Article

Effects of feeding different roughage-based diets on gastric mucosa after weaning in Warmblood foals

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Abstract

Equine gastric mucosal ulcer syndrome (EGUS) is a well-known disease entity in equine medicine. Many studies have evaluated this disorder, by investigating prevalence, etiology and treatment. The effect of feeding different roughage-based diets to weanling foals has not been examined to date. In this study, 89 weanlings aged between 172-174 days were randomly allocated to two feeding trials. Trial 1 consisted of three groups: Group 1 alfalfa chaff (group 1), hay (Group 2) and Group 3: a total mixed ration (TMR). There were 20 foals in each group. Trial 2 consisted of two groups: Group 4: molassed alfalfa chaff and Group 5: hay. There were 19 foals in each group. Gasfroscopic examination was performed immediately before weaning and after a feeding period of 15-16 days. In the first part of the study (or trial 1) the prevalence of gastric mucosal lesion was 44% with a low severity score (median 0; 25/75% percentile: 0/0) before weaning. There was a significant increase in the number of lesions in the Pars nonglandularis of the Curvature minor in all groups of trial 1 post weaning. The group 1 (alfalfa chaff) exhibited significantly more mucosal lesions at the pylorus compared to group 2 (hay) and 3 (TMR). Significant healing of gastric ulcers was seen in the hay and TMR group. Results of the second part of the study (trial 2) indicated a prevalence of 86% before weaning increasing to 97% after the feeding period. There was an increase in the number of lesions at the Curvatura major and minor of both Pars nonglandularis and Pars glandularis in both groups (hay and alfalfa chaff). A significantly higher number of lesions at the pylorus were seen in the molassed alfalfa chaff group only. Despite the high number and severity score of the lesions none of the weanlings showed clinical signs associated with a gastric disorder.

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... Previous studies concluded that alfalfa may be useful for control and prevention of squamous gastric ulcers (Nadeau et al. 2000, Lybbert et al. 2007, Vondran et al. 2017). In contrast, alfalfa chaff has been shown to induce gastric mucosal lesions at the pylorus and/or antrum pyloricum in different age groups probably due to mechanical injury (Fedtke et al. 2015, Vondran et al. 2017) and particle size (Vondran et al. 2016). ...
... Former studies have demonstrated the impact of diet's particle size on the gastric mucosa in horses and foals. Warmblood weanlings fed with alfalfa chaff and molassed alfalfa chaff exhibited significantly more mucosal lesions at the pylorus compared to a hay-grain diet or a total mixed ratio fed group (Fedtke et al. 2015). Mechanical injury due to alfalfa chaff was suspected as an initiator of gastric glandular lesions in young horses (Fedtke et al. 2015). ...
... Warmblood weanlings fed with alfalfa chaff and molassed alfalfa chaff exhibited significantly more mucosal lesions at the pylorus compared to a hay-grain diet or a total mixed ratio fed group (Fedtke et al. 2015). Mechanical injury due to alfalfa chaff was suspected as an initiator of gastric glandular lesions in young horses (Fedtke et al. 2015). Vondran et al. (2016) observed higher pyloric ulcer scores in weanlings during the weaning process after feeding more coarse alfalfa chaff compared to alfalfa pellets with a smaller particle size. ...
... The prevalence of gastric ulcers in Thoroughbred racehorses is estimated to be >80 % in the squamous mucosa [1]. In weanlings it ranges between 32 and 94 % [2,3]. Risk factors for gastric mucosa lesions, specifically for equine squamous gastric ulcer disease, are stall confinement, strenuous exercise, transport stress in adult horses (as reviewed by Andrews and others [4]), and the weaning process in foals [2,3]. ...
... In weanlings it ranges between 32 and 94 % [2,3]. Risk factors for gastric mucosa lesions, specifically for equine squamous gastric ulcer disease, are stall confinement, strenuous exercise, transport stress in adult horses (as reviewed by Andrews and others [4]), and the weaning process in foals [2,3]. Nonsteroidal anti-inflammatory drugs have been demonstrated to be a risk factor for the equine glandular region in adult horses and foals [5,6]. ...
... Dietary factors that may effect squamous gastric mucosa in horses include buffering substances [7], the level of starch intake [8], or the type and daily amount of food [8,9]. Furthermore, the particle size of the diet appears to be a factor in glandular gastric mucosa [2]. In foals, feeding alfalfa chaff resulted in glandular mucosal lesions, which may have been related to mechanical irritation [2]. ...
