Evaluation of Owner-Reported Clinical Signs and Fecal Occult Blood Tests as Predictors of Equine Gastric Ulcer Syndrome in Competition Dressage Horses.
Authors: Frippiat Thibault, Bonhomme Maëlle, Dyson Sue, Votion Dominique-Marie
Journal: Journal of veterinary internal medicine
Summary
# Editorial Summary: Owner-Reported Signs and Fecal Blood Tests Cannot Replace Gastroscopy for EGUS Diagnosis in Dressage Horses Equine gastric ulcer syndrome remains a significant concern in competition horses, yet definitive diagnosis requires gastroscopy—an invasive procedure. Frippiat and colleagues evaluated whether non-invasive screening tools could identify dressage horses needing gastroscopic examination by comparing owner-reported clinical signs and faecal occult blood tests (FOBTs) against gastroscopic findings in 80 competition horses; 19 subsequently underwent repeat assessment after treatment. Despite girth aversion being reported in 78% of affected horses and commonly perceived as pathognomonic for EGUS, neither this sign nor others (poor performance 33%, weight loss 30%) showed statistical differences between horses with and without ulceration, and neither clinical signs nor FOBT demonstrated sufficient sensitivity or specificity for reliable screening. Most tellingly, clinical improvement following treatment proved a poor predictor of actual mucosal healing on repeat gastroscopy, suggesting that owner perception of resolution substantially diverges from objective pathological status. These findings underscore that gastroscopy cannot currently be replaced as the gold standard for both diagnosis and treatment monitoring in sports horses, and that relying on clinical signs alone risks both missing affected horses and providing false reassurance in those treated medically.
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Practical Takeaways
- •Do not rely on owner reports of girth aversion, poor performance, or weight loss alone to diagnose or rule out EGUS in dressage horses—gastroscopy is the only reliable diagnostic tool
- •Fecal occult blood testing is not useful for screening competition horses for EGUS or monitoring treatment response
- •Treatment cannot be assumed successful based on resolution of clinical signs; gastroscopic re-evaluation is necessary to confirm mucosal healing in horses undergoing EGUS therapy
Key Findings
- •69% of competition dressage horses (55/80) had EGUS confirmed by gastroscopy
- •Girth aversion (78%), poor performance (33%), and weight loss (30%) showed no statistical difference between horses with and without EGUS (p=0.44-0.99)
- •Neither owner-reported clinical signs nor fecal occult blood tests had sufficient sensitivity or specificity for EGUS screening
- •Among 19 horses reassessed after treatment, clinical sign resolution did not reliably predict mucosal healing on gastroscopy