EQUINE | