Gastric Disease

Question 1

What are the components of the equine stomach?

Answer 1

Squamous (non-glandular) mucosa
Glandular mucosa (mucous cells, parietal cells, chief cells, G cells)

Question 2

What are the aggressive vs protective factors that are associated with gastric ulcers?

Answer 2

Aggressive: hydrochloric acid, pepsin, organic acids
Protective: mucus, bicarbonate, mucosal perfusion

Question 3

What provides input to parietal cells to produce hydrochloric acid?

Answer 3

Histamine
Gastrin
Acetylcholine

Question 4

What are potential causes of gastric ulcers?

Answer 4

Decreased blood flow
Increased acid contact time
Decreased PGE2
Decreased mucus
Increased HCl

Question 5

Clinical signs of gastric ulcers in adults

Answer 5

Colic
Poor BCS
Poor hair coat
Poor performance
Changing appetite
Attitude changes
“Girthiness”
Back pain
In contrast to foals, NO diarrhea

Question 6

Clinical signs of gastric ulcers in foals

Answer 6

Colic
Teeth grinding
Diarrhea
Excessive salivation
Reduced appetite
In contrast to adults, can perforate

Question 7

Tx for gastric ulcers encompasses what 2 areas?

Answer 7

Management
Medical

Question 8

How are gastric ulcers managed?

Answer 8

Allow 24/7 feed access
Feed with high calcium content
Vegetable oils may offer natural protection against gastric ulceration

Question 9

What are medical treatments for gastric ulcers?

Answer 9

Antacids = maalox
Proton pump inhibitors = omeprazole
Antihistamines = cimetidine, ranitidine, famotidine
PGE2 analogue = misoprostol
Sucraflate = pain relief only

Question 10

What is the prognosis of gastric ulceration?

Answer 10

Good: squamous mucosa, management changes
Fair: glandular mucosa
Poor: if perforated