New Perspectives in Equine Gastric Ulcer Syndrome

The Prevalence of Gastric Ulcer Syndrome in 395 Horses in Jiangyin City, China, Jiangsu Province

The aim of this study was to determine the prevalence and association of EGUS in horses of different ages, breeds and occupations. Gastroscopies were performed on 395 horses, and gastric ulcers were graded on a scoring system from 0 to 4. The relationship between age, breed, and work, along with the prevalence of gastric ulcers and their influences, were evaluated. The prevalence rate of ulcers in this herd was 78%. Older horses were prone to ulcers in both the glandular and squamous mucosal areas. Across the different jobs surveyed, 60% of the horses had a score of 2 or above. For the horses participating in more intense jobs (group performances, pulling carts, etc.), the number of horses with an ulcer score of 2 or above exceeded 50% of the total number of horses in this job. The prevalence of gastric ulcers was high, and these ulcers were severe in the horses belonging to the examined club, with no association between age or breed and the prevalence of ulcers; however, there was a difference in the location of the ulcers between breeds, as well as differences in the incidence and severity of ulcers depending on work activity. This study provides data reference values for the control and prevention of gastric ulcers in horses in this horse farm.

Equine Gastric Ulcer Syndrome: An Update on Current Knowledge

Equine Gastric Ulcer Syndrome (EGUS) is a term that has been used since 1999, initially being used to describe all gastric mucosal disease in horses. Since this time, the identification of two distinct main disease entities of the equine gastric mucosa have been described under the umbrella of EGUS; these are Equine Squamous Gastric Disease (ESGD) and Equine Glandular Gastric Disease (EGGD). In 2015 the European College of Equine Internal Medicine (ECEIM) released a consensus statement defining these disease entities. This document highlighted the lack of evidence surrounding EGGD compared to ESGD, and identified knowledge gaps for further research to be directed. Subsequently, many studies on EGGD have been published, especially on pathophysiology, diagnosis, and treatment. This article updates current knowledge on both ESGD and EGGD as understanding has evolved since the last large-scale review.

A Survey of Pennsylvania Horse Management: Part One-Nutrition

Various aspects of nutritional management can impact both a horse's gastrointestinal (GI) health and caretaker costs. The objective of this study was to characterize the feeding management and GI issues of horses in Pennsylvania (PA). An online survey was distributed from February 27th to August 31st, 2020. Kruskal-Wallis and Mann-Whitney tests were used to analyze the data. Nonparametric statistics were used when data were not normally distributed. From 470 responses collected, the average horse age was 15.7 ± 7.5 years, and the most common breeds were the Quarter Horse and Thoroughbred. Of the 345 horses who received premixed feed, 81% were fed on a volume basis. Most horses (95%) received hay on a volume basis, and 57% of horses were fed hay on the ground rather than in a feeder. No difference was detected in the number of scoops of premixed feed (median = 2; P = .284) or the flakes of hay per day (median = 5.7; P = .765) between horses in different exercise categories. The frequency of reported GI issues was 10% (46/470). Owner perceived, veterinary perceived, and veterinary diagnosed ulcers were found in 2.3%, 4%, and 2.3% of horses, respectively. No statistical difference was detected in the number of scoops of premixed feed fed per day between horses with or without GI issues (P = .536). Horses were provided the same amount of premixed feed and forage regardless of reported exercise category. Most equine caretakers fed concentrates on volume rather than weight, a common practice despite most feeding requirements being based on feed weights.

Equine Gastric Ulcer Syndrome affects fitness parameters in poorly performing Standardbred racehorses

Introduction

Equine Gastric Ulcer Syndrome (EGUS) is a highly prevalent disorder in horses, which can be classified, based on the localization of the lesions, as Equine Squamous Gastric Disease (ESGD) or Equine Glandular Gastric Disease (EGGD). Although EGUS is recognized as a common cause of poor performance in racehorses, objective investigations about its relation with athletic capacity are lacking. Therefore, the present retrospective study aims to evaluate the associations between EGUS severity and some fitness parameters measured during an incremental treadmill test in Standardbred racehorses in training.

Methods

With this aim, data from 87 Standard bred racehorses which underwent a complete diagnostic evaluation for poor performance was reviewed. During gastroscopic examination, a 0-4 score was assigned to ESGD, while EGGD was evaluated for absence/presence; a total EGUS score was obtained by adding 1 point to ESGD score in horses showing concomitant EGGD. Fitness parameters obtained during incremental treadmill test included speed at a heart rate of 200 bpm (V200), speed and heart rate at a blood lactate of 4 mmol/L (VLa4, HRLa4), peak lactate, lactate and heart rate at 30 minutes post-exercise, maximum speed, minimum pH and maximum hematocrit. The associations between fitness parameters and EGUS and ESGD scores were evaluated by Spearman correlation, while Mann-Whitney test was used to compare them between horses with or without EGGD. Statistical significance was set at p<0.05.

Results

EGUS grade was inversely correlated with V200 (p = 0.0025) and minimum pH (p = 0.0469); ESGD grade was inversely correlated with V200 (p = 0.0025) and VLa4 (p = 0.0363). Although a trend was observed, no significant differences in V200 were observed between horses with or without EGGD (p = 0.073); horses with EGGD reached a lower minimum pH (p = 0.0087).

Discussion

These results show a negative association between aerobic capacity and EGUS, in particular ESGD. Although different hypotheses have been proposed, including abdominal pain and decreased appetite due to lactate accumulation, the underlying mechanisms are still unknown, and it is not clear whether EGUS represents a cause or a consequence of an early lactate accumulation and post-exercise acidosis.

Effects of the Ingestion of Ripe Mangoes on the Squamous Gastric Region in the Horse

Erosions and gastric ulcers may be present in horses at any age and under different conditions of rearing and handling. In tropical regions, horses can feed on fruits rich in soluble carbohydrates, such as mangoes, but little is known about how these foods interact with their digestive systems. To test the hypothesis that the ingestion of ripe mangoes with peels could cause disturbances in the digestive processes of horses, an experiment was developed to monitor animals that had free access to ripe mangoes in their pasture areas. Horses (purebred Arabians, n = 5; ~340 kg, ~13 years) were evaluated by video gastroscopy and blood analysis. A controlled postprandial glucose curve for mango intake was also performed. Gastroscopies were performed at intervals of 15 days, starting in December, just before the beginning of the harvest, until the beginning of February, and days after the end of the harvest. Blood collection was performed on the same day between November and February for blood analysis. The results were submitted to ANOVA and Tukey’s test, with a significance level of p < 0.05. Gastroscopies indicated that four out of five horses had erosions and ulcers in the squamous region between 15 and 30 days after the start of the season. Biochemical tests indicated a reduction in plasma proteins during the harvest period, and the postprandial glucose curve showed concentrations above 200 mg/dL between 30 and 180 min after ingestion of 5.37 kg mangoes. The animals were not treated and recovered after 15 days of harvest and without ripe mangoes on the ground. It is concluded that the indiscriminate ingestion of mangoes favors the appearance of lesions in the gastric squamous region, to varying degrees, and that animals recover naturally after an average of 15 days from the end of the season when the animals return to their regular feeding with hay and grass pasture.

Manifestation of gastric ulcers in horses used in public safety

ABSTRACT We evaluated 28 horses from a squad applied in public safety in Paraná (Brazil), in order to check the incidence of gastric ulcers and its correlation with mounted policing activity, considering the initial and maintenance training to which such animals are submitted. Horses were divided in two groups, one named control with 14 individuals, used in policing community activities, and the 14 others named as target group, these were used in restoration and maintenance of public order. Both groups have differentiated maintenance training protocols, and all had been evaluated for fecal occult blood, clinical evaluation, gastroscopy and histopathological. There were no significant changes that proved the development of gastric ulcers in horses used in public safety due to initial and maintenance training, and the main factor for prevention was the diversified diet with emphasis in hayed alfalfa.

Prevalence and treatment of gastric ulcers in Thoroughbred racehorses of Korea

Background

Gastric ulcer is one of the prevalent diseases in racehorses. However, it has not been recognized as important in Korea, and drugs used to treat gastric ulcers are included in the doping test list, so they are not allowed to be administered to racehorses in training.

Objectives

This study was performed 1) to investigate the prevalence and the severity of gastric ulcers in Thoroughbred racehorses in Korea, 2) to confirm the therapeutic effect of ranitidine and omeprazole, and 3) to compare the efficacy between ranitidine and omeprazole.

Methods

Forty-nine horses were randomly recruited, and gastroscopy was performed within two days after racing. Twelve horses with a sum grade of five or higher were randomly assigned to two treatment groups. Seven horses were administered ranitidine, and five horses were administered omeprazole. Follow-up gastroscopy was scheduled within one to five days after finishing the treatment.