Article
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Background Feeding alfalfa hay is often recommended for its buffering components, like protein and calcium, to prevent lesions of the gastric mucosa in horses. Until now, there has been no information regarding the influence of alfalfa particle size on the gastric mucosa. The aim of this study was to investigate the effects of feeding two alfalfa preparations with different particle sizes (alfalfa chaff vs alfalfa pellets) in comparison with grass hay on the gastric mucosa in weanling horses. We hypothesized that feeding a high proportion of fine alfalfa particles would negatively impact gastric mucosa and that feeding long alfalfa chaff would improve gastric mucosal health in weanlings. Results Before weaning, the prevalence of gastric mucosa lesions (one or more lesions considering all locations in the stomach) was 84.3 %; at 14 days after weaning, it was almost 100 %. Before and after weaning, most of the lesions were found at the greater curvature of the squamous mucosa and at the lesser curvature. After weaning, gastric mucosal lesions at the pylorus were significantly more severe in the group fed alfalfa chaff (p = 0.002). In the other regions, no differences related to the feeding regimes were observed. Conclusions Feeding alfalfa failed to improve gastric mucosal lesion scores in weanlings. Furthermore, foals fed alfalfa chaff had higher lesion scores at the pylorus. Alfalfa leaves contain a superior protein source and high amounts of calcium and magnesium, providing extra nutritional advantages in growing horses. At this time, either traditional grass hay rations or grass hay with alfalfa pellets can be recommended.
... Alfalfa chaff (short chopped forage) and molasses alfalfa chaff significantly increased lesions at the pylorus in weanling foals compared with grass hay or a total mixed ration. 75,76 The sharp structure of the alfalfa chaff used in these studies might have mechanically injured the pylorus, making it more vulnerable to further injuries. This may lead to pylorus stenosis with delayed gastric emptying. ...
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Many horses are fed differently than their wild ancestors. They often have limited access to pasture and are fed conserved forage and concentrates rich in starch and sugars, in only 2 meals per day. Feeding practices in contrast to natural feeding behavior can lead to gastrointestinal issues. Standard nutritional evaluation is warranted because of its important role in prevention and in treatment and management of diseases. When medical and nutritional treatments are combined, success rates are higher. New techniques to characterize equine microbiota have been used, allowing for microbiota manipulation to prevent and treat intestinal diseases.
... While dietary changes in addition to therapeutic medication are important in the management of this syndrome, poor nutrition (lower quality feedstuffs and/or inappropriate ration formulation) can also be one of the trigger factors for EGUS Jonsson & Egenvall, 2006). More specifically, nutritional factors such as intermittent feeding (Murray, 1994), alfalfa chaff in weaned foals (Fedtke, Pfaff, Volquardsen, Venner, & Vervuert, 2015;Vondran, Venner, & Vervuert, 2016), high sugars and starch intake, high amounts of straw in the diet and prolonged time without access to forage ) have been associated with a high pre-disposition to EGUS. The aim of this particular study was to investigate which nutritional practices are commonly seen in clinical ESGD cases in Belgium. ...
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Equine gastric ulcer syndrome (EGUS) is a pathological condition affecting the glandular and squamous regions of the stomach. It is characterized by non‐specific clinical signs, behavioural changes or can also be found without any overt clinical manifestations. Nutritional factors such as intermittent feeding, high sugars and starch intake, large amounts of straw as forage and prolonged time without access to forage have all been associated with an increased risk of equine squamous gastric disease (ESGD). The aim of this study was to investigate which nutritional practices are commonly seen in clinical ESGD cases in Belgium. Medical records of 27 horses referred to the equine nutritional service at Ghent University (2013–2018) due to equine gastric ulcer lesions were reviewed. Twenty‐one healthy horses referred for dietary evaluation during the same period were selected as control cases (CC). Dietary evaluation was performed on an individual basis. Forage/concentrate ratio on dry matter basis, forage content in the diet, total dietary sugars and starch intake per day and per meal were analysed. Retrospective descriptive and statistical analyses were performed. Significantly, higher amounts of forage intake (%DM per BW) in the CC vs. ESGD group were noted (p ≤ .05) with average values of 1.39 (SD ± 0.27) and 1.27 (SD ± 0.70) respectively. There were no significant differences for sugars and starch intake in g/kg BW/day (p = .18). However, the sugars and starch intake per meal (g/kg BW/meal) in the CC group (average value 1.06, SD ± 0.56) was significantly (p < .001) lower than in the EGUS group (average value 1.85 SD ± 0.78). Forage intake below the recommended absolute minimum value as well as high sugars and starch intake were most commonly associated with EGUS in the present case series. An adequate diet formulation taking into account these main nutritional factors is therefore essential to avoid gastric problems in horses.
