Studies have demonstrated that greater than 80% of racehorses have been documented as having stomach ulcers during their training and racing careers. Gastric ulceration in horses is known as Equine Gastric Ulcer Syndrome (EGUS). This syndrome is considered a multifactor disease because there are a plethora of risk factors that have been associated with gastric ulceration, including but not limited to diets high in fermentable carbohydrates, feed deprivation, non-steroidal anti-inflammatory medications (NSAIDs) such as Bute or Banamine, lack of paddock or pasture turnout (confinement has been associated with increased natural corticosteroid release) and exercise schedule.Unlike in humans, the bacteria Helicobacter pylori has not been definitively associated with EGUS.
Clinical signs in horses may include acute or recurrent colic, poor body score condition, decreased appetite (especially for grain), poor performance, grinding of teeth, recurrent impactions and changes in the animal’s attitude. The diagnosis of the disease is based on clinical signs, endoscopic examination and response to treatment. Endoscopic examination is used to help determine the presence of ulceration, location and severity of the ulceration and the response to treatment.
Location of the ulceration can help determine the factors associated with the disease. For example, an ulcer located in the region of the pylorus (the portion of the stomach that connects it to the small intestine) could be associated with the use of NSAIDS.
Treatment consists of the use of an FDA-approved omeprazole product (Gastroguard® or Ulcerguard® made by Merial, for example), Carafate or histamine type-2 receptor antagonist (Cimetidine or Ranitidine). A recent veterinary study has shown that compounded omeprazole products are not as effective as the commercially available FDA-approved product in the healing of gastric ulcers in Thoroughbred racehorses. It therefore is very important to make sure that if your horse(s) require treatment for EGUS, they are prescribed the FDA-approved omeprazole product and not a compounded omeprazole product.
This question was answered by Dr. Nathan Slovis, the Director of the McGee Center and a Member of the Practice. He is a native of Annapolis, Maryland. He received his Bachelor of Science from Radford University, Doctor of Veterinary Medicine from Purdue University, interned at Arizona Equine Center and completed his residency in Internal Medicine at the University of California, Davis. Dr. Slovis has published over 30 manuscripts in both national and international peer reviewed veterinary journals. He is the editor of both the Atlas of Equine Endoscopy and The Atlas of Diseases/Disorders of the Foal, both distributed by Elsevier. He implemented the current Infectious Disease and Equine Emergency Response Programs at Hagyard and holds the position of Infectious Disease Officer and Equine Emergency Response Director. He is also a Certified Hyperbaric Technologist and a Member of the Veterinary Infectious Disease Society.