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Q: Diagnosis of Gastric Ulcers in Horses ( Answered 5 out of 5 stars,   4 Comments )
Subject: Diagnosis of Gastric Ulcers in Horses
Category: Science > Chemistry
Asked by: zippe-ga
List Price: $100.00
Posted: 31 Mar 2005 02:00 PST
Expires: 30 Apr 2005 03:00 PDT
Question ID: 503083
The current method of diagnosing gastric ulcers in horses is, I
believe, by use of a 3m endoscope which involves sedating the horse
and is quite an expensive and invasive method to use as it it is
usually done by a vet. I have heard that over 60% of horses have
ulcers and I was wondering wheteher there was a cheaper,reliable
method of diagnosing ulcers in horses that could be used by the horse
owner. Even if there is not a method currently on the market are there
any institutions or companies working on such a diagnostic method?
Subject: Re: Diagnosis of Gastric Ulcers in Horses
Answered By: crabcakes-ga on 06 Apr 2005 21:36 PDT
Rated:5 out of 5 stars
Hello zippe,
  You are correct? gastric ulcers (Also known as Equine gastric ulcer
syndrome, or EGUS) are very common in horses, particularly race and
performance horses. Symptoms include diarrhea, loss in appetite, colic
and decreased energy.

  The most common diagnostic method is, as you stated, endoscopy. Many
veterinarians do not have the long endoscopes needed for horses, due
to the cost, necessitating that the horse be referred to a large
veterinary clinic. Because of the cost of testing, many horse owners
have opted to treat ?as if? the horse did have ulcers. Because
unnecessary medication is costly, as well as causing possible side
effects, horse owners should be glad to know there is a new test(more

The cost of equine endoscopy ranges from $150-400, per the following site:

Here is a photo:

It appears, according the link below, that endoscopy in horses is not
always accurate.
?However, much debate exists regarding the accuracy of these grading
systems. One study carried out in America found that endoscopic
examination underestimated the severity of the ulceration.
Many vets do not have access to endoscopes that are long enough to
examine horse`s stomachs. Researchers have been investigating other
methods for identifying gastric ulcers. One technique that might prove
useful as a screening test is to measure the absorption of sucrose
across the stomach wall. Normally sucrose is not absorbed in the
stomach and is rapidly broken down to fructose and glucose when it
reaches the small intestine. However, it can be absorbed across the
stomach wall when ulcers are present. The sucrose is then excreted the
urine. Researchers have been investigating whether the measurement of
sucrose in the urine after oral dosing can be used as a screening test
for gastric ulceration.?

?A second significant contributor to the development of lesions in a
horse's stomach is the intensity of his training. For reasons not yet
fully understood, a program that demands more of a horse may
predispose him to ulcers. In fact, the results of treadmill studies
have shown equine researchers that the occurrence of ulcers increased
as horses' levels of exercise increased.
"Therefore," Murray continues, "it is our management of horses - the
way we feed, train and trailer them, and how we confine them to stalls
- that causes the lining in the top part of the stomach to be exposed
to acid more and more. Because this part of the equine stomach is very
sensitive to acid, wounds or ulcers form."

?A third cause of ulcers in performance horses is trailering. Horses
must frequently tense their abdominal muscles to maintain balance in a
moving trailer, which tends to have the same effect as heavy exercise.
Since many people do not offer hay when hauling, their horses are
faced with long, uncomfortable rides. It?s no wonder that many horses
start kicking and pawing in the trailer!
Finally, saddling and tightening the girth can cause your horse to
tighten his muscles, forcing the acid into contact with any existing
ulcers and aggravating ulcer pain. The association point for the
stomach meridian lies under the back of the saddle where the ribs join
the spine. If you suspect that your horse has ulcers, put light
pressure on this point to see whether your horse has a pain response.? 

Horses also seem to get ulcers from not being provided with always
available food. The lack of food in the stomach causes the pH
(acidity) of the stomach to increase, allowing ulcers to form, and
form quickly. As grazing animals, they prefer (and need) to eat small
amounts, but often.
?Equine gastric ulcer syndrome (EGUS) is the most common disorder of
the equine stomach. It affects over 90% of racehorses in training and
nearly 60% of other sport horses. No specific cause has been
determined, but various factors are thought to play a part, including
stabling, ingestion of concentrate foods, intensive exercise and

?If a horse is deprived of food for only a couple of hours the stomach
contents will rapidly become more acidic (pH2 or lower).Ulcers can
appear within 24-48 hours if the horse is prevented from eating.

Others have suggested  that a mechanical effect of exercise keeps the
stomach acid in contact with the non-glandular mucosa for longer).
They suggest that an increase in pressure in the abdomen during
intense exercise compresses the stomach, pushing the acidic contents
up onto the non-glandular part of the stomach. According to their
theory, horses that spend more time training, have acid in contact
with the non-glandular part of the stomach for longer, causing more

?Horses, unlike humans, secrete stomach acid continuously and
independent of a meal. The presence of food in the stomach buffers
this acid and so helps protect the lining from damage.

