Evaluation of a technique for percutaneous endoscopic gastrostomy tube placement in horses

Summary Inhibition of gastric acid and increased stomach pH>4.0 is currently accepted as the mainstay of treatment for gastric ulcers in horses. Measurement of gastric pH is complicated and requires placement of a cannula and collection of gastric juice or placement of pH electrodes in the stomach. Since the distance from the nares to the stomach is approximately 200 cm, finding a system with a pH electrode with this length is difficult, not to mention difficult to maintain. There has been a fascination with the measurement of gastric juice pH in horses that has covered three‐quarters of a century starting with a fistula model in 1933 and culminating in a recent technique described in this issue. Placement of gastric cannulas and various pH electrodes have been used to measure gastric juice pH in horses in the past and present, but the future may require more sophisticated methods as we look at the efficacy of different formulations of acid suppressive drugs for treatment of equine gastric ulcer syndrome.

Section: Introductionmentioning

confidence: 97%

Gastric juicepHmeasurement in horses: Three‐quarters of a century of history!

Andrews

2015

“…A similar PEG technique without first creating a gastropexy has previously been described (Toth et al . ). However, in pilot investigations using this technique, the authors of this study twice experienced displacement of the PEG tube since it was not adequately secured within the stomach.…”

Section: Methodsmentioning

confidence: 97%

Placement of an indwelling percutaneous gastrotomy (PEG) tube for the measurement of intra‐gastric pH in two horses

Sykes

McGowan

Mills

2015

Summary Intra‐gastric pH monitoring is an important tool in the validation of acid suppressive drugs. To date, several methods of monitoring intra‐gastric pH in the horse have been described. However significant limitations are present in the existing models. This article describes the placement of a percutaneous gastrotomy (PEG) tube secured with a button gastropexy in the standing horse through which the pH of the ventral stomach can readily be measured under both fed and fasted conditions.

“…A potential alternative technique, percutaneous endoscopic gastrotomy (PEG), has recently been described in the horse (Toth et al . ). However, despite the complication rate associated with the use of PEG and oesophagotomy in other species being similar (Minar et al .…”

Section: Modes and Targets Of Nutritional Supportmentioning

confidence: 97%

Nutritional support for the dysphagic adult horse

Pirie

Jago

2015

Summary The dysphagic horse will frequently require nutritional support due to a failure to ingest either sufficient or any feed at all to meet its daily energy and protein requirements. There are a variety of means by which this nutritional support can be provided, the choice of which is largely dependent on the cause of the dysphagia, anticipated duration of the dysphagia, metabolic demands of the underlying disease/disorder associated with the dysphagia, any financial restraints and facilities available. This manuscript provides an overview of the various means by which nutritional support can be provided and highlights some of the advantages and disadvantages of each which may be considered when choosing the most appropriate approach.