• How common is EGUS?
• What are the signs of EGUS?
• Why are performance horses more susceptible to stomach ulcers than non-performance horses?
• What are the causes of gastric ulceration in all horses?
• How are equine gastric ulcers diagnosed?
• What are the clinical manifestations of gastric ulcers in horses?
• How do ulcers in horses compare to human ulcers?
• What are the clinical manifestations of gastric ulcers in horses?
• What is colic and how does it relate to EGUS?
• How are equine gastric ulcers treated?
• How do ulcers form?

How common is EGUS?

Gastric ulceration is a widespread condition in horses and foals. EGUS affects up to 93 percent of racehorses and almost 60 percent of other performance horses such as show horses. In foals, the overall prevalence of gastric lesions is up to 57 percent.

What are the signs of EGUS?

There are many clinical signs and symptoms that are associated with EGUS; however, it is important to note that many horses with stomach ulcers do not exhibit any obvious signs. Because the prevalence of stomach ulcers in horses has only been recently understood, ulcer symptoms can go unrecognized by trainers, owners and veterinarians. In adult horses, common signs include poor performance, colic, and poor appetite. Other signs associated with ulcers include attitude changes, poor body condition, a tucked-up appearance, and a poor coat. In foals, clinical signs include intermittent diarrhea, intermittent colic, rough hair coat, poor growth and a pendulous abdomen. Also seen are teeth grinding, laying on the back, salivation and frequently interrupted nursing. Of symptomatic horses, 92 percent were found to have gastric ulcers upon endoscopic examination.

Why are performance horses more susceptible to stomach ulcers than non-performance horses?

Like human ulcers, stomach acid appears to be the main cause of equine ulcers. Excess acid can "eat" through the protective lining and damage the stomach. The high prevalence of ulcers seen in performance horses results from many factors including the way the horses are fed and managed. Intensity of training also may contribute to ulcer formation, but the exact cause remains undetermined. Helicobacter pylori, bacteria that are a factor in the development of human ulcers, have not been isolated from horse stomachs and are currently not considered to be a cause of ulcers in horses. In addition, grains and pelleted concentrates can increase the production of gastrin, a hormone that stimulates acid production. Therefore, horses that are fed high grain diets are more likely to have higher gastric acidity than horses offered free choice forage without grain.

What are the causes of gastric ulceration in all horses?

Causes of gastric ulcers in horses include feeding management practices, physical stress, diet and specific medications given in high doses. Any horse with serious illness is also at risk of developing ulcers. Intensity of training also may contribute to the high prevalence of stomach ulcers in horses.

How are equine gastric ulcers diagnosed?

A clinical examination should be performed if ulcers are suspected. A 3-meter (9.8 feet) endoscope is used to confirm the existence of stomach ulcers in horses, but endoscopes of sufficient length to visualize the horse stomach are not always available to all equine practitioners. Luckily, several clinical signs and symptoms are highly suggestive of EGUS, making empirical therapy a viable option.

What are the clinical manifestations of gastric ulcers in horses?

Clinical signs of EGUS in adult horses can include a combination of colic, poor appetite, decreased performance, dullness, attitude changes, poor body condition, rough hair coat, and weight loss. Foals tend to exhibit signs including intermittent nursing, laying on the back, poor appetite, intermittent colic, poor body condition, diarrhea, teeth grinding and salivation.

How do ulcers in horses compare to human ulcers?

Similar to ulcers in humans, ulcers in horses may develop from increased production of gastric acid and decreased resistance of the lining of the stomach to gastric acid. However, a bacteria, Helicobacter pylori, which is a factor in human ulcers, has not been found as yet in horse stomachs. Therefore, at this point, it is not considered to be a cause of ulcers in horses.

What are the clinical manifestations of gastric ulcers in horses?

Gastric ulcers can cause clinical problems in horses ranging from suppressed appetite to colic. These signs are attributed to ulcers because when the horses are treated with acid suppressive therapy, the clinical signs resolve.

Unfortunately, common clinical signs of ulcers are often overlooked or not observed until the problem has progressed. Because of this, stomach ulcers are often undiagnosed or misdiagnosed. While definitive diagnosis can only be made with endoscopy, the clinical signs and symptoms may form the basis for empirical therapy for ulcers after other disorders have been excluded. Gastric ulcers are a major source of discomfort for horses affecting appetite, attitude and performance. Risk factors for ulcers include some feeding practices, training and illness.

What is colic and how does it relate to EGUS?

Colic is abdominal discomfort and can be a clinical sign of gastric ulcers or other problems in horses. Most cases of colic in horses are not caused by ulcers, but ulcers should be considered when other causes have been ruled out.

How are equine gastric ulcers treated?

GASTROGARD® (omeprazole) Paste is the first and only FDA-approved medication to treat and prevent the recurrence of stomach ulcers in horses. Until now, many different medications used to treat heartburn and stomach ulcers in humans have been used by veterinarians to treat horses, but unfortunately many of these medications were ineffective, had variable results or required that the horse be removed from training. Some of these therapies include histamine receptor antagonists, antacids and mucosal protectants. None of these medications have been approved for use in horses by the FDA and safety in horses has not been assessed. Because GASTROGARD is specially formulated for horses, it should not be administered to other species, including humans.

How do ulcers form?

The equine stomach secretes acid continuously. Lesions in the upper portion of the equine stomach (the squamous mucosa lining) result primarily from excessive acidity, whereas lesions that affect the bottom of the stomach (the gastric glandular mucosa lining) result primarily from defective mucosal protection. Like human ulcers, stomach acid appears to be the main cause of equine ulcers. Excess acid can eat through the protective lining and damage the stomach. The high prevalence of ulcers seen in performance horses results from many factors including the way the horses are fed and managed. Intensity of training also may contribute to ulcer formation, but the exact reason why remains undetermined. Helicobacter pylori, bacteria that are a factor in the development of human ulcers, have not been isolated from horse stomachs and are currently not considered to be a cause of horse ulcers.

Federal (USA) law restricts GASTROGARD to use by or on the order of a licensed veterinarian. GASTROGARD is indicated for the treatment and prevention of recurrence of gastric ulcers in horses and foals 4 weeks and older. In efficacy trials, no adverse reactions were observed. Safety in pregnant and lactating mares has not been determined.