Horses, unlike humans, have an upper portion of the stomach that has
an unprotected lining and is vulnerable to damage by acid. The lower
portion is the acid-producing part and is more resistant to acid
damage. Recent research has shown that when horses are exercised at a
trot or gallop, the pressure in the abdomen (the space around the
internal organs) increases. This raises the level of the ?acid pool,?
which normally lies down low in the more resistant portion of the
stomach, to the more sensitive upper part. This favors the formation
of ulcers in this area.

There are several different and distinct ulcer ?syndromes? in
different classes of horses which affect either the upper or lower
portion of the stomach, or both. The bacterial cause of ulcers that
has been determined to be such an important causative factor in human
gastric ulcers has not been found to date in horses.

Nutrition plays an important role in determining how acidic the
stomach fluid is. High grain diets cause more acidity than low grain
diets. Alfalfa actually causes a lower acidity than grass hay.
One of the most important points is that ulcer syndromes can be
unapparent. Mild problems are often attributed to other causes.?
(This is a cached/stored page, the reason for the colored highlighting)

There is a new test, the Sucrose Permeability Test! It does not appear
to be  available for the do-yourselfer yet.

Sucrose Permeability Test: Sucrose is a form of plant sugar, also
called saccharose,and is used now to test for equine gastric ulcers.
?This new test, called a sucrose permeability test, is performed on
the horse?s urine.  This test is fairly simple and inexpensive as a
pound of sucrose in water is given to the horse by nasogastric tube. 
Two hours later, urine is retrieved and tested for the amount of
sucrose present.  In this study, 11 horses were found to have ulcers,
and the horses with ulcers were found to have higher urinary sucrose
values than horses without ulcers.  These horses were then treated
with Gastroguard to heal the ulcers.  Follow up sucrose testing after
the ulcers healed revealed lower urinary sucrose values.  Due to the
expense of endoscopy, many people have just treated their horses for
ulcers assuming this might be the problem.  The disadvantage of that
approach is that the drugs for treatment of ulcers are expensive, and
it is never a good idea to give any drug unless it is necessary. 
Hopefully, this test will be a more accurate and less expensive method
of diagnosing of gastric ulcers.?
You can find a link on this page to the Texas Farm Bureau Network,
where you can listen to a paper being presented on the sucrose test.

?Sucrose is not synthesized or hydrolyzed in the circulatory system;
therefore, once sucrose is absorbed across the gastric mucosa, it is
filtered from the blood by the kidneys, where it is then concentrated
and excreted in the urine. Thus, urinary sucrose concentration after
administration or ingestion of sucrose is a useful indicator of
gastric ulceration.
The purpose of this study was to determine if urinary sucrose
concentration in a sample collected at a specified time after sucrose
administration could be used to accurately predict the presence and
severity of gastric ulceration in horses.?

?Our data indicate that sucrose permeability testing is a useful
method for detecting equine gastric ulceration. Urinary sucrose
concentrations were significantly higher in those horses with induced
gastric ulcers compared with the same horses after 21 days of
omeprazole treatment. More importantly, urinary sucrose concentrations
were significantly correlated with the severity of gastric ulcers.
Reliable detection of clinically important ulcers may be one of the
most important findings from the study presented here.?

?The signs of stomach ulcers in foals can include grinding of the
teeth, colic, drooling of saliva, interrupted nursing and lying on
their back. Diarrhea may also be associated with ulcers. Signs in
adult horses typically include a general decrease in performance,
appetite and body condition. Recurrent colic is also a sign of this
problem as are attitude changes in the horse. It is also important to
know that many horses with ulcers may show very few signs at all.?
?Fortunately, your veterinarian has an FDA approved product to treat
gastric ulcers in horses. This product is given orally and will help
heal the ulcer in 3 to 4 weeks.
If you suspect your horse could be suffering from a gastric ulcer,
contact your veterinarian. He or she is the best person to accurately
diagnose and treat this condition.?

Procedure of Sucrose Permeability Test ?Following induction of gastric
ulcers by intermittent feed deprivation, horses underwent sucrose
permeability testing (administration of sucrose by nasogastric
intubation followed by collection of urine at 2 and 4 hours after
intubation) and gastric endoscopy. Squamous ulcers were assigned a
severity score (range, 0 to 3) by use of an established scoring
system. Horses were subsequently administered omeprazole for 21 days,
and sucrose testing and endoscopy were repeated. Pair-wise comparisons
of urine sucrose concentration were made between horses with induced
ulcers before and after omeprazole treatment. Urine sucrose
concentrations also were compared on the basis of ulcer severity
score.? Page 5

?Sucrose, a disaccharide sugar, is not normally present in either the
urine or the blood of horses because the molecules are too bulky to
pass through healthy stomach mucosa (lining) and are almost
immediately broken down once they hit the small intestine.  But when
the stomach mucosa is damaged or ulcerated, sucrose molecules can
escape through the damaged tissues and into the bloodstream. 
Eventually, they?re filtered from the blood by the kidneys, ending up
in concentrated form in the urine.?

?Now, a team of researchers at Texas A&M University, led by Noah
Cohen, VMD, PhD, and J. B. Meddings of the University of Calgary's
Gastrointestinal Research Group, says gastric ulcers can be identified
and assessed for severity using a simple test for sucrose in the
urine. This method has already proved reliable in diagnosing ulcers in
humans, rats, and dogs.

With results this conclusive, and a testing protocol established, it
should take very little time for veterinarians to incorporate urine
testing--a much simpler, cheaper, and less invasive technique--into
their diagnostic routine for gastric ulcers.

There's also potential to use sucrose levels in the blood of suspected
ulcer cases to indicate the presence of ulcers. This convenient
possibility is currently being explored by Texas A&M and Mississippi
State University researchers.

Furthermore, researchers at the University of Adelaide in Australia
are investigating the use of a sucrose breath test, which has
successfully detected gastric ulcers in humans and dogs. Essentially,
an individual who doesn't absorb sucrose properly should have
detectably higher levels of hydrogen and methane in his exhaled
breath. If this holds true for horses, it could provide another
simple, efficient, and inexpensive way to diagnose gastric ulceration
and, with any luck, help veterinarians catch ulcers faster and treat
them earlier."

?The scientific literature shows that Disaccharides* eg sucrose, do
not cross from the gastrointestinal tract to the bloodstream unless
the gastrointestinal barrier function is damaged and hence permeable*.
The presence of sucrose in the blood indicates damage in the upper
gastrointestinal tract, particularly the stomach. The sucrose
permeability test (SPT) has been developed in the medical arena for
the identification of small intestinal dysfunction and has been used
successfully in rats and humans. The patented sucrose breath test
(SBT) has been used successfully in dogs and humans for the detection
of gastric ulcers. Neither of these tests has been validated for use
in the horse.

This new project will determine whether the sucrose breath test (SBT)
can identify horses with gastric ulceration. The researchers will
undertake testing on three groups of horses. The first group will
consist of 8 horses with normal gastric mucosa, the second test group
will consist of 8 horses with mild gastric ulceration and the final
group of 8 horses to be tested will have severe gastric ulceration.
The results of the experiments will show how well the sucrose breath
test is able to identify horses with gastric ulceration. It will also
indicate whether the test can determine between mild and severe cases
of gastric ulceration.?

More information:
Sucrose Permeability Test

More information on ulcers and a diagram of a horse?s stomach

Warning** graphic photos of ulcers



You (Your horse, actually) MAY be eligible for a study

Because the Sucrose Permeability test is relatively new, try asking
your vet for the closest veterinary care center that has the test
This site has a list of centers in the US

I hope this is the information you were seeking. There is not a great
deal yet published about this test, and what I have posted is what
there was available, without becoming repetitive.

If any part of my answer is not clear, please do not rate this answer
without asking for an Answer Clarification. This will enable me to
respond and assist you further, if possible.

Regards, Crabcakes

Search Terms
horses gastric ulcers + sucrose test
Diagnosing equine gastric ulcers
Testing horses + gastric ulcrs
zippe-ga rated this answer:5 out of 5 stars
The Question was well researched and the information provided I
beleive to be the most up to date available.Thanks for your efforts.

Subject: Re: Diagnosis of Gastric Ulcers in Horses
From: myoarin-ga on 02 Apr 2005 08:01 PST
What are the side effects or negative effects of the medical treatment
for gastric ulcers in horses that have none?
If 60% of them have ulcers (!?), maybe they should all be given the
medicine, helping the majority and and not doing damage to the others.
 (They can't sue for malpractice).
Subject: Re: Diagnosis of Gastric Ulcers in Horses
From: zippe-ga on 03 Apr 2005 13:36 PDT
I believe certain supplements - or a combination of them - can have a
very benificial effect without any side effects.
Subject: Re: Diagnosis of Gastric Ulcers in Horses
From: crabcakes-ga on 07 Apr 2005 10:35 PDT
Thank you for the stars zippe!
Subject: Re: Diagnosis of Gastric Ulcers in Horses
From: zippe-ga on 09 Apr 2005 00:27 PDT
Hi Crabcakes!
Since logging the question I have found an excellent product by an
Irish based company caller NutriScience ( Their
product, Gastrocare, Is a food supplement rather than a drug of any
sort and has a triple action.It contains an antacid, soluble fibre to
absorb excess acid in the stomach and a component that helps to repair
the gut lining. It makes sense to put a horse on it as a long term
solution if you suspect that the horse has ulcers (considering the
cost of scoping!!). I have had a very positive result with 2 of my
horses which I suspected to have ulcers.

Thanks again.

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