A VARIETY of equine health issues were discussed in great detail at the CAFRE Equine Health Conference on Wednesday. Over 50 people, including veterinary surgeons and horse owners and riders attended the conference where four experts took to the stage at the CAFRE Greenmount Campus in Antrim.

The first of four speakers was David Rendle BVs, MRCVS. Rendle spoke about the causes and treatments of ulcers on the equine in modern society.

He began by explaining how veterinary surgeons are now moving away from using the term gastric ulcers because this is not the most accurate term.

The new term being used is Equine Gastric Ulcer Syndrome. This is then divided into two more categories - Equine Squamous Gastric Disease and Equine Glandular Gastric Disease.

Randle explained that what we normally refer to as gastric ulcers are more a kin to lesions or erosions, hence why the syndrome has been renamed.

SIGNS OF GASTRIC ULCER SYNDROME

Rendle added that for symptoms such as a change in behaviour and rideability owners are usually the best judge of their own horse and they will know what is normal for their own horse.

The only way of effectively diagnosing Equine Gastric Ulcer Syndrome is gastroscopy. This is when a small camera is inserted into the stomach, entering from the oesophagus. Gastroscopies should be performed on a sedated horse and the safest place to do them is with the horse in a stocks or stable.

He added: “A gastroscopy is a very routine and safe procedure.”

Rendle showed video footage from a number of different gastroscopies being performed so everyone attending the conference got a clear idea of what a healthy stomach looked like in comparison to an unhealthy one with lesions.

He highlighted that no faecal tests are capable of diagnosing ulcers and that there also are no ulcer pressure points which can be used to aid diagnosis.

EQUINE SQUAMOUS GASTRIC DISEASE

Food enters the stomach from the oesophagus into the upper area of the stomach, known as the Squamous area. This area should contain fibrous material which is relatively non-acidic. Equine Squamous Gastric Disease occurs in the Squamous area.

The contents of the stomach should be layered so that the fibrous contents should be at the top working down to the most acidic liquid at the base.

The less forage horses eat the more likely that these layers become mixed and the acid will reach the higher parts of the stomach where it should be.

EQUINE GLANDULAR GASTRIC DISEASE

Not as much is known about Equine glandular gastric disease in comparison to Equine Squamous Gastric Disease. It occurs in the lower, acidic part of the stomach, called Glandular area. This is where contents of the stomach sits before heading into the Duodenum.

It is thought that Equine glandular gastric disease occurs due to altered blood supply, which can be caused by exercise or stress. Studies are ongoing to find out more about this theory.

Rendle explained how for a period of time it was suspected that bacterial infection and anti-inflammatory drugs were causing Equine glandular gastric disease but this does not seem to be the case and these theories have been disproven.

LESIONS

Rendle explained some of the reasons why stomach lesions and erosions develop in horses:

Less fibre in horses’ diets means:

TREATMENT

Rendle emphasised that although veterinary treatment for both forms of Equine Gastric Ulcer Syndrome are improving all the time and a range of studies are increasing how much veterinary surgeons understand about the syndrome, that one of the most effective and important forms of long-term treatment relation to changing feeding and management practices.

He went through a number of case studies from his own practice and from different studies around the world to explain how different treatments options have worked.

The main message he had in relation to treatment was that acid suppression is the most important thing. The main way of achieving acid suppression is through the use of Omeprazole. Omeprazole is found is products such as Peptizole, UlcerGold and Gastrogard.

This most important thing to remember when using any product with Omeprazole is that they need to get through the stomach to be effective, so the formulation used in each product is very important.

Rendle emphasised that human products will not work for treating horses and said: “You do get what you pay for so it’s worth playing by the rules,” in relation to importing products from overseas which is illegal.

In general Equine Squamous Gastric Disease is easier to cure that Equine Glandular Gastric Disease. Rendle said that treating horses for Equine Squamous Gastric Disease with Omeprazole paste will heal 70-80% squamous lesions will heal in three weeks. Getting rid of the lesions is not actually the challenging part of dealing with Equine Squamous Gastric Disease, the difficultly is keeping the lesions from coming back and this often comes back changing how the horse is fed and managed.

The use of injectable Omeprazole is becoming more common for treating lesions because it is much easier to manage the horse, for oral Omeprazole the horse’s stomach must be empty. This is a relatively new treatment but so far Rendle has not seen many adverse reactions to the injections.

Treating horses for Equine Glandular Gastric Disease is harder, treatments are not as effective and many of the treatments are not yet licensed for horses. Rendle recommended that if Equine glandular gastric disease is not resolved in three months that a biopsy be taken to determine is there is another disease at play.

Key points Ulcers are a disease of domestication:

Treatment is not always straightforward: