Equine gastric disease treatment grows more lesion-specific

Treating equine gastric disease still comes down to a familiar formula: make the diagnosis first, then match drug therapy and management changes to the lesion type. A recent sponsored educational update from The Horse reinforces that point for equine practitioners, while newer literature continues to sharpen the distinction between equine squamous gastric disease, or ESGD, and equine glandular gastric disease, or EGGD. Across the evidence base, gastroscopy remains the diagnostic standard, omeprazole remains central to ESGD treatment, and glandular disease often requires a more nuanced plan that can include sucralfate or misoprostol alongside management changes. (pubmed.ncbi.nlm.nih.gov)

Why it matters: For veterinarians, the practical message is that “ulcers” aren’t one condition, and response to treatment can differ substantially by location and underlying pathophysiology. Reviews and clinical studies have found that ESGD generally responds well to acid suppression, while EGGD is less predictable; one PubMed-indexed study reported higher healing and improvement rates with misoprostol than with combined omeprazole-sucralfate in horses with glandular disease. At the same time, recurrence after stopping therapy remains a real problem, and a newly published blinded, randomized, placebo-controlled trial found that a lecithin-pectin-meadowsweet nutraceutical did not significantly prevent recurrence on gastroscopy after omeprazole treatment, despite changes in salivary biomarkers. (pubmed.ncbi.nlm.nih.gov)

What to watch: Expect continued attention on lesion-specific protocols, recurrence prevention, and whether adjunctive nutraceuticals can show clinically meaningful benefits beyond biomarker changes. (pubmed.ncbi.nlm.nih.gov)