Results

The prevalence of gastric ulcer in Korean Thoroughbred racehorses after racing was 100%, and the grade was more severe in the non-glandular region than in the pyloric region. There was no correlation between the severity of gastric ulcer in the two regions. Omeprazole had a greater therapeutic effect than ranitidine.

Conclusions

This study shows the importance of recognizing gastric ulcers as an important factor, and omeprazole as a possible treatment option in Korea, as it has been removed from the list of prohibited substances for racehorses. Thus, the use of omeprazole is currently recommended until one day before the race.

UK Horse Carers' Experiences of Restricting Grazing When Aiming to Prevent Health Issues in Their Horses

Laminitis and obesity are leading welfare issues for UK leisure horses. Limiting grass intake is a common preventative measure but may result in other aspects of welfare being compromised. This study aimed to determine how commonly different restricted grazing methods are used in the UK, barriers limiting their accessibility, and the potential benefits and welfare issues associated with each. A cross-sectional online survey was distributed with questions relating to horse carers' opinions of different restricted grazing practices, which methods they used, and how they implemented these. Closed questions were analyzed using descriptive statistics and non-parametric tests. Free text questions underwent content analysis. 503 respondents completed the questionnaire, 468 (93.0%) had practiced restricted grazing. Strip grazing was the most commonly tried method (67.7% of restricted grazers), followed by grazing muzzles (61.3%), starvation paddocks (57.4%), stabling (49.9%), crew yards (27.5%) and track systems (15.3%). Perception of welfare impact differed significantly between methods for both those who had (P < .001) and had not (P < .001) restricted grazing. Both groups considered strip grazing best for welfare and stabling worst. Barriers (including ease of implementation [52.0%], yard restrictions [24.0%], cost/affordability [23.7%]) prevented some from using their preferred methods. Respondents had similar priorities when choosing a restricted grazing method but did not agree which methods met these criteria. Strip grazing was favored by the greatest proportion of respondents whilst grazing muzzles and stabling polarized opinion. This study has provided initial insights into the challenges faced by horse carers when aiming to restrict grazing to combat equine health issues.

Effects of Cannabidiol on the In Vitro Lymphocyte Pro-Inflammatory Cytokine Production of Senior Horses

Cannabis sativa L. contains cannabidiol (CBD), a compound that has many anti-inflammatory properties. In this study, 99.9% CBD powder was used to determine its in vitro efficacy as an anti-inflammatory agent. Heparinized blood was collected via jugular venipuncture from senior horses. PBMCs were isolated then incubated for 24 hours with increasing dilutions of CBD dissolved in DMSO. PBMCs were stimulated the last 4 hours of incubation with PMA/IO and Brefeldin A. A Vicell counter was used to evaluate viability after incubation. PBMCs were stained intracellularly for IFNγ and TNFα then analyzed via flow cytometry. RT-PCR was used to analyze samples for gene expression. Five equine-specific intron-spanning primers/probes used are: CB1, CB2, TNFα, IFNγ, IL-10, and Beta-glucuronidase. Data was analyzed using RM One-way ANOVA (significance P < .05). Viability of PBMCs with CBD was completed to determine cytotoxicity. The dilution of CBD that did not affect cell viability was 4 µg/mL (P<0.05). CBD at 4 µg/mL significantly reduced production of IFN-γ and TNF-α (P < .05). RT-PCR results for TNFα and IFNγ at 4 µg/mL showed a reduction compared with the positive control and IL-10 showed a similar reduction at 2 µg/mL and 4 µg/mL. RT-PCR gene expression results showed significance for 10 μg/mL CBD in CB1 and CB2. CBD at 4 µg/mL reduced in vitro production of inflammatory cytokines from senior horses. This in vitro study supports further investigation of CBD to determine if it may be effective as an anti-inflammatory treatment for chronic inflammation in the horse.

