Misoprostol: A Better Option for Treating Equine Glandular Gastric Disease

British researchers found more success treating EGGD with misoprostol than with a combination of omeprazole and sucralfate, two drugs known to effectively treat equine squamous gastric disease.
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Misoprostol: A Better Option for Treating Equine Gastric Glandular Disease
Hallowell and colleagues found that misoprostol-treated horses experienced superior healing over omeprazole/sucralfate-treated animals (72% vs. 20%) as evidenced by gastroscopic (seen with an endoscope passed into the stomach) improvement in lesions and resolution of clinical signs. | Photo: Courtesy Danny Holbrook
It’s common knowledge that many horses suffer from gastric disease. What you might not know is that two distinct forms of gastric ulcers exist—equine squamous gastric disease (ESGD) and equine glandular gastric disease (EGGD)—depending on the exact location in the stomach. Researchers in the U.K. recently reported that these two diseases really shouldn’t be considered the same and, therefore, mandate different treatments. In their study they found better success treating EGGD with misoprostol than with a combination of omeprazole and sucralfate, two drugs known to effectively treat ESGD.

“While both types of disease fall under the umbrella term equine gastric ulcer syndrome, research shows that they are actually distinctive entities with different risk factors and, therefore, likely different ways of developing,” explained Gayle. D. Hallowell, VetMB, PhD, Dipl. ACVECC and ACVIM, a professor in veterinary internal medicine and critical care at the University of Nottingham.

Hallowell described how while horses with ESGD have apparent ulcerative damage to the stomach wall, horses with EGGD instead seem to have a mixed type of nonulcerative inflammation. Another example of how the two differ is that omeprazole, an oral medication proven useful for treating ESGD, doesn’t appear particularly effective for horses with EGGD.

“Omeprazole decreases the acidity of the stomach, thereby protecting the squamous or upper region of the stomach in ESGD. The fact that horses with EGGD do not respond favorably to omeprazole suggests that other factors contribute to disease, such as a breakdown of normal gastric defenses, reduced gastric blood flow, or that EGGD is an extension of inflammatory bowel disease,” Hallowell said

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Written by:

Stacey Oke, MSc, DVM, is a practicing veterinarian and freelance medical writer and editor. She is interested in both large and small animals, as well as complementary and alternative medicine. Since 2005, she’s worked as a research consultant for nutritional supplement companies, assisted physicians and veterinarians in publishing research articles and textbooks, and written for a number of educational magazines and websites.

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