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Equine gastric ulcer syndrome in horses and foals

07 March 2024
13 mins read
Volume 8 · Issue Sup2

Abstract

Gastric ulcers are common in adult horses and can also be present in foals. It is important to realise that ulcers can occur in the squamous and/or glandular mucosa of the stomach, and that these represent two different disease entities, namely equine squamous gastric disease and equine glandular gastric disease. Horses suspected of having gastric ulcers based on clinical signs should undergo gastroscopy to confirm the presence of ulcers and determine their severity, although there is a poor correlation between gastroscopic findings and clinical severity. As both squamous and glandular gastric disease are the result of tissue damage caused by gastric acid, the proton pump inhibitor omeprazole forms the mainstay of ulcer treatment. In cases of glandular gastric disease, sucralfate is usually added to the therapeutic plan. As several husbandry and management practices are known to be risk factors for the development of ulcers, these should be addressed during treatment and to prevent recurrence.

The term ‘equine gastric ulcer syndrome’ has been in use since the turn of the century, but since then it has become clear that this syndrome actually consists of two quite different disease entities: equine squamous gastric disease and equine glandular gastric disease. Although they can occur simultaneously, these two entities have different risk factors, pathogenesis and treatment (Sykes et al, 2015). This article discusses the prevalence, pathogenesis, symptoms and management of equine gastric ulcer syndrome in adult horses and foals.

Many studies have reported on the prevalence of squamous and glandular gastric disease in adult horses (van den Boom, 2022). Both disease entities are common, and the prevalence depends on the populations studied and largely reflects the way horses are kept and used, with dietary, exercise and husbandry factors being most important.

The lowest prevalence of squamous gastric disease (11%) was reported in horses in a university riding programme, with most ulcers in 3-year-olds. This low prevalence was thought to be related to the fact that these horses did not travel, and their diet and environment remained more or less constant in 3-year-olds (Chameroy et al, 2006). When Prinsloo et al (2019) investigated the prevalence of squamous gastric disease in horses in a university teaching herd, they found that 56% of those horses had squamous gastric disease. These horses also did not travel and were provided with the same diet year round, and the difference in the prevalence of squamous gastric disease may be related to the use for teaching, rather than riding.

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