... While dietary changes in addition to therapeutic medication are important in the management of this syndrome, poor nutrition (lower quality feedstuffs and/or inappropriate ration formulation) can also be one of the trigger factors for EGUS Jonsson & Egenvall, 2006). More specifically, nutritional factors such as intermittent feeding (Murray, 1994), alfalfa chaff in weaned foals (Fedtke, Pfaff, Volquardsen, Venner, & Vervuert, 2015;Vondran, Venner, & Vervuert, 2016), high sugars and starch intake, high amounts of straw in the diet and prolonged time without access to forage ) have been associated with a high pre-disposition to EGUS. The aim of this particular study was to investigate which nutritional practices are commonly seen in clinical ESGD cases in Belgium. ...
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Malabsorption syndrome results in impaired nutrient digestion/absorption. Diagnostic tests in horses are focused on reduced carbohydrate absorption demonstrated by abnormal oral glucose tolerance test. However, to determine the definitive diagnosis a biopsy should be performed. The objective was to evaluate the progress of horses believed to be suffering from malabsorption syndrome without other infectious conditions, following institution of appropriate dietary advice. Medical records of 15 horses admitted to the equine hospital of Ghent University (2014–2017) were reviewed. All horses had received corticosteroid treatment and individual dietary advice. All horse owners were contacted in 2017 for a follow-up. Most horses (86 per cent) had tolerated the recommended diets well and gained weight. Owners noticed the greatest improvements at three and six months after starting the diet. Adequate dietary formulation may therefore be a valuable adjunct to medical treatment. However, it may take several months before increases in bodyweight and condition are seen.
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Over the last 10 years there has been increasing awareness and subsequently recorded cases of equine gastric ulcer syndrome and with this comes an increased interest in appropriate nutrition and feed management. This review presents a systematic approach to assessing the ration of a horse at risk or diagnosed with equine gastric ulcer syndrome and demonstrates the ample evidence upon which to base nutritional recommendations for horses with equine squamous gastric disease, and to a lesser extent, equine glandular gastric disease, with an emphasis on forage. Careful selection and management of the forage ration should be the first step in designing a suitable ration, followed by selection of an appropriately low starch and sugar (less than 2g per kg body weight per day and 1g per kg body weight per meal) complementary feed. There is still more to learn about the role of supplements in the prevention and treatment of equine gastric ulcer syndrome, thus these should currently be viewed as an adjunct to an appropriate base diet and not as an isolated solution.
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The aim of this study was To assess the prevalence of gastric ulcers and the development of bodyweight of weanling foals before and after weaning and to evaluate the effect of treatment with Omeprazole on gastric findings after weaning. Weanlings (n=79) (5 to 7.5 month) were examined in two subsequent studies with about 40 foals each. Each study had 2 randomly formed groups of 20 foals, a treatment group and a control group. In the first study (VI) the foals received Omeprazole-paste 2.2mg /kg bwt q 24 h by oral administration. Foals of the second study (V2) received 4mg/kg bwt q 24 h of Omeprazole-powder via feeding, to avoid the stress of daily catching and oral administration. The control groups remained untreated. On day TO and day T14 after weanling the body condition score (BCS) and the bodyweight were determined and foals were gastroscopied. The nonglandular, glandular and the pyloric region were scored separately. There were no significant differences between groups regarding body weight and BCS. Of all 79 foals included in this studies 38 foals had gastric lesions in one or more gastric regions before weaning. Control foals of both studies showed significant worsening in the nonglandular portion 14 days after weaning (VI-control: T0-6 foals and T14-16 foals; V2-control: TO-7 foals and T14-15 foals). Both of treated groups showed significant worse findings in the glandular and/or pyloric region on day 14 (gl.reg.: 1 foal / pyl.: 0 foal before and gl.reg.: 9 / pyl.: 6 after weaning in the Omeprazole-paste-study and gl.reg.: 1 / pyl.: 1 before and gl.reg.: 3 / pyl.: 10 after weaning in the omeprazole-powder-study). There was a significant improvement in the nonglandular portion besides a significant worsening in the glandular portion and the pylorus in the treated groups. Omeprazole at 4mg/kg bwt q 24 h via feeding is effective to prevent and treat lesions of the nonglandular portion. Nevertheless Omeprazole seems to be associated to inflammation of the mucosa in the pyloric region. Practical significance: For the time being generalised prophylactic use of Omeprazole in weanlings in the protocol used here cannot be recommended.
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Background GastroGard, an omeprazole powder paste formulation, is considered the standard treatment for gastric ulcers in horses and is highly effective. Gastrozol, an enteric-coated omeprazole formulation for horses, has recently become available, but efficacy data are controversial and sparse.Objectives To investigate the efficacy of GastroGard and Gastrozol at labeled doses (4 and 1 mg of omeprazole per kg bwt, respectively, PO q24h) in healing of gastric ulcers.Animals40 horses; 9.5 ± 4.6 years; 491 ± 135 kg.Methods Prospective, randomized, blinded study. Horses with an ulcer score ≥1 (Equine Gastric Ulcer Council) were randomly divided into 2 groups and treated for 2 weeks each with GastroGard followed by Gastrozol (A) or vice versa (B). After 2 and 4 weeks, scoring was repeated and compared with baseline. Plasma omeprazole concentrations were measured on the first day of treatment after administration of GastroGard (n = 5) or Gastrozol (n = 5).ResultsCompared with baseline (squamous score (A) 1.65 ± 0.11, (B) 1.98 ± 0.11), ulcer scores at 2 weeks ((A) 0.89 ± 0.11, (B) 1.01 ± 0.11) and 4 weeks ((A) 1.10 ± 0.12, (B) 0.80 ± 0.12) had significantly decreased in both groups (P < .001), independent of treatment (P = .7). Plasma omeprazole concentrations were significantly higher after GastroGard compared with Gastrozol administration (AUCGG = 2856 (1405-4576) ng/mL × h, AUCGZ = 604 (430-1609) ng/mL × h; P = .03). The bioavailability for Gastrozol was 1.26 (95% CI 0.56–2.81) times higher than for GastroGard.Conclusions and Clinical ImportanceBoth Gastrozol and GastroGard, combined with appropriate environmental changes, promote healing of gastric ulcers in horses. However, despite enteric coating of Gastrozol, plasma omeprazole concentrations after single labeled doses were significantly higher with GastroGard.
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Pars nonglandularis (PN) is the main affected area of gastric ulcers in pigs. Several factors are discussed to affect integrity of porcine gastric mucosa, but special emphasis is given to physical form of the feed. A total of 26 pigs (bw: 36.4±10.5kg) were housed individually and test diets were fed ad libitum for 3days. The four diets used in this study were identical in botanical and chemical composition, but differed in grinding intensity (fine/coarse) and physical form (pelleted/meal). On day 3, animals were sacrificed 6hours after free access to feed (after an overnight fast). The stomach was withdrawn in toto and frozen immediately at −80°C. A sagittal cut was made and samples of the frozen gastric content were taken from 15 standardized localisations to determine dry matter content, pH and chloride (Cl) concentration using standard methods. Physical form of diets noticeably affected quality and composition of stomach content. Marked effects were found in the PN. The finely ground and pelleted diet (FP) resulted in a more liquid chyme and a significantly higher Cl-concentration at PN in comparison to the results observed after feeding the unpelleted diets (CM/FM). There was no distinct pH gradient between the regions after feeding FP. However, the coarsely ground meal (CM) caused highest pH values at PN and low pH values at fundus region. Cl-concentrations at PN were markedly lower when pigs were fed the unpelleted diets (CM/FM). In pigs fed FP a significantly higher Cl-secretion rate of the upper gastrointestinal tract was found. Therefore this study shows clearly effects of grinding intensity and physical form of the diet on composition and quality of gastric chyme within the different regions of porcine stomach. The relatively high pH at PN after feeding the FP indicates that pH presumably is not the key factor for development of gastric ulcers in pigs at PN.
Article
Equine gastric ulcer syndrome (EGUS) is highly prevalent in horses and most commonly found in racing and performance horses. This condition may negatively impact the health and athletic performance of affected horses (Vatistas et al. 1999). Proton pump inhibitors are commonly used to treat EGUS, however, a less expensive method, such as a change of diet, may give similar results. Alfalfa hay may offer some buffering capabilities within the stomach (Nadeau et al. 2000). The objective of this study was to further investigate any possible antiulcerogenic properties of alfalfa hay. Twenty-four Quarter Horse yearlings, 12-16 months of age, were utilized in this study. The 77-d experiment consisted of two 28-d periods separated by a 21-d wash-out period. Horses were endoscopically examined at the beginning and end of each period and blocked into two treatment groups. Treatment 1 included coastal bermuda grass (CB) hay and Treatment 2 included alfalfa hay as the only forage source. Horses were fed in stalls, housed in small dry lots, and subjected to an exercise regimen using a mechanical horse-exerciser. A significant effect of diet, was observed on ulcer score (P< 0.05). CB hay–fed yearlings experienced an increase in ulcer score severity compared to that of alfalfa hay– fed yearlings. Significant healing did not occur during the wash-out period, but horses experienced a significant increase in ulcer score severity (P< 0.05). The outcome of this study suggests that alfalfa hay does have antiulcerogenic capability.
