The Current Status of Equine Gastric Ulcer Syndrome in Horses - Focusing on Diagnosis, Treatment and Prevention

The term Equine Gastric Ulcer Syndrome (EGUS) has been used since 1999. As there are important differences, the terms Equine Squamous Gastric Disease (ESGD) and Equine Glandular Gastric Disease (EGGD) have been introduced in 2015. Risk factors like die-tary management, training regimens and drug side effects, as described for NSAIDs, predispose horses to ESGD or EGGD. To date, gastroscopy remains the gold standard for a reliable diagnosis. However, there are new diagnostic approaches using less in-vasive biomarkers. The proton pump inhibitor omeprazole is currently recommended by the American College of Veterinary Internal Medicine and the European College of Equine Internal Medicine (ACVIM/ECEIM) for the treatment of both ESGD and EGGD. Omeprazole per os is much less effective in treating EGGD, so it is often combined with sucralfate, which forms a protective mucosal barrier to shield it from the gastric acid. Intramuscular application of omeprazole has been shown to increase efficacy in EGGD therapy. Alternative non-pharmacological treatments have been investigated due to the high cost of approved omeprazole, long-term adverse effects in humans and the re-striction on omeprazole use in some equestrian sports. An update on diagnosis, treat-ment and prevention of ESGD/EGGD is the focus of this review.