Evaluation of a questionnaire to detect the risk of developing ESGD or EGGD in horses

Equine gastric ulcer syndrome (EGUS) affects various categories of horses worldwide. This syndrome is now divided into two different diseases, based on the presence of lesions on either the squamous (Equine Squamous Gastric Disease, ESGD) or the glandular (Equine Glandular Gastric Disease, EGGD) mucosa. Diagnosis is based on the evaluation of the presence of gastric lesions with gastroscopic examination. As a gastroscopy can be considered expensive by clients, therapy is started often on the basis of clinical signs only. The aim of this study was to validate a questionnaire to detect the risk of developing ESGD or EGGD. The owners of 418 horses that were submitted to gastroscopic evaluation were asked to answer a questionnaire on risk factors for ESGD and EGGD. Horses were divided into three groups based on the results of the questionnaire and their risk of developing gastric lesions. In our population the survey was not useful to detect the presence and the severity of the lesions detected during gastroscopic examination, however answers to some of the questions did correlate with the development of gastric lesions. The questionnaire could therefore be a useful tool to evaluate the risk of ESGD or EGGD. Having owners periodically complete the survey could also make them more aware of changes in the conditions of the horses that could lead to gastric lesions. This could then help them seek advice from veterinarians on how to manage this potential risk.

A preli­minary study of endoscopic diagnosis of gastric ulcer in Egyptian donkeys (Equus asinus) pa­ra­sitised by Gasterophilus intestinalis (Diptera: Oestridae)

Equine gastric ulcer syndrome (EGUS) is a communal broad problem in equines but in donkeys, the disease is a subclinical disorder which leads to economic losses. Gasterophilus intestinalis larvae are the most predominant parasitic infestation in donkeys. The present study was planned to facilitate the early and efficient diagnosis of gastric ulceration in donkeys through gastroscopic examination. The study was conducted on 120 adult Egyptian donkeys (Equus asinus) from both sexes after a one-month acclimatisation period. Gastroscopic examination was used to evaluate the presence of gastric lesions. In the majority of infested donkeys, G. intestinalis larvae were in the non-glandular part of the stomach. The prevalence of Gastrophilus larvae in animals reached 96.66%. The infestation percentage among jennets (97.5%) was slightly higher than that among jacks (96.25%). After morphological identification of the 3rd instar of larvae, all donkeys were found to be infested by G. intestinalis larvae. The histopathological examination of the affected stomach revealed severe necrosis of the gastric mucosa. Gastroscopic examination is the main diagnostic tool for examination of gastric lesions in the donkeys, so it is necessary as a routine diagnostic tool in donkeys’ examinations.

Effect of a novel fermented soy product on gastric ulcer scores in horses

Non-pharmaceutical methods are desirable to treat or prevent gastric ulceration in horses. This two-period, randomised, double-blinded placebo-controlled study was designed to evaluate the efficacy of dietary supplementation (25 g once daily in feed for 30 days) with Fermaid®Ease 187 (FE, Lallemand Australia Pty Ltd, Maroochydore, Australia) on gastric squamous and glandular mucosal ulcer scores in horses. Gastroscopy of 120 horses presented to the Veterinary Clinical Centre at Charles Sturt University (CSU; Bathurst, Australia) or at local training establishments identified 60 horses with spontaneous gastric ulcer disease (50%). Of horses eligible for inclusion, 29 horses were recruited and randomised to receive either the FE or placebo for 30 days. Effects were assessed by repeat gastroscopy (Day 31), at which time horses started the reciprocal treatment. Eleven horses successfully completed both treatment periods. Treatment with FE showed a significant decrease in squamous ulcer scores in period 1 (P=0.008), with a similar effect observed in period 2. No change was observed in squamous ulcer scores for horses receiving placebo treatment in period 1, but increased squamous scores were observed in horses receiving placebo treatment in period 2 (P=0.062). Squamous ulcer scores on Day 31 were significantly lower (P=0.005) following FE treatment than for horses receiving the placebo treatment. No effects were observed on glandular ulcer scores. This study supported the use of FE in horses predisposed to ulceration of the squamous gastric mucosa.

The Effect of a Seaweed-Derived Calcium Supplement on Gastric Juice pH in the Horse

