Gastric Ulceration in Foals

Gastric Ulceration in Foals


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Basic Information image



Definition


Disruption of the gastric mucosa, potentially extending into the lamina propria



Synonym(S)


Gastroduodenal ulcer disease (GDUD)



Epidemiology



Species, Age, Sex


Most common in foals ages 1 to 6 months but is also occasionally seen in younger foals



Risk Factors




• Gastrointestinal (GI) disease, especially diarrhea


• Nonsteroidal antiinflammatory drug (NSAID) therapy


• Anorexia or withholding of enteral nutrition



Associated Conditions and Disorders


Neonatal encephalopathy (neonatal maladjustment syndrome) and sepsis in young foals



Clinical Presentation



History, Chief Complaint




• Colic


image Variable severity but usually more severe than in adult horses with gastric ulceration.

image May be manifest as increased periods of recumbency.

image Young foals with gastric ulcers are often observed to roll onto their backs or lie in dorsal recumbency, but this may also be observed in foals with colic due to other causes.

• Bruxism


• Hypersalivation


• Inappetence


• Diarrhea is commonly associated with GDUD in foals in contrast to the case in adult horses.


• Poor condition if the case is chronic and severe.


• In contrast to adult horses, foals with GDUD almost always show related clinical signs.



Physical Exam Findings




• Tachycardia and tachypnea are common during colic episodes


• ± Fever


• ± Evidence of diarrhea


• Poor body condition and rough hair coat may be present in severe cases



Etiology and Pathophysiology




• Similar to adult horses, in which an imbalance between innate gastroprotective factors and injurious factors such as hydrochloric acid and proteolytic enzymes (pepsin) occurs


image Innate gastroprotective factors include the mucus-bicarbonate barrier; adequate gastric mucosal blood flow; and nursing or eating, which rapidly increases gastric pH.

image These protective mechanisms are easily disrupted in foals, with rapid decreases in gastric pH seen in healthy foals with more than 20 minutes of not nursing. This may result in lesions in the glandular mucosa.

image The gastric squamous mucosa undergoes rapid thickening and then desquamation in neonatal foals, which may also predispose them to squamous mucosal lesions.

image Concurrent disease in foals, such as neonatal encephalopathy or sepsis, may significantly disrupt gastric mucosal blood flow and may result in or worsen both glandular and squamous gastric ulceration.

• Duodenal ulceration is uncommon in adult horses but occurs frequently in foals. This may be a direct result of impaired duodenal mucosal defenses and subsequent injury from exposure to gastric acid, or it may be related to more diffuse intestinal disease (bacterial enterocolitis).



Diagnosis image



Differential Diagnosis




• Infectious enterocolitis


• Pyloric stenosis (congenital)


• Small intestinal obstructive lesions



Initial Database




• Complete blood count


image Usually within reference intervals with primary GDUD.

image Mild anemia may be present with severe ulceration, but severe hemorrhage is uncommon.

image Abnormalities in the leukogram, such as leukopenia or leukocytosis, may be present in severe cases of GDUD or may reflect concurrent infectious enterocolitis, sepsis, or other illness.
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Jul 24, 2016 | Posted by in SMALL ANIMAL | Comments Off on Gastric Ulceration in Foals

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