Article
The aim of this study was to investigate the effects of feeding oats alone before or after feeding chopped alfalfa or, in admixture with the alfalfa on the glycaemic and insulinaemic responses of horses as well as post-prandial breath hydrogen and methane excretion. Horses were fed in a randomized order, chopped alfalfa as a source of dietary fibre and unprocessed oats as a source of starch. Chopped alfalfa intake was adjusted to a crude fibre intake of 0.5 g/kg bodyweight (BW) per meal and the oats intake was adjusted to a starch intake of 2 g/kg BW per meal. The feeds were offered in three different ways: (i) alfalfa followed by oats (A/O), (ii) oats followed by alfalfa (O/A) or (iii) a mixture of alfalfa and oats (A + O). Oats alone were used as a control. Blood and breath were collected after the test meal was fed at the end of a 11.5-h overnight fast following a 10-day acclimatization period. The highest glycaemic and insulinaemic responses were measured when the A/O and O/A diets orders were fed, whereas most hydrogen was produced after feeding oats alone. It was concluded that adding alfalfa chaff to a meal of oats prolonged the pre-caecal digestion of starch, but there was no evidence for any effect on pre-caecal starch digestibility.
Article
The relationship between diet, pH, and microbial digestion of carbohydrate was examined in 24 pigs fed either a conventional or a low-protein, high-cellulose experimental diet and sacrificed 2, 4, 8, or 12 h after a meal. In animals fed the control diet contents of the cranial half of the stomach demonstrated marked, cyclic fluctuations in pH and high concentrations of organic acids. Contents of the caudal (glandular) half were lower in both pH and organic acid concentration. Despite concentrations of volatile fatty acids (VFAs) as high as 250 meq/liter in the large intestine, the pH remained relatively neutral. The VFA levels remained relatively constant throughout the length of the colon. The VFA transport across isolated gastric and large intestinal mucosa also was examined. All four types of gastric mucosa absorbed and transported VFA at substantial rates. Mucosa of pig cecum and colon transported VFA at much greater rates than gastric mucosa and greater rates than previously determined in equine large intestinal mucosa or even bovine rumen epithelium. Comparison with results of earlier studies in the pony suggested that the higher concentration of VFA in the large intestinal contents of pigs was due to the more rapid rate of digesta passage rather than to less efficient absorption of fatty acids.
Article
Sixteen neonatal foals stressed by disease underwent endoscopic examination of their stomachs and blood was assayed for triiodothyronine (T3), reverse T3 (rT3), thyroxine (T4) and cortisol, to determine the effects of severe physiological stress and the occurrence of gastric ulcers. compared with eight age-matched controls, six foals had abnormal cortisol, seven had abnormal T3 and 12 had abnormal T4. Eleven of 13 foals had rT3 outside the 95 per cent confidence interval for clinically normal foals of comparable ages. Gastric lesions were seen more frequently in stressed foals, and gastric glandular mucosal lesions were noted in 40 per cent of the stressed foals. Previous studies report low (3 per cent) occurrence of gastric mucosal lesions. The frequency of squamous mucosal lesions was not different from that reported previously, indicating that stress has little effect on the development of lesions at this site.
Article
Of 183 foals examined by use of gastroendoscopy during 1987 and 1988, 94 had gastric lesions. Sixty-eight of 120 foals in the 1- to 85-day-old age range had endoscopically confirmed gastric lesions, and 26 of 63 foals in the 90- to 310-day-old age range had gastric lesions. Lesions were observed most frequently in the stratified squamous mucosal epithelium, particularly adjacent to the margo plicatus. Lesions were observed in the gastric glandular mucosa in 26 of the 94 foals with gastric lesions, and with a greater frequency in foals with a clinical disorder than in foals with no disorder (27% vs 3%). In young foals, lesions were consistently observed in the stratified squamous mucosal epithelium adjacent to the margo plicatus along the greater curvature of the stomach at 2 specific sites. These lesions were frequently associated with desquamation of the stratified squamous mucosal epithelium, which was observed in 69 of the 82 foals less than or equal to 30 days old and in 13 of the 101 foals greater than 30 days old. Lesions in the stratified squamous mucosal epithelium adjacent to the margo plicatus were associated with concurrent clinical disorders in foals greater than 90 days old, but developed with identical frequency in foals less than 90 days old with or without a clinical disorder. Lesions in the stratified squamous mucosal epithelium along the lesser curvature of the stomach were observed only in foals with concurrent clinical disorder, and with a higher frequency in foals greater than 90 days old than in younger foals (24% vs 3%).
