College of Veterinary Medicine, Inner Mongolia Agricultural University, Hohhot, China.
Agriculture and Animal Husbandry Bureau, Karaqin Banner, Chifeng, China.
Equine Vet J. 2024 May;56(3):562-572. doi: 10.1111/evj.13962. Epub 2023 Jun 19.
Phenylbutazone (PBZ) is the most commonly used drug to treat symptoms of lameness in horses; however, it is associated with adverse effects such as gastric ulcer syndrome (EGUS). Interestingly, many practitioners prescribe omeprazole (OME) concurrently with PBZ to prevent the development of EGUS. However, the efficacy and safety of this practice in Mongolian horses with chronic lameness remain unknown.
To evaluate the clinical effects of a combination of PBZ and OME on chronic lameness in Mongolian horses.
Randomised block experimental design.
Eighteen Mongolian horses with lameness score was ≥3 points, were divided into three treatment groups, with six horses in each group: placebo (CON), PBZ (4.4 mg/kg PO q. 24 h), or PBZ plus OME (4 mg/kg PO q. 24 h; PBZ + OME) in a randomised block design based on the initial lameness score. The horses were treated for 15 days. During this period, weekly gastroscopy, and physiological and biochemical tests were performed.
Both PBZ (median 1.0, interquartile range [IQR]: 0.8-1.3; p = 0.01) and PBZ + OME (median 1.0, IQR: 1.0-1.0; p = 0.01) significantly decreased the lameness score compared with before administration. In addition, PBZ significantly increased the equine glandular gastric disease (EGGD) score (3.0 ± 0.6, p < 0.001), GT-17 content (293.4 ± 21.8 pg/mL, p < 0.001), and pepsinogen-1 (PG1) content (295.3 ± 38.3 ng/mL, p < 0.001) compared with CON or PBZ + OME. However, it significantly reduced the total protein (53.6 ± 1.5 g/L, p < 0.05) and albumin (25.5 ± 1.8 g/L, p < 0.05) contents. Nevertheless, compared with PBZ, PBZ + OME significantly decreased the EGGD score (0.3 ± 0.5, p < 0.001) and significantly increased the gastric fluid pH (7.3 ± 0.5, p < 0.001), total protein content (62.5 ± 4.6 g/L, p = 0.009), and albumin content (29.4 ± 1.1 g/L, p = 0.004). Meanwhile, they significantly diminished the gastrin 17 (GT-17) (162.0 ± 21.0 pg/mL, p < 0.001) and PG1 (182.4 ± 22.5 ng/mL, p < 0.001) contents.
Individual differences in horses were larger, but the sample size was small. There was larger interval between observations for each index.
Compared with PBZ alone, PBZ + OME had no therapeutic effect on chronic lameness; however, it reduced the occurrence of EGGD in Mongolian horses. Horses may be protected against chronic lameness and PBZ-induced EGGD by increasing the pH value, decreasing serum PG1 and GT-17 content, and preventing the reduction of myeloperoxidase content.
保泰松（PBZ）是治疗马跛行最常用的药物，但它与胃溃疡综合征（EGUS）等不良反应有关。有趣的是，许多从业者在给马开 PBZ 的同时还开奥美拉唑（OME），以预防 EGUS 的发生。然而，这种在患有慢性跛行的蒙古马身上的应用的疗效和安全性尚不清楚。
评估 PBZ 和 OME 联合治疗蒙古马慢性跛行的临床效果。
随机分组实验设计。
18 匹跛行评分≥3 分的蒙古马，随机分为三组，每组 6 匹马：安慰剂（CON）、PBZ（4.4mg/kg PO q. 24h）或 PBZ 加 OME（4mg/kg PO q. 24h；PBZ+OME）。根据初始跛行评分，马匹采用随机分组块设计进行治疗。在治疗期间，每周进行一次胃镜检查和生理生化检查。
与治疗前相比，PBZ（中位数 1.0，四分位距 [IQR]：0.8-1.3；p=0.01）和 PBZ+OME（中位数 1.0，IQR：1.0-1.0；p=0.01）均显著降低了跛行评分。此外，PBZ 显著增加了马腺胃疾病（EGGD）评分（3.0±0.6，p<0.001）、GT-17 含量（293.4±21.8pg/mL，p<0.001）和胃蛋白酶原-1（PG1）含量（295.3±38.3ng/mL，p<0.001），与 CON 或 PBZ+OME 相比。然而，它显著降低了总蛋白（53.6±1.5g/L，p<0.05）和白蛋白（25.5±1.8g/L，p<0.05）含量。然而，与 PBZ 相比，PBZ+OME 显著降低了 EGGD 评分（0.3±0.5，p<0.001），显著增加了胃液 pH 值（7.3±0.5，p<0.001）、总蛋白含量（62.5±4.6g/L，p=0.009）和白蛋白含量（29.4±1.1g/L，p=0.004）。同时，它们显著降低了胃泌素 17（GT-17）（162.0±21.0pg/mL，p<0.001）和 PG1（182.4±22.5ng/mL，p<0.001）的含量。
马匹个体差异较大，但样本量较小。每个指标的观察间隔较大。
与单独使用 PBZ 相比，PBZ+OME 对慢性跛行没有治疗作用；然而，它减少了蒙古马 EGUS 的发生。通过增加 pH 值、降低血清 PG1 和 GT-17 含量以及防止髓过氧化物酶含量降低，马匹可能会预防慢性跛行和 PBZ 诱导的 EGUS。