Low gastric pH for extended periods of time can increase the risk of gastric ulceration in horses. Therefore, nutritional interventions that buffer stomach acid may be helpful to decrease ulcer risk. The objective of this trial was to evaluate whether the incorporation of calcified Lithothamnion corallioides and Phymatolithon calcareum (Calmin; Celtic Sea Minerals, Cork, Ireland) into an equine ration would buffer equine gastric juice. Nine mature, Thoroughbred-cross horses, including 6 geldings and 3 mares (524 ± 49 kg) were housed in stalls and fed 2 kg/day of a texturized concentrate (Purina Omolene 100) and 1.5% BW grass hay/day. On testing days 0, 7, and 14, the horses received one of three pelleted dietary treatments (CON, MIN1 ×, MIN2 ×) in a randomized, crossover design. CON contained no added Calmin, MIN1 × provided Calmin at a 1 × concentration, and MIN2 × provided a 2 × dose. All horses underwent gastroscopy (Karl Storz, El Segundo, CA) prior to feeding the treatments, and at 2 and 4 hours postfeeding. Gastric juice was aspirated and pH measured using a benchtop pH meter (ThermoOrion pH Meter Model 410A). Overall, there was a significant time effect (P < .0001) with an increase in gastric juice pH from time 0 (2.31 ± 0.58) to 2 hours (5.52 ± 0.48) and 4 hours (3.59 ± 0.48). Gastric juice pH at 2 hours was higher (P = .0122) in MIN1 × (5.92 ± 0.58) and MIN2 × (5.92 ± 0.57) than CON (5.08 ± 0.58). These results demonstrate that adding Calmin to a meal increases buffering capacity at 2 hours postfeeding.

Prediction of pharmacokinetic clearance and potential Drug-Drug interactions for omeprazole in the horse using in vitro systems

Horses are exposed to various kinds of medication, however, there are limited determinations of plasma clearance (CL_p) for the drugs used due to the high cost of equine in vivo studies.Many of the CL_p values generated come from the equine sports industry for determining drug plasma screening limits in the control of medications at the time of competition.The kinetics of omeprazole metabolism were investigated in freshly isolated and cryopreserved equine hepatocytes and hepatic microsomes (n = 3 horses).The V_max, K_m and intrinsic clearance (CL_int) of omeprazole were determined via the substrate depletion method as well as K_m values for the formation of three metabolites.The CL_int values were extrapolated to in vivo hepatic plasma clearance (CL_H) using the well stirred and parallel tube models.Cl_p for omeprazole was successfully predicted using freshly isolated or cryopreserved equine hepatocytes, while microsomes under-predicted.Equine microsomes were used to perform a drug-drug interaction (DDI) study between omeprazole and chloramphenicol. The average inhibitor constant K_i, assuming competitive inhibition, was 15.4 ± 5 µM.To the authors' knowledge, this is the first report showing the successful extrapolation of drug CL_p in the horse using equine hepatocytes and the prediction of a DDI using microsomes.

The Contribution of Specific and Nonspecific Biomarkers in Diagnosis of Equine Gastric Ulcer Syndrome (EGUS) Under Field Condition

The aim of this study is to investigate the diagnostic efficiency of gastrin, pepsinogen, proinflammatory cytokines (TNF-α, IL-6), and oxidative stress biomarkers in horses with equine gastric ulcer syndrome (EGUS). Thirty horses diagnosed with gastroscopic EGUS and 15 clinically healthy horses were selected for this study. The serum levels of gastrin, pepsinogen showed nonsignificant changes in horses with EGUS when compared with healthy horses. The serum levels of TNF-α, IL-6 revealed a significant increase in horses with EGUS when compared with healthy ones. Oxidative stress is evident in horses with EGUS in comparison with healthy horses as detected by higher levels of malondialdehyde (MDA) and decreased serum levels of total antioxidant capacity (TAC), Superoxide dismutase (SOD), glutathione (GSH), and nitric oxide (NO). MDA and TNF-α showed better sensitivity and specificity than IL-6 in distinguishing horses with EGUS from control horses. Conclusively, examination of serum gastrin and pepsinogen levels had a limited value in diagnosis of EGUS in horses under investigation. Moreover, this study showed that oxidative stress is evident in horses with EGUS. Higher levels of TNF-α and IL-6 indicate their role in EGUS pathogenesis in horses. Finally, MDA, TNF-α, and IL-6 could be used as biological markers for preliminary screening of horses with EGUS. Gastroscopy still accredited as the "gold standard" for diagnosis EGUS.

