Bishop Rebecca C, Kemper Ann M, Wilkins Pamela A, McCoy Annette M
Department of Veterinary Clinical Medicine, University of Illinois, Urbana, Illinois, USA.
Equine Vet J. 2021 Oct 31. doi: 10.1111/evj.13534.
Equine gastric ulcer syndrome (EGUS) is a common and significant cause of morbidity in horses, with a range of clinical signs, including inappetence, colic and poor performance. Hospitalised horses are exposed to factors that may induce EGUS, including fasting and nonsteroidal anti-inflammatory drug (NSAID) administration, and may be at risk for development of squamous (ESGD) and glandular gastric disease (EGGD). Prophylactic anti-ulcer medication is often prescribed for these patients, but drug selection is complicated by different aetiology and response to treatment of ESGD and EGGD.
To establish the efficacy of sucralfate or omeprazole used prophylactically in horses exposed to a combined feed-fast and NSAID administration EGUS induction protocol. We hypothesised that these drugs would be equally effective for prevention of gastric lesions in the experimental cohort.
Randomised crossover experimental design.
Horses (n = 14) received either omeprazole (1 mg/kg PO q24h) or sucralfate (20 mg/kg PO q8h) while undergoing the feed-fast/NSAID protocol, allowed an 8-week washout period, and then administered the alternate treatment. Serial gastroscopy, ultrasound and haematology documented treatment effects.
ESGD and EGGD score increased over time under both treatments. There was a significant effect of treatment on EGGD scores (P < .001), with post-treatment EGGD scores higher for horses receiving sucralfate (median 3; IQR 2.25,3) than omeprazole (1; 1,1). The effect of treatment on ESGD scores just achieved significance (P = .05), with post-treatment ESGD scores higher for sucralfate (4; 3,4) than omeprazole (2; 2,3).
This study was performed in healthy horses, and response to treatment may differ in horses with clinical illness. Additional investigation in a larger population may be required to detect significant differences in other clinical parameters.
Omeprazole was superior to sucralfate for mitigating gastric lesion severity in healthy horses exposed to a feed-fast/NSAID model.
马胃溃疡综合征（EGUS）是马匹发病的常见且重要原因，有一系列临床症状，包括食欲不振、绞痛和性能不佳。住院马匹会接触到可能诱发EGUS的因素，包括禁食和使用非甾体抗炎药（NSAID），并且可能有发生鳞状胃疾病（ESGD）和腺性胃病（EGGD）的风险。通常会为这些患者开具预防性抗溃疡药物，但由于ESGD和EGGD的病因不同以及对治疗的反应不同，药物选择变得复杂。
确定硫糖铝或奥美拉唑在接受联合禁食和NSAID给药的EGUS诱导方案的马匹中预防性使用的疗效。我们假设这些药物在预防实验队列中的胃部病变方面同样有效。
随机交叉实验设计。
14匹马在接受禁食/NSAID方案时接受奥美拉唑（1mg/kg口服，每24小时一次）或硫糖铝（20mg/kg口服，每8小时一次），有8周的洗脱期，然后给予替代治疗。连续胃镜检查、超声检查和血液学检查记录治疗效果。
在两种治疗下，ESGD和EGGD评分均随时间增加。治疗对EGGD评分有显著影响（P <.001），接受硫糖铝治疗的马匹治疗后EGGD评分（中位数3；四分位数间距2.25,3）高于接受奥美拉唑治疗的马匹（1；1,1）。治疗对ESGD评分的影响刚刚达到显著水平（P = 0.05），硫糖铝治疗后ESGD评分（4；3,4）高于奥美拉唑治疗后（2；
