b'YOUR GUIDE TO THE 2017 AAEP CONVENTION SPONSORED BYTreating Tricky Gastric Glandularand pharmacodynamics, Banse said. Disease in Horses Previous research supports the following Not all equine gastric ulcer syndromeThe Cost of Treatment feeding regimen: offering EGGD horses cases are the same. In fact, in 2015Heidi Banse, DVM, PhD, Dipl. ACVIMtheir evening meal, withholding hay researchers split the condition into two(LA), a veterinary specialist in Louisianaand feed overnight before administeringcategoriesequine glandular gastricState Universitys (LSU) DepartmentGastroGard, and continuing to withhold disease (EGGD) and equine squamousof Veterinary Clinical Sciences, sharedfeed for 90 minutes post-administration.gastric disease (ESGD)because of eachcurrent prices of ulcer medications fromOne studys authors suggested adding ones distinct pathology, risk factors, diag- LSUs pharmacy: the protectant sucralfate to the omepra-nostics, and treatment approaches. GastroGard: $30-35/day zole dose, after observing a 65% healing Heidi Banse, DVM, PhD, Dipl. ACVIMSucralfate: $5/day for a normal dose,rate when combining the two drugs. An-(LA), described how to manage the more$13-18/day for a high dose others suggested the hormone misopro-problematic of these two diseases: EGGD.Misoprostol: $50-80/day stol alone might be more effective (73% Equine squamous gastric disease af- returned to normal) than omeprazole fects the upper squamous region of theplus sucralfate (22%).stomach, which is unprotected from gas- After confirming EGGD via gastros- Researchers have also tried treating tric acid. Equine glandular gastric diseasecopy, Banse suggested veterinarians usethis condition with antimicrobials, such involves the lower region. Its prevalencethe European College of Equine Internalas trimethoprim-sulfadimidine, and depends on riding discipline and horseMedicine glandular lesion descriptiondietary supplements containing polysac-breed but ranges from 10% to 65%, saidand the modified Equine Gastric Ulcercharides. But Banse does not currently Banse, a veterinary specialist in LouisianaSyndrome scoringsystem to characterizerecommend antimicrobials because we State Universitys Department of Veteri- severity and monitor improvement.dont know what they do to the horses nary Clinical Sciences, in Baton Rouge.When it comes to treating EGGD,microbiome (resident GI tract micro-The conditions prevalence is highomeprazole (GastroGard, not the genericorganisms) and suggests that dietary among Warmbloods and sport horsesor compounded types, she said) remainssupplements are likely better for preven-(46-65%). In preliminary findings fromthe gold standard; however, said Banse,tion than treatment.one study, she said, exercise frequencyglandular disease tends to be more chal- Based on the research, Banse recom-and performance level were associatedlenging to treat than squamous.mended vets start horses with mild with an increased risk of EGGD in showWhile the reason for this disparity isEGGD lesions (Grade 1 and 2) on 4 mg/jumping Warmbloods, while feeding andunknown, diet and duration of fast- kg omeprazole daily, and if theres no im-exercise appear to contribute to increaseding prior to omeprazole administrationprovement after one month, add sucral-risk in Thoroughbred racehorses. may impact the drugs pharmacokineticsfate or misoprostol. She recommended Study: Horsesfrequently in regions withand measuring fecal sedimenta- fluids and passing a nasogastric naturally sandy soils, includingtion are only effective in abouttube to administer enteral fluids, With Sand ColicCalifornia, Texas, and Florida.20% of cases, she said. psyllium, and either magnesium Have ExcellentAffected horses, which consumeWith a positive diagnosis,sulfate or mineral oil. sand inadvertently while grazingthe veterinarian can discussBoth medical and surgical Prognosis or eating off the ground, cantreatment optionseithermanagement resulted in over For most horse owners noth- develop gastrointestinal tractmedical or surgicalwith the94% of treated horses surviving obstructions, intestinal tract lin- owner. Kilcoyne said one of theto discharge from our hospital, ing about colic is good news.ing irritation, altered gut motility,key factors he or she shouldbased on a review of the medical But one researcher has reportedweight loss, diarrhea, and overtconsider when selecting anrecords of 153 horses with sand that when it comes to sand colic,colic. approach is how much gas hascolic, Kilcoyne said. One factor theres some positive news.If a practitioner suspects sandbuilt up in the abdomen, basedto consider, however, is that half Isabelle Kilcoyne, MVB, Dipl.colic, Kilcoyne recommendedon radiographs and transrectalof all horses treated medically ACVS, of the University of Califor- that, in addition to a standardpalpation.suffered recurrent colic, whereas nia, Davis, School of Veterinarycolic work-up, he or she takeEvidence of intestinalonly 17% of surgically treated Medicine, said horses with thisradiographs to confirm sand indistention (swelling) due to thathorses suffered sand colic again.condition generally have anthe gut and quantify how muchgas accumulation, based onIn sum, the amount of sand excellent prognosis regardless ofhas accumulated. This is be- radiographs or rectal palpation,in the gastrointestinal tract does whether they undergo medical orcause listening to the abdomenssuggests that surgery should benot dictate management strategy. surgical treatment. oceanlike sounds using a stetho- performed, she said. Instead, gas accumulation ap-Sand accumulation in thescope (a traditional method ofOtherwise, medical therapypears to be a more important large colon occursrelativelydiagnosing sand accumulation)involves providing intravenousfactor.Stacey Oke, DVM, MSc A44 TheHorse.com/AAEP2017 AAEP Wrap-Up THE HORSEMarch 2018'