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Discussion on New way to Test for Gastric Ulcer?

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Susan Jeys
Member
Username: Sjeys

Post Number: 33
Registered: 1-2005
Posted on Wednesday, May 31, 2006 - 2:23 pm:   Edit PostPrint Post

Journal of Veterinary Internal Medicine: Vol. 20, No. 2, pp. 388–394.

Sucrose Concentration in Blood: A New Method for Assessment of Gastric Permeability in Horses with Gastric Ulceration
M. Hewetson, N.D. Cohen, S. Love, R.K. Buddington, W. Holmes, G.T. Innocent, and A.J. Roussel



ABSTRACT

A urine sucrose test has recently been reported to be a reliable method of detecting gastric ulcers in horses; however, technical difficulties associated with urine collection have limited the practical value of the test. The objective of this pilot study was to determine whether gastric sucrose permeability, as evaluated by serum sucrose concentration, could be used to detect gastric mucosal injury in horses. Twelve adult horses with naturally acquired gastric ulceration were studied. After a 20-hour nonfeeding period, each horse was dosed with 250 g of sucrose via nasogastric intubation. Blood samples were collected at 0, 15, 30, 45, 60, and 90 minutes, and horses underwent gastroscopy 4 hours later. The severity of gastric ulceration in each horse was defined by means of a 4-point ulcer-scoring system, and the relationship with serum sucrose concentration was analyzed by means of a linear mixed-effects model. Serum sucrose concentration was measured by liquid chromatography operating in tandem with electrospray mass spectrometry. After nasogastric administration of table sugar, horses with moderate to severe gastric ulceration had significant increase in serum sucrose concentration at 30, 45, 60, and 90 minutes, relative to earlier times (P < .05). Peak sucrose concentration was observed at 45 minutes, and was correlated with ulcer severity (Spearman's rank correlation coefficient = 0.898, P < .05). These data indicate that determination of sucrose concentration in equine serum may be a useful test for identifying horses with endoscopically visible gastric ulceration and has potential use as a noninvasive method for screening and monitoring horses engaged in racing training and other performance-related disciplines..


Keywords: Blood, Gastric ulceration, Horse, Sucrose.


Manuscript Received by the Society April 17, 2005
Manuscript Accepted August 9, 2005

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Chris Stevens
Member
Username: Stevens

Post Number: 32
Registered: 8-2002
Posted on Wednesday, May 31, 2006 - 6:51 pm:   Edit PostPrint Post

Susan,

I tried to get the sucrose urine test performed on a horse I purchased last fall who had a previous gastric ulcer. I couldn't get the vet to go for it. In addition to not having the protocol for performing the test, or the sucrose, or the lab ...

Hopefully, this new blood test will be more widely available although I'd question whether a sample size of 12 is statistically significant.

Chris
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Susan Jeys
Member
Username: Sjeys

Post Number: 36
Registered: 1-2005
Posted on Wednesday, May 31, 2006 - 7:44 pm:   Edit PostPrint Post

I'm getting my horse scoped tomorrow (today he is sans food and water, which is about the worst thing I can think of for an ulcer prone horse) and will ask about it. I'm willing to buy it especially when urine (though harder to obtain) showed the same correlation between ulcer severity and sucrose.
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Chris Stevens
Member
Username: Stevens

Post Number: 33
Registered: 8-2002
Posted on Thursday, Jun 1, 2006 - 9:42 am:   Edit PostPrint Post

Good Luck! I hope you get good news.