Article
The relationship between diet, pH, and microbial digestion of carbohydrate was examined in 24 ponies fed either a conventional or a low protein, high cellulose experimental diet and sacrificed 2, 4, 8, or 12 hr following a meal. Animals fed the control diet demonstrated marked cyclic fluctuations in gastric pH, volatile fatty acid (VFA), and lactic acid, with concentrations of organic acid as high as 100 meq/l 4 hr after feeding. Higher concentrations of VFA in the large intestine also varied with time after feeding. VFA transport was studied in isolated mucosa of the stomach and large intestine. Mucosa of the cecum and colon transported VFA at substantial and approximately equivalent rates. Proper gastric and pyloric mucosa absorbed VFA, but only the pyloric mucosa transported significant amounts to the blood side while the stratified squamous mucosa of the cranial stomach neither absorbed nor transported these fatty acids. Although the large intestine of animals fed the experimental diet contained twice the amount of VFA found in controls and transport across cecal mucosa was markedly inhibited, the rate of digesta passage and the volume of feces were essentially unaffected.
Article
1. Saliva flowed from the horse's parotid duct only during mastication.2. The surface-active local anaesthetic administered by mouth inhibited salivary secretion.3. Salivary secretion was stimulated by pilocarpine and inhibited by atropine.4. The volume and composition of saliva secreted in 24 hr from one parotid duct was determined.5. The concentration of sodium, potassium, calcium, chloride and bicarbonate depended upon the rate of flow. The highest concentrations of these electrolytes were observed during periods of high flow rates.6. Horse parotid saliva contained a high concentration of calcium.7. In the absence of a dietary supplement of sodium bicarbonate, the sodium concentration of the saliva fell after about 21 days. There was an associated increase in the potassium concentration. The addition of a sodium supplement restored the sodium concentration of the saliva within 24 hr.
Article
To arrive at a basic understanding of the pathogenesis of reflux esophagitis, we developed an acute experimental model in the rabbit for studying the early lesion. Acid was perfused in vivo into the lower esophagus while potential difference was monitored intermittently. At varying degrees of potential difference decline, indicating epithelial injury, the esophageal stratified squamous epithelial tissue was removed for morphologic studies and in vitro electrophysiologic and transport studies. At 50 per cent reduction in potential difference, there was dilation of intercellular spaces, which when correlated with physiologic results of increased permeability indicates increased intercellular water. At 100 per cent reduction in potential difference, cells in the midepithelium were observed to be swollen and ruptured, forming vesicular spaces, midepithelial cleavages, and later early ulceration. Results of functional studies at this stage showed inhibition of sodium transport. The midepithelial site of disruption corresponds to the site of active sodium pumping out of cells in other stratified squamous epithelia. Since sodium is transported by esophageal epithelium and this function was inhibited by acid, we propose that this early morphologic lesion may be the result of damage to the sodium-transporting mechanisms of the epithelium.
Article
Ulceration of the gastric squamous epithelial mucosa was induced in 10 horses using a feeding protocol previously shown to expose the gastric mucosa to repeated periods of high acidity. The feeding protocol consisted of alternating feed deprivation with free access to hay. Over a period of seven days, each horse was provided hay for 84 hr and deprived of hay for 84 hr. Hay was never withheld for longer than 24 hr at a time. Gastroscopy was performed on each horse at the beginning of the protocol after 12 hr of feed deprivation, and after a total of 36 hr, 60 hr, and 84 hr of feed deprivation. All horses had normal esophageal and gastric mucosa at the beginning of the protocol. Alternating periods of feeding and feed deprivation resulted in progressive ulceration of the gastric squamous epithelial mucosa in all but one of the horses. Lesions progressed from erosions to ulceration within 36-72 hr of feed deprivation, and by 84 hr of feed deprivation ulcers had developed thickened, raised margins. Esophageal mucosa appeared normal in all horses throughout the study. The protocol of alternating feeding with feed deprivation in horses consistently produced gastric squamous epithelial ulceration and provided a useful model for characterizing temporal transitions in peptic-injured alimentary squamous epithelia.
