Equine gastric ulcer syndrome in adult horses.
Authors: van den Boom Robin
Journal: Veterinary journal (London, England : 1997)
Summary
# Editorial Summary: Equine Gastric Ulcer Syndrome in Adult Horses Gastric ulceration affects a substantial proportion of the domestic horse population and can be reliably identified and staged via gastroscopy, yet clinical presentation is highly variable—some affected horses remain asymptomatic whilst others display poor appetite, mild colic, girthing sensitivity, behavioural problems, or performance decline. Van den Boom's 2022 review distinguishes between two distinct pathophysiological entities: equine squamous gastric disease (ESGD), driven by acid mucosal exposure, and equine glandular gastric disease (EGGD), arising from failure of mucosal defence mechanisms, which importantly carry different treatment implications. Whilst omeprazole-based acid suppression therapy reliably resolves ESGD cases, EGGD responds less predictably and typically requires extended treatment duration, with adjunctive agents such as sucralfate frequently necessary and prostaglandin analogues (misoprostol) or alternative therapeutics sometimes required when conventional protocols fail. Practitioners should therefore prioritise risk factor management—particularly minimising high-concentrate feeding, intense exercise schedules, and stressors—to prevent ulcer recurrence, recognising that diagnostic confirmation through gastroscopy is essential for targeted treatment selection and accurate prognosis in cases where clinical signs are ambiguous or performance impairment is otherwise unexplained.
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Practical Takeaways
- •Gastroscopy is essential to differentiate ESGD from EGGD, as treatment protocols and prognosis differ significantly between the two conditions
- •High concentrate diets, intense exercise, and stress should be minimized or avoided to prevent ulcer recurrence in treated horses
- •Treatment duration and medication selection must be tailored to ulcer type; EGGD cases typically require longer therapy and may need combination or alternative treatments beyond standard omeprazole
Key Findings
- •A distinction exists between ESGD (caused by acid exposure) and EGGD (caused by compromised mucosal defence mechanisms), requiring different treatment approaches
- •Omeprazole is the mainstay acid-blocking treatment, but is more successful for ESGD than EGGD
- •EGGD requires longer treatment duration and may require adjunctive therapy with sucralfate, misoprostol, or alternative agents
- •Clinical signs in horses with gastric ulcers are variable and may include poor appetite, mild colic, girthing discomfort, behavioural changes, and reduced performance