, and subscribe to Equinews to receive these articles directly

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Genetics To Blame For Friesian’s Eye Issues

A study team led by Dr. Rebecca Bellone, of the University of California Davis Veterinary Genetics Laboratory, has identified a genetic variant as the cause of a painful eye condition in Friesian horses. The condition, called distichiasis, causes hairs to grow at odd angles along the eyelid; these hairs rub the cornea, making the eye irritated and painful. Severe cases may result in corneal ulceration and possibly the loss of the eye.

Distichiasis can be treated by removing the offending hairs via thermocautery, but the condition recurs in nearly 50 percent of cases. To determine the genetic cause of this condition, the scientists traced the family trees of 14 horses afflicted with the condition. The team discovered a large chromosome deletion between two genes on the ECA13 chromosome strongly associated with distichiasis.

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The team concluded that distichiasis in Friesians is a trait with incomplete penetrance, meaning that the condition may show up in some individuals with two copies of the variant, or the horse may show no sign of the condition at all. The research team noted that testing can avoid crosses that produce animals that are homozygous for the variant. Results can also be used to ensure affected horses are evaluated often to prevent irreversible corneal damage.

To read the full study, click here.

Study: Diet Change Imperative For Ulcer Resolution In Horses

When a horse begins ulcer treatment, the way he is managed is often scrutinized; alleviating stress will hopefully mitigate ulcer recurrence. A new study out of Denmark shows that management changes alone may not be enough—adjustment to the horse's diet should also be investigated.

A low-starch diet can be beneficial for a horse that has gastric ulcers, but diet as a whole is often overlooked when ulcers medication is prescribed. Dr. Nanna Luthersson created a study to highlight the necessity for diet adjustment.

Luthersson used 58 horses that were diagnosed with ulcers. The horses were divided into two groups based on the severity of their lesions: 24 horses had moderate lesions, graded as 1 or 2 out of 4, and 34 horses had severe ulcerations, determined to be a 3 or a 4. The horses were placed into pairs based on similarities in diet, feeding times, management and workload.

At the beginning of the study, the horses with severe ulcers were placed on omeprazole, but the other horses were not. Additionally, one horse out of each pair was put on a low-starch feed that was fed three times a day instead of twice a day.

After four weeks, the omeprazole treatment was stopped, but the assigned diets continued; researchers examined each horse with an endoscope and graded their lesions. Six weeks later (10 weeks after the study began), the horses again received endoscopic exams and had their lesions graded.

Horses with severe ulcers had a significant reduction in lesions between the start of the study and when the omeprazole ended. However, those horses that received the reduced-start diet sustained the lesion improvement for the entire 10 weeks. Horses that did not have their diets changed returned to their same lesions score by week 10 even though they had received the omeprazole treatment. This means that these horses received no long-term benefit from the omeprazole.

Luthersson concluded that adjusting a horse's diet is imperative for long-term management of a horse that is ulcer prone. Though some ulcers heal with diet change alone, she notes that treatment and diet change may necessary for horses with more-severe lesions.

Red more at EQUUS magazine.

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