Article
To determine the effect of decreasing gastric acidity in a feed-deprivation protocol on induction of gastric ulcers, and to determine whether stall confinement may be a factor contributing to gastric ulceration in horses. 8 adult horses, 4 geldings and 4 mares, 3 to 8 years old, and 7 adult horses, 5 geldings and 2 mares, 4 to 11 years old. Gastric ulceration was induced in horses by alternating 24-hour periods of feed deprivation and ad libitum access to hay, for a total of 96 hours' feed deprivation. This protocol was repeated with the horses receiving the histamine type-2 receptor (H2) antagonist ranitidine (6.6 mg/kg of body weight, PO, q 8 h). In another group of horses, severity of gastric lesions was compared after 7 days' pasture turnout and 7 days' stall confinement with ad libitum access to hay. Gastroscopy was performed after each feed-deprivation protocol was completed, and total lesion area in the gastric squamous epithelial mucosa was measured. Gastroscopy was performed at the beginning and end of 7 days' pasture turnout and 7 days' stall confinement. Alternating periods of feed deprivation resulted in erosion and ulceration of the gastric squamous epithelial mucosa of each horse. Concurrent treatment with ranitidine resulted in significantly (P < 0.05) less area of ulceration in the gastric squamous epithelial mucosa. After 7 days' stall confinement, 6 of 7 horses had ulceration in the gastric squamous epithelial mucosa, and 1 horse had a lesion in the glandular mucosa, whereas after 7 days' pasture turnout, 2 horses had reddening of the gastric squamous mucosa along the lesser curvature (P < 0.05). Severe ulceration of the gastric squamous epithelial mucosa, caused by excess acidity, can develop rapidly in horses deprived of feed or not consuming feed. Suppression of gastric acidity with the histamine type-2 receptor antagonist ranitidine effectively minimized the area of ulceration caused by feed deprivation. Compared with being turned out to pasture, stall confinement alone appears to be an important factor in the development of gastric ulcers in horses, probably as a result of altered eating behavior.
Article
Gastroendoscopic examinations were performed on 187 horses, ranging from one to 24 years. Eighty-seven horses had clinical problems including chronic, recurrent colic for seven or more days (25), one or more episodes of colic within the previous seven days (13), or acute colic (10), diminished appetite (53), poor bodily condition (40), and/or chronic diarrhoea (9). One hundred horses that had no signs of gastrointestinal problems were examined as part of a gastroendoscopic survey. Lesions observed in the squamous fundus, squamous mucosa adjacent to the margo plicatus along the greater curvature, glandular fundus, and the squamous mucosa along the lesser curvature were scored on a scale of 0-4, with 0 representing no lesions and 4 representing the most severe lesions. The mean endoscopic scores for the squamous fundus, margo plicatus and lesser curvature were significantly greater (P < 0.001) in horses with clinical signs than those without signs. This was because of the greater number of horses with lesions in the symptomatic group (80/87) compared to those without signs (52/100), and the greater severity of lesions in the horses with clinical signs. Of the horses, 74 were in race training. There was a significantly (P < 0.01) greater prevalence and severity of lesions at all sites except the glandular fundus in horses in training compared to those not in training, and in the horses in training with clinical signs (n = 37) compared to those in training without clinical signs (n = 37).
Article
Gastric contents were sampled in horses via nasogastric tube to determine changes in pH and bile salt concentrations during feeding and fasting periods. The horses were rotated through 4 feeding protocols. (1) hay; (2) hay with twice daily grain meals; (3) and (4) fasting preceded by either hay only or hay and grain. Sequential, hourly samples were collected from 3 horses prepared with gastric cannulas. Horses were fed hay twice daily and grain mix either twice daily or in small aliquots dispensed every 90 min. The horses were sampled during normal feeding or after 14 h of feed deprivation. Gastric pH values varied with time, but there was no significant difference between the feeding protocols or the fasting period on mean pH. Bile salt concentrations in fasted animals averaged 0.23-0.44 mmol/l with individual samples greater than 0.9 mmol/l. The bile salt concentrations in fed animals were consistently below 0.2 mmol/l. The effect of bile salt and acid on the stratified squamous gastric mucosa was tested in vitro. Mucosa, stripped of muscle and serosal layers, was mounted in Ussing chambers and the electrical potential difference (PD) across the tissue recorded. Sodium taurocholate or deoxycholate (0.3 mmol/l, bile salt) and/or HCl were added to the mucosal bathing solutions. The bile salt alone had no significant effect. Addition of acid (pH 2.5) to control tissues caused a decrease in the PD, which recovered within 20 min. Addition of acid to tissues exposed to bile salts resulted in a significant decrease in the PD, which did not recover. We conclude that combinations of bile salts and acid are more injurious to the stratified squamous gastric mucosa of the equine than acid alone. Concentrations of bile salts and acid sufficient to alter the electrolyte transport function of this mucosa can be found in the gastric contents of horses deprived of feed for as little as 14 h.