Investigation of effects of omeprazole on the fecal and gastric microbiota of healthy adult horses

OBJECTIVE To determine the effects of oral omeprazole administration on the fecal and gastric microbiota of healthy adult horses. ANIMALS 12 healthy adult research horses. PROCEDURES Horses were randomly assigned to receive omeprazole paste (4 mg/kg, PO, q 24 h) or a sham (control) treatment (tap water [20 mL, PO, q 24 h]) for 28 days. Fecal and gastric fluid samples were collected prior to the first treatment (day 0), and on days 7, 28, 35, and 56. Sample DNA was extracted, and bacterial 16S rRNA gene sequences were amplified and sequenced to characterize α and β diversity and differential expression of the fecal and gastric microbiota. Data were analyzed by visual examination and by statistical methods. RESULTS Composition and diversity of the fecal microbiota did not differ significantly between treatment groups or over time. Substantial variation in gastric fluid results within groups and over time precluded meaningful interpretation of the microbiota in those samples. CONCLUSIONS AND CLINICAL RELEVANCE Results supported that omeprazole administration had no effect on fecal microbiota composition and diversity in this group of healthy adult horses. Small sample size limited power to detect a difference if one existed; however, qualitative graphic examination supported that any difference would likely have been small and of limited clinical importance. Adequate data to evaluate potential effects on the gastric microbiota were not obtained. Investigations are needed to determine the effects of omeprazole in horses with systemic disease or horses receiving other medical treatments.

Searching for serum protein markers of equine squamous gastric disease using gel electrophoresis and mass spectrometry

BACKGROUND

Equine squamous gastric disease (ESGD) is a very common disorder but an accurate and practical screening technique for detecting ESGD is currently lacking.

OBJECTIVES

To identify serum protein markers to detect ESGD using electrophoresis and mass spectrometry.

STUDY DESIGN

Proteomic analysis and bioinformatics.

METHODS

ESGD was diagnosed using gastroscopy in 30 horses. Gastric ulceration was categorised into three groups: normal, mild/moderate and severe ESGD. Pooled sera from each group were compared using 1D electrophoresis and mass spectrometry. The candidate proteins for ESGD markers were selected based on their specifically high expression in nonglandular stomach, and their association with gastric ulceration using public gene and protein databases.

RESULTS

The prevalence of ESGD in this study was 43% (with mild/moderate ESGD at 33% and severe ESGD at 10%). The proteomic study revealed that the identified serum protein markers for normal equine stomach were B4GALNT2 and XDH. The marker for mild/moderate EGSD was KRT10, while the marker for severe ESGD was KLK13. Furthermore, markers for both ulcer types were SLC4A7, PPARG, FCGBP, PKP1, ASPRV1 and KRT5-like proteins.

MAIN LIMITATIONS

The functions of the identified proteins are not well characterised in horse. Proteomics is a tool for screening protein markers, but confirmation of putative protein markers with specific antibodies is required.

CONCLUSIONS

In total, 10 serum proteins found in this study may be used as putative markers for ESGD. However, confirmation of candidate proteins with specific antibodies in a larger study cohort is necessary before it can be used in the veterinary clinic or on horse farms. The Summary is available in Portuguese - see Supporting Information.

Optimisation of a serum albumin removal protocol for use in a proteomic study to identify the protein biomarkers for silent gastric ulceration in horses

Silent gastric ulceration occurs without evidence of clinical signs and is common in horses. There is currently no a simple and effective method to diagnose this disease. Proteomics can be used to identify serum biomarkers, but the most abundant serum protein, albumin, could conceal candidate biomarkers. Therefore, it is recommended to remove albumin before a proteomic study; however, there is no specific albumin depletion kit or standard protocol available for horse samples. The objectives of this study were to optimise a protocol to remove equine serum albumin and to use albumin-depleted serum to identify the protein biomarkers for silent gastric ulceration. Gastroscopy was used to identify gastric ulceration, and serum was obtained from horses with either a healthy gastric mucosa or gastric ulceration. Serum albumin was removed using the trichloroacetic acid (TCA) protein precipitation method, and this protocol was optimised by varying the concentration of TCA, type of organic solvents, ratio of serum to protein precipitation solution, and incubation times. Electrophoresis and image analysis were used to compare the amounts of albumin, immunoglobulins G (IgG), and protein degradation before and after TCA precipitation. The best protocol was chosen to remove albumin for a proteomic study (electrophoresis and mass spectrometry). The results revealed that protocol 2 (ratio of serum to solution 1:5, 10% TCA in acetone, and 90 min incubation) was the most efficient protocol to remove albumin (98%) and IgG heavy (80%) and light (98%) chains without degrading other proteins. After electrophoresis and mass spectrometry analysis, KRT1, KRT6A and KRT18 were identified as potential markers for silent gastric ulceration.

First demonstration of equid gammaherpesviruses within the gastric mucosal epithelium of horses

Horses commonly develop gastric mucosal ulcers, similar to humans, a condition known as equine gastric ulcer syndrome (EGUS) that can lead to poor performance and lost training time and care expenses. Unlike humans, however, an infectious bacterial cause of ulcers has not been conclusively identified. Herpesviruses, while well-established causative agents of diseases such as cold sores, genital lesions, and certain types of cancer, have also been implicated in the development of a subset of gastric ulcers in humans. The presence of equid herpesviruses in the gastrointestinal tract and their potential contribution to EGUS has not been evaluated. Here, we provide the first evidence of equid gammaherpesviruses 2 and 5 (EHV-2 and -5) within the epithelium of the gastric mucosa of horses. These viruses were initially detected by a nested PCR screen of gastric tissue samples obtained from client- and university-owned horses with and without ulcers; however, no association with EGUS was found in this limited sample set. We then validated a highly sensitive in situ hybridization (ISH) assay and used this assay to characterize the distribution of these viruses in necropsy gastric tissue samples from five racehorses. Analyses revealed frequent EHV-2 and EHV-5 co-infections within the gastric mucosal epithelium, regardless of the ulcer status. These results are the first to demonstrate the presence of equid gammaherpesviruses in the gastric mucosa of horses and warrants further investigation to determine the contribution of these viruses to the development of EGUS and/or other gastrointestinal diseases.

Efficacy of omeprazole powder paste or enteric-coated formulation in healing of gastric ulcers in horses

Background

GastroGard, an omeprazole powder paste formulation, is considered the standard treatment for gastric ulcers in horses and is highly effective. Gastrozol, an enteric‐coated omeprazole formulation for horses, has recently become available, but efficacy data are controversial and sparse.

Objectives

To investigate the efficacy of GastroGard and Gastrozol at labeled doses (4 and 1 mg of omeprazole per kg bwt, respectively, PO q24h) in healing of gastric ulcers.

Animals

40 horses; 9.5 ± 4.6 years; 491 ± 135 kg.

Methods

Prospective, randomized, blinded study. Horses with an ulcer score ≥1 (Equine Gastric Ulcer Council) were randomly divided into 2 groups and treated for 2 weeks each with GastroGard followed by Gastrozol (A) or vice versa (B). After 2 and 4 weeks, scoring was repeated and compared with baseline. Plasma omeprazole concentrations were measured on the first day of treatment after administration of GastroGard (n = 5) or Gastrozol (n = 5).

Results

Compared with baseline (squamous score (A) 1.65 ± 0.11, (B) 1.98 ± 0.11), ulcer scores at 2 weeks ((A) 0.89 ± 0.11, (B) 1.01 ± 0.11) and 4 weeks ((A) 1.10 ± 0.12, (B) 0.80 ± 0.12) had significantly decreased in both groups (P < .001), independent of treatment (P = .7). Plasma omeprazole concentrations were significantly higher after GastroGard compared with Gastrozol administration (AUC_GG = 2856 (1405‐4576) ng/mL × h, AUC_GZ = 604 (430‐1609) ng/mL × h; P = .03). The bioavailability for Gastrozol was 1.26 (95% CI 0.56–2.81) times higher than for GastroGard.

Conclusions and Clinical Importance

Both Gastrozol and GastroGard, combined with appropriate environmental changes, promote healing of gastric ulcers in horses. However, despite enteric coating of Gastrozol, plasma omeprazole concentrations after single labeled doses were significantly higher with GastroGard.

Resolving an inflammatory concept: the importance of inflammation and resolution in tendinopathy

Injuries to the superficial digital flexor tendon (SDFT) are an important cause of morbidity and mortality in equine athletes, but the healing response is poorly understood. One important drive for the healing of connective tissues is the inflammatory cascade, but the role of inflammation in tendinopathy has been contentious in the literature. This article reviews the processes involved in the healing of tendon injuries in natural disease and experimental models. The importance of inflammatory processes known to be active in tendon disease is discussed with particular focus on recent findings related specifically to the horse.

Whilst inflammation is necessary for debridement after injury, persistent inflammation is thought to drive fibrosis, a perceived adverse consequence of tendon healing. Therefore the ability to resolve inflammation by the resident cell populations in tendons at an appropriate time would be crucial for successful outcome. This review summarises new evidence for the importance of resolution of inflammation after tendon injury. Given that many anti-inflammatory drugs suppress both inflammatory and resolving components of the inflammatory response, prolonged use of these drugs may be contraindicated as a therapeutic approach. We propose that these findings have profound implications not only for current treatment strategies but also for the possibility of developing novel therapeutic approaches involving modulation of the inflammatory process.

The influence of two lucerne-based forage feeds, FiberProtect® and FiberEdge® on Equine Gastric Ulcer Syndrome in horses

Equine Gastric Ulcer Syndrome (EGUS) is extremely prevalent in both racing and non-racing horse populations. The exact aetiology of EGUS is unclear but many stress related risk factors have been implicated including the feeding of grain-based diets. Current treatment techniques often necessitate drug therapy which, when added to feed costs, can be expensive and may have a detrimental effect on digestion due to the mode of action of these therapies. The following experiment set out to investigate if feeding fermented, forage-based feeds (Modified Bio-Fermentation (MBF) lucerne feeds treated with Xanotyde®, registered as FiberProtect® and FiberEdge®; Fiber Fresh Feeds Ltd, Reporoa, New Zealand), could assist in the healing and prevention of ulceration. Nine adult horses with demonstrable and sustained gastric ulceration (diagnosed by gastric endoscopy), were used in a two part study. The first 42 d healing phase investigated the impact of feeding FiberProtect® (FPT) or FiberEdge® (FED) on established gastric ulcers. After 14 d on these diets 44% (4/9) of horses had no ulceration or hyperaemia (inflammation) (EGUC grade 0) and all horses were ulcer free (EGUC grade 0) at d 42. A significant (P < 0.01) relationship was determined between length of time fed and disappearance of ulcers (R2 = 0.9004; DF = 2). The prevention phase utilised the same horses, ulcer-free at d 42, and fed them a grain-based high energy racing diet alongside FPT at 40% and 60% of the total diet (DM basis). The horses were monitored for a further 28 d (d 42 – d 70), and only three showed a recurrence of ulceration throughout this period. At d 70, eight out of nine horses were ulcer free (EGUC grade 0). The findings suggest that FPT and FED can be used to heal and prevent gastric ulceration, and that FPT can be fed alongside a high grain diet to prevent recurrence of gastric ulcers.

Efficacy of omeprazole paste in the prevention of gastric ulcers in 2 years old Thoroughbreds

Prevalence of equine gastric ulcer syndrome in 85 young Thoroughbreds was investigated. The presence of gastric ulcers was confirmed in 27.1% (23/85) of the horses by endoscopic examination. Sixty-two horses without gastric ulcers were allocated randomly to either the treated group (31 horses) or sham-dosed control group (31 horses) in order to investigate the efficacy of omeprazole oral paste in the prevention of gastric ulcers. At the second endoscopic examination conducted after 28 days of administration, only 1 horse in the treated group developed gastric ulcers, while 12 horses developed gastric ulcers in the control group. Based on these data, the efficacy of omeprazole in prevention of equine gastric ulcers in young Thoroughbreds during the training period was confirmed.

Prevalence of gastric ulcers and relationship to other parameters in Standardbred racehorses

Gastric ulcer prevalence rate is reported to be 60-90% in racehorses. This study examined a population of 40 Standardbred horses in race training and assessed the relationship of ulcers to performance history and body condition score (BCS). Forty Standardbreds on two racing facilities in southern Michigan were examined during the last 2 weeks of December 2007 and the second week of January 2008. Age of horses (as of January 1) ranged from 3 to 12 years. Squamous epithelial ulcers were graded (0-4) using an established scoring system during gastroscopic examinations and BCS was recorded (1 to 9 scale). Trainers graded racing performance of each horse on a scale of A to F, with A being best. Horses were grouped according to gender, age, and BCS. Prevalence of ulcers was similar between facilities (50% and 56%) but the mean prevalence (52.5%) was lower than in previous reports. Ulcer score was not related to gender (P=0.84), age (P=0.72), BCS (P=0.64), or performance history (P=0.55). These findings suggest that commonly cited prevalence rates of ulcers may not be consistent for all populations of racehorses. Further, given that less than 20% of the horses examined had an ulcer score grade 2 or higher, the impact that ulcers have on performance may be overestimated in some equine populations. Finally, this study clearly demonstrates that a gastroscopic examination is necessary to determine presence of ulcers, rather than assuming their presence based on decreased performance or low body condition score.