Field survey of the prevalence of gastric ulcers in Thoroughbred racehorses and on response to treatment of affected horses with omeprazole paste

Associations between Medical Disorders and Racing Outcomes in Poorly Performing Standardbred Trotter Racehorses: A Retrospective Study

Poor performance in racehorses is commonly associated with subclinical diseases. This study aims to evaluate the associations between medical disorders and racing results in Standardbred trotters. The clinical records of 248 poorly performing Standardbreds were retrospectively reviewed, and their racing results were extracted from an online database, concerning the periods 3 months before and 6 months after hospitalization and the entire lifetime. Generalized linear models were used to evaluate the effects of different disorders on racing outcomes. Airway neutrophilia was associated with limiting lifetime starts and wins pre- and post-hospitalization, while mastocytosis was associated with less wins in the post-hospitalization period. Therefore, lower airway inflammation showed both short- and long-term impacts on racing performance. Severe upper airway obstructions and gastric ulcers showed associations with less placings in the post-discharge period but no long-term influence on performance. The significance of exertional rhabdomyolysis was indeterminable, yet interference with the number of starts in the post-discharge period was reported and associated with lower total career earnings. Exercise-induced pulmonary hemorrhage and cardiac arrhythmias were not associated with worse racing outcomes: therefore, their role in poor performance remains unclear.

Doping control in horses in the Czech Republic in 2010-2019

The aim of this study was to evaluate data on doping controls in racehorses over a given ten-year period, primarily to identify positive findings and to summarise recommendations for the prevention of accidental contamination with prohibited substances, where appropriate. Data on doping controls of racehorses in the Czech Republic from 2010 to 2019 were obtained from the archives of the Jockey Club of the Czech Republic. For each year, the total number of horses starting at races held in the Czech Republic, the number of horses tested, and the results of the doping controls were determined. Data on the type of samples, positive findings and statements from responsible persons about the cause of the positive finding were recorded. During the monitoring period, 11,852 horses competed in races in the Czech Republic and 641 of them underwent a doping control. Blood was taken from 356 horses as the sample for testing and urine was collected from 285 horses. A total of 13 positive findings (2.03% of the 641 tested) were found during the period, namely of morphine, caffeine, theobromine, omeprazole sulphide, furosemide, clenbuterol, norketamine, ritalinic acid, dexamethasone, flunixin, hydroxylidocaine and oripavine. The most common cause, in a total of seven horses, was confirmed as suspected feed contamination. Prevention of positive doping results in our circumstances should therefore be directed primarily towards compliance with proper feed and stable management.

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 a dietary supplement on gastric ulcer number and severity in exercising horses

This study evaluated the effect of a dietary supplement on the treatment of equine gastric ulcer syndrome (EGUS). Gastroscopy was performed on university riding horses of mixed breeds at two locations and only horses exhibiting gastric ulcers were selected to participate in this study (location A, n = 13; location B, n = 15). Gastric ulcer severity was assessed using two different methods depending on location before treatment (Pre). After gastroscopy, horses were fed the supplement in addition to their regular diet for 44 d (14-d adaptation period followed by 30-d feeding period). All horses were subjected to gastroscopy again at the end of the feeding period (Post) to evaluate changes in gastric lesions. Statistical analysis was performed using SAS. Individual horses were the experimental unit with dependent variables including severity and number of gastric ulcers. At location A, dependent variable included severity of gastric lesions with fixed effects of time (Pre and Post) and location (stall or pasture). For location B, dependent variables included severity and number of gastric lesions with fixed effects of time. Severity of gastric ulcers decreased at both locations in horses following the feeding period. Gastric lesion scores decreased from 2.2990 to 1.3760 (P = 0.0015) at location A and gastric lesion severity from 3.8000 to 2.5667 (P = 0.0322) at location B. No differences were found in gastric lesion scores at location A between horses housed in stalls or pastures (1.8750 and 1.8000; P = 0.7783). The number of gastric ulcers observed at location B were similar Pre and Post treatment (3.4667 and 3.5333; P = 0.8363). There were no changes in body condition score (P ≥ 0.2607), BW (P ≥ 0.4551), or behavior at either location. Results suggest that oral supplementation may decrease severity of gastric ulcers in horses participating in university riding programs.

Gastritis, Enteritis, and Colitis in Horses

The gastrointestinal system of horses is affected by a large variety of inflammatory infectious and noninfectious conditions. The most prevalent form of gastritis is associated with ulceration of the pars esophagea. Although the diagnostic techniques for alimentary diseases of horses have improved significantly over the past few years, difficulties still exist in establishing the causes of a significant number of enteric diseases in this species. This problem is compounded by several agents of enteric disease also being found in the intestine of clinically normal horses, which questions the validity of the mere detection of these agents in the intestine.

Prevalence of gastric ulcer syndrome in high-level endurance horses

REASONS FOR PERFORMING THE STUDY

Equine gastric ulcers syndrome (EGUS) prevalence studies are rare in the endurance horse and none has been carried out to date in horses competing at high level.

OBJECTIVES

To determine the prevalence of EGUS in high-level endurance horses.

METHODS

Thirty endurance horses competing at high level were selected and submitted to 2 gastroscopic examinations. The first gastroscopy was performed during the interseason period, and the second during the competition season within 2-3 days following a ride of 90-160 km. Data related to housing, feeding, training system as well as age, breed and gender were recorded for each horse.

RESULTS

The prevalence of squamous gastric ulcers was 48% during the interseason period (mean score 0.85 ± 0.13 on a scale from 0-4) and 93% during the competition season (mean score 1.60 ± 1.15) with a highly significant difference between the seasons (P = 0.001). Most of the lesions were situated in the squamous portion of the stomach but 33.3% of horses showed also glandular lesions. Significant influence of training and performance level on the gastric score (according to the distance of the ride preceding the second gastroscopy) was shown (P = 0.038). There was also a significant influence of housing on the gastric score (P = 0.002) showing higher scores in the horses kept totally on pasture (mean score: 2.14 ± 0.14) vs. horses housed in a mixed environment (stable + pasture, mean score: 1.43 ± 0.17). Both the pastured and (stabled + pastured) groups were receiving a grain supplement but the pastured group received a higher daily starch intake, which might explain the higher ulcer prevalence. There was no influence of age, breed or gender on the gastric scores.

CONCLUSIONS

The high prevalence of gastric lesions observed in this study is probably related to the high level of training and performance of the horses examined compared to the population of horses included in the prior study.

POTENTIAL RELEVANCE

This prevalence of EGUS in high-level endurance horses is comparable to the prevalence established in racing horses. The equine veterinarians may take into consideration EGUS as a potential cause of poor performance.

Effect of repeated oral administration of hypertonic electrolyte solution on equine gastric mucosa

REASONS FOR PERFORMING STUDY

Electrolyte supplementation is common in horses during endurance competitions, but the effect on the gastric mucosa is unknown.

HYPOTHESIS

Repeated oral administration of hypertonic electrolyte solution is associated with exacerbation of gastric ulcers in mature horses.

METHODS

The study design was a randomised, blinded, crossover trial. Fourteen horses were divided randomly into equal groups and administered either 60 ml water (placebo) or 56.7 g commercial electrolyte supplement mixed with 60 ml water by dose syringe orally once an hour for 8 h. The minimum concentration of individual constituent electrolytes/28.35 g dry commercial product used was: sodium (5528 mg); chloride (11,886 mg); potassium (3657 mg); calcium (754 mg); and magnesium (153 mg). Gastric lesions were scored prior to and after oral treatments, and analysis of variance procedures were then performed.

RESULTS

Administration of hypertonic electrolytes resulted in a significant increase in mean ulcer number (P = 0.0174) and severity (P = 0.0006) scores in the nonglandular stomach. Mean ulcer number score was 3.6 and mean ulcer severity score 2.7 after hypertonic electrolyte treatment.

CONCLUSIONS

Oral hypertonic electrolyte administration to horses in this model was associated with exacerbation of gastric ulcers.

POTENTIAL RELEVANCE

Our findings suggest that one schedule of electrolyte supplementation used commonly in endurance horses may be harmful to the gastric mucosa.

In vitro effects of hydrochloric and lactic acids on bioelectric properties of equine gastric squamous mucosa

REASONS FOR PERFORMING STUDY

Volatile fatty acids, byproducts of carbohydrate fermentation by resident bacteria, have been implicated in causing nonglandular (NG) gastric ulcers. Lactic acid (LA), also produced by stomach bacteria, may cause gastric ulcers when exposed to the equine NG mucosa.

OBJECTIVES

To investigate the in vitro effects of LA on equine NG mucosa bioelectric properties, sodium transport and tissue resistance.

METHODS

Gastric tissues obtained from 13 mature horses were studied in Ussing chambers. Short-circuit current (Isc) and potential difference (PD) were measured, and electrical resistance (R) and conductance (G) calculated for tissues after addition of HCl and LA (5, 10, 20 and 40 mmol/l) in normal Ringer's solution (NRS).

RESULTS

Mucosa exposed to HCl or LA (5, 10 and 20 mmol/l) in NRS (pH 1.5 and to a lesser extent pH 4.0) had a significant decrease in Isc and PD. Mucosa exposed to a high concentration of LA (40 mmol/l) in NRS (LRS) at pH 1.5 showed an increased G, but this increase was not significant. Values returned to baseline after solutions were returned to pH 7.0. Histological changes were consistent with HCl-induced (pH <4.0) acid damage.

CONCLUSIONS

HCl induced alteration in bioelectric properties of equine NG mucosa whereas addition of LRS did not, other than those changes seen with HCl alone.

Equine gastric ulcer syndrome in adult horses: a review

In recent years, gastric ulceration has been recognised as a common, possibly performance-limiting disease of adult horses. Here, we aim to provide the reader with a useful review of recent literature covering all aspects of equine gastric ulcer syndrome (EGUS) in adult horses. The anatomy and physiology of the stomach, with particular reference to secretion of acid and mucosal protective mechanisms, are reviewed, as are the differing theories relating to the aetiopathogenesis of gastric ulceration. We also explore the possible influence of various management factors on development of the disease. The prevalence of the disease in racehorses has been reported to be as high as 100%. In general, horses that are in active training for racing tend to have a prevalence of around 90%, whereas pleasure horses in full work have a reported prevalence of approximately 60%. Emerging diagnostic tests which could obviate the need for gastroscopy are introduced and current recommendations for treatment are summarised, focussing on proton pump inhibitors, in particular omeprazole, administered orally. The oral administration of omeprazole has been shown to be effective in both treating horses with gastric ulceration and at preventing re-occurrence whilst the horses are in training, provided that daily dosing is maintained.

The prevalence of gastric ulceration in racehorses in New Zealand

AIM

To establish the prevalence and factors influencing the prevalence and severity of gastric ulceration in racehorses in New Zealand.

METHODS

Horses (n=171) in active training for racing by trainers (n=24) located throughout New Zealand were examined using gastroscopy during 2003 and 2004. Images of the examination were recorded and reviewed, and an ordinal grade based on the severity of gastric ulceration present was assigned, using the grading system proposed by the Equine Gastric Ulcer Council (EGUC). Information about the horses such as age, breed, sex, stabling, time at pasture, pasture quality, and presence of clinical signs consistent with equine gastric ulcer syndrome (EGUS) was recorded.

RESULTS

Of the 171 horses in the study, 133 (78%) were Thoroughbreds and 38 (22%) were Standardbreds. Evidence of gastric ulceration was present in 151 (88.3%) of these. Prevalence of ulceration was higher at the lesser curvature (LC) and greater curvature (GC) of the stomach than at the saccus caecus (SC; p<0.01), and ulceration was more severe at the LC than at either the GC (p=0.02) or the SC (p<0.001). The prevalence of ulceration did not differ between the two breeds (p=0.51) or between horses of differing ages (p=0.56). Gastric ulceration was evident in 125/141 (89%) horses kept at pasture for at least 4 h/day, in all 13 (100%) horses kept at pasture full time, and in 16/17 (94%) horses stabled full time. Prevalence and severity of ulceration did not differ between horses stabled full time, kept at pasture for part of the day or kept at pasture full time (p=0.33 and 0.13, respectively), and for horses grazed on pasture severity of ulceration did not vary significantly with the quality of the pasture (p=0.12). Neither prevalence (p=0.26) nor severity (p=0.49) of gastric ulceration varied significantly with duration of training.

CONCLUSIONS

The prevalence of gastric ulceration in racehorses in New Zealand is similar to that reported elsewhere for horses in active training for racing. Access to pasture for some or all of the day did not appear to be protective.

Gastric ulcer development in horses in a simulated show or training environment

OBJECTIVE

To determine whether conditions representing activities that are typical in the recreational use of horses, including transport to and from show grounds, stall confinement in unfamiliar surroundings, and light exercise, are associated with increased incidence of gastric ulcers in horses.

DESIGN

Randomized controlled study.

ANIMALS

20 client-owned horses.

PROCEDURE

Horses had no gastric ulcers as determined by endoscopic examination on study day -1. Ten control horses were maintained on-site with no changes in management variables. Ten horses were transported via trailer for 4 hours on day 0 to another site, placed in individual stalls, fed twice daily, and exercised twice daily for 3 days. On day 4, they were transported back to the original site via trailer for 4 hours. On day 5, endoscopic examinations were performed on all horses to assess gastric mucosa status.

RESULTS

Horses that were transported and housed off-site had a significantly higher incidence of hyperkeratosis and reddening of the gastric mucosa than control horses. Two control horses and 7 transported horses developed gastric ulcers by day 5. Ulcer scores of transported horses increased significantly from day -1, whereas ulcer scores in control horses did not change significantly from day -1.

CONCLUSIONS AND CLINICAL RELEVANCE

Activities that are typical in recreational use of horses were ulcerogenic, and ulcers in the gastric squamous mucosa can develop under these conditions within 6 days.

Treatment and prevention of equine gastric ulcer syndrome

EGUS is a common problem in horses and foals. Acids are the important causative factors and current therapy targets the suppression of gastric HCl and creation of a permissive environment for ulcer healing. Diagnosis is based on history, clinical signs, gastroscopy, and response to treatment. Of the products available, only GastroGard (FDA approved) and ranitidine have been shown to be efficacious in the treatment of EGUS. Ranitidine is often associated with treatment failure as a result of incorrect dosing and lack of owner compliance, because of the three times daily dosing required. Also, EGUS occurs in critically ill neonatal foals, but the pathogenesis may be different than in adult horses and acid-suppressive therapy may not be as effective.