Prevalence of gastric and duodenal ulceration in 691 nonsurviving foals (1995–2006)

Abstract

SummaryReason for performing study: Gastric ulcer disease is reported to be a significant cause of morbidity in foals, but the prevalence of ulcers in this population has not recently been evaluated. Objectives: To determine the prevalence of gastric and duodenal ulceration in nonsurviving foals, and the association of ulceration with the body system of primary diagnosis. Secondary objectives were to evaluate a potential association between age and ulcer prevalence and to evaluate the use of antacid medication in the neonatal hospital population during the study years. Methods: Necropsy records were searched for all equine accessions from 1995 to 2006. Foals aged from one day to 6 months were included. Year, age, breed, sex, diagnosis and the presence of glandular, nonglandular and/or duodenal ulceration were recorded. Diagnoses were divided into groups based on the body system of primary diagnosis, with multiple diagnoses possible. A computerised database was searched for antacid treatment of all neonatal admissions. Results:The overall prevalence of ulcers was 22%, with nonglandular ulcers predominating. Ulceration was significantly associated with gastrointestinal disease. There was no significant change in ulcer prevalence over time, although there was a significant decrease in the use of antacid medications in the later study years. Neonatal foals (<1 month) had a lower ulcer prevalence than older foals. Conclusions:The prevalence of ulcers in foals, although low, has remained stable over time. Gastric or duodenal ulcers are associated with a primary diagnosis of gastrointestinal disease and are less prevalent in neonates. Potential relevance: The prevalence of ulcers in nonsurviving foals is low. Foals with gastrointestinal disease are more likely to have ulcers than foals with other primary diagnoses, and older foals are more likely to have ulceration than neonates. The prevalence of ulceration did not appear to be related to hospital-wide antacid medication use in neonates.

A review of equine sepsis

“…The use of these drugs is controversial in septic neonatal foals. Recent reports suggest that these medications do not significantly decrease risk of ulcer formation and may increase the risk of diarrhoea (Elfenbein and Sanchez 2012;Furr et al 2012). Therefore, gastroduodenal ulcer prophylaxis in foals should be instituted on an individual basis.…”

The impact of peer‐reviewed literature on equine neonatal care

“…Indeed, particularly in equine neonatal care, it appears that scientific evidence, rightly or wrongly, occasionally lags behind clinical developments, as demonstrated by the contributions of Jose‐Cunilleras et al . (2012), Sanchez and Elfenbein (2012) and Furr et al . (2012) in this supplement.…”

“…There is some, albeit indirect, evidence that this cumulative increase in knowledge over time has been paralleled by an increase in survival, at least in bacteraemic foals (Fig 1).Some of the articles presented here will confirm our clinical impressions and reinforce current clinical practice, whereas others might change the way we view and treat hospitalised foals. Indeed, particularly in equine neonatal care, it appears that scientific evidence, rightly or wrongly, occasionally lags behind clinical developments, as demonstrated by the contributions of Jose-Cunilleras et al (2012), Sanchez and Elfenbein (2012) and Furr et al (2012) in this supplement.…”

Heineke–Mikulicz pyloroplasty for the treatment of pyloric stenosis secondary to gastro‐duodenal ulcer disease in three foals

“…Gastroduodenal ulcer disease (GDUD) in foals have four distinct presentations; silent (subclinical), active (clinical), perforated or strictures from healing ulcers (Becht and Byars 1986). The reported prevalance of glandular or duodenal ulcers in foals at post-mortem is 12% (Elfenbein and Sanchez 2012). The healing process can cause pyloric or duodenal stenosis, which in turn can lead to gastric outflow obstructions.…”