Article
Ulceration of the nonglandular, stratified squamous mucosa of the equine and porcine stomach is a common event in both species, although in pigs the fatality rate is significant and it is an economically important disease. Because the barrier function of this mucosa in horses and pigs appears similar, it is probable that similar pathophysiological mechanisms may be responsible for the initiating lesions and reparative events. Recent studies of ulcer pathogenesis in the pig have shown that feed preparation or prolonged fasting can result in disruption of the normal stratification of gastric contents, thereby allowing high concentrations of HCl, pepsin and refluxed bile to mix in the proximal stomach. Conditions simulating those found in vivo have been shown to damage this mucosa in vitro and indicate that luminal products, such as short chain fatty acids and bile salts, which act in synergy with HCl, probably are necessary to induce significant damage to this mucosa. Studies of the equine stomach have shown a similar proximal to distal pH gradient in the fed stomach, a significant duodenal-gastric reflux, and induction of squamous ulcers with fasting, thereby illustrating that similar conditions may be responsible for damage to the equine nonglandular mucosa.
Article
This study examined whether a product containing a pectinlecithin complex (Pronutrin) (1) could prevent gastric lesions induced in the equine gastric squamous epithelial mucosa using a protocol of intermittent feed deprivation that resulted in prolonged increased gastric acidity (Murray and Eichorn 1996). Eight ponies were used and served as their own controls in 2 trials in which there were 72 h cumulative deprivation (alternating 24 h with no feed, then 24 h free choice hay), with a 4-week interval between trials. Ponies were assigned randomly to receive either 250 g Pronutrin plus 200 g pelleted feed, or 450 g pelleted feed only. Ponies were conditioned to each treatment for 7 days and received Pronutrin and pellets or only pellets once daily during the feed deprivation protocol. Gastroscopy was performed at the beginning and conclusion of the feed deprivation protocol. The endoscopist (MJ.M.) was blinded as to treatments, and lesion severity was scored on a scale of 0-5. Gastroscopy revealed normal-appearing gastric mucosa at the beginning of feed deprivation, with the exception of 2 ponies which had focal squamous mucosal erosion and 1 pony with focal glandular mucosal erosion. After 72 h cumulative feed deprivation, each pony, except 1 pony in one of the trials, developed erosions or ulcers in the gastric squamous mucosa. There was no difference (P = 0.6) in the presence or severity of gastric lesions between treatments. Lesions did not develop in the gastric glandular mucosa as a result of the intermittent feed deprivation with either treatment. In this study, the pectin-lecithin complex in Pronutrin failed to prevent lesions in the gastric squamous mucosa induced by intermittent feed deprivation.
Article
In recent years, gastric ulceration has been recognised as a common, possibly performance-limiting disease of adult horses. Here, we aim to provide the reader with a useful review of recent literature covering all aspects of equine gastric ulcer syndrome (EGUS) in adult horses. The anatomy and physiology of the stomach, with particular reference to secretion of acid and mucosal protective mechanisms, are reviewed, as are the differing theories relating to the aetiopathogenesis of gastric ulceration. We also explore the possible influence of various management factors on development of the disease. The prevalence of the disease in racehorses has been reported to be as high as 100%. In general, horses that are in active training for racing tend to have a prevalence of around 90%, whereas pleasure horses in full work have a reported prevalence of approximately 60%. Emerging diagnostic tests which could obviate the need for gastroscopy are introduced and current recommendations for treatment are summarised, focussing on proton pump inhibitors, in particular omeprazole, administered orally. The oral administration of omeprazole has been shown to be effective in both treating horses with gastric ulceration and at preventing re-occurrence whilst the horses are in training, provided that daily dosing is maintained.
Equine Gastric Ulcer Syndrome
  • M T Picavet
Picavet M. T. (2002) Equine Gastric Ulcer Syndrome. Proc. 1st Equine Nutrition Health Congress Antwerpen, 1-12
Beobachtungen zum Vorkommen fütterungsbedingter Magenulzera beim Pferd
  • M Coenen
Coenen M. (1990) Beobachtungen zum Vorkommen fütterungsbedingter Magenulzera beim Pferd. Schweiz. Arch. Tierheilk. 132, 121-126
Nutritive Risiken für das Auftreten von Magengeschwüren beim Pferd
  • I Vervuert
  • M Coenen
Vervuert I., Coenen M. (2004) Nutritive Risiken für das Auftreten von Magengeschwüren beim Pferd. Pferdeheilkunde 20, 349-352
Untersuchungen über Magenentleerung und Zusammensetzung des Mageninhaltes beim
  • H Meyer
  • L Alswede
  • M Pferdekamp
Meyer H., Alswede L., Pferdekamp M. (1980) Untersuchungen über Magenentleerung und Zusammensetzung des Mageninhaltes beim Pferd. Dtsch. Tierärztl. Wschr. 87, 43-47