My boy was scoped for diagnostics, treated with Gastroguard, then rescoped at the end of the treatment. No problems since and it's been close to 6 years.
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Robert N. Oglesby DVM
Moderator
Username: Dro

Post Number: 15757
Registered: 1-1997
Posted on Thursday, Jun 1, 2006 - 12:27 pm:   Edit PostPrint Post

Hello All,
This summary, which appeared in PubMed last month, is currently in our list of edits. However prior to publishing this, I am trying to find where sucrose testing is done regularly. Sucrose is just simple table sugar but I don't know any lab that tests for it. The standard test is for glucose which does not measure sucrose directly. Sucrose a disaccharide would be converted to the monosaccharides glucose and fructose in the small bowel and absorbed so I don't think glucose levels would be useful. So far all the labs I have contacted do not know of a blood or urine test for sucrose but I still have several feelers out.
DrO
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Susan Jeys
Member
Username: Sjeys

Post Number: 38
Registered: 1-2005
Posted on Sunday, Jun 4, 2006 - 6:36 pm:   Edit PostPrint Post

Well, Good news and Bad, Calvin broke out and ate some grass and got some water before the test. He was supposed to be fasted for 24 and no water for 12 before the test. They could rinse away things from inside the stomach using the scope, so we saw 3/4 of his stomach anyway.

He had 3 very small pinpoint ulcers. The vet said there's a possibility that there could have been a monster ulcer behind the chunk of grass in the last quarter of the stomach we couldn't see, but more likely if there were ulcers there, they'd be the same type and scope as the ulcers we'd already seen.

His stomach was smooth and white with a darker pink part and just the 3 pinpoint ulcers. He thought I could get away with 1/4 tube of UlcerGard, due to the light ulcers. Here's hoping. The vet said it sure sounded like ulcers based on his previous turnaround once he was started on gastroguard. He suggested trying 1/4 tube a day (and even suggested 1/4 every other day on maintenace dose) of UlcerGard.

I'm surprised that he would be so bothered by these, but of course, I haven't been working him and he doesn't really start to show serious discomfort until I do work him and by then, he probably has developed more.

We're going to just go as quietly and long and low as possible (as usual) and see if we can get these taken care of...If the 1/4 tube doesn't work I'll try the pectin lecithin soon. Thanks!
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Chris Stevens
Member
Username: Stevens

Post Number: 38
Registered: 8-2002
Posted on Monday, Jun 5, 2006 - 10:52 am:   Edit PostPrint Post

Susan,

I don't think it would be unusual for him to show discomfort when worked. There is evidence that stomach acid gets sloshed about when the horse moves faster than a walk.

You may want to try an acid reducer. My boy's been on 16 generic Cost-co brand ranitidine tablets twice daily since his ulcer. So far so good.
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Cindy Richards
New Member
Username: milanne

Post Number: 1
Registered: 1-2007
Posted on Friday, Jan 26, 2007 - 11:53 am:   Edit PostPrint Post

If you go the gastro gaurd route what is the chance of this actually being cured. Im looking at a new horse we just got and found out after about the ulcer problem . has already been teated for 3 30 day periods and the horse is only 5 years old. This is a school horse situation and although he is an awsom horse for us to have will i ever have a horse back that can really work. His manner is quiet and very calm, he is on all hay now at vet's advise. He was working a max of 2 hours a day. Any advice
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Chris Stevens
Member
Username: stevens

Post Number: 223
Registered: 8-2002
Posted on Saturday, Jan 27, 2007 - 12:55 am:   Edit PostPrint Post

Hi Cindy,

Well, I only have 1 experience with this. As I noted above, my horse was diagnosed with an ulcer via scope, treated with gastro-guard then the over the counter ranitidine from then on. I've had him for a little over 1 year now and haven't had any problems. Since he was scoped before and after the gastro-guard, I'd have to say "yes" it cured him. Since he hasn't had a recurrence, it's hard to say whether the ranitidine has actually been a preventative and I'm not willing to stop it to find out.

What was the horse treated with? Was the horse treated for 3 consecutive 30 day periods, or has he been treated 3 times, each time for 30 days?

Chris
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Robert N. Oglesby DVM
Moderator
Username: dro

Post Number: 17622
Registered: 1-1997
Posted on Saturday, Jan 27, 2007 - 6:09 pm:   Edit PostPrint Post

The prognosis for treatment is in the article on gastric ulcers Cindy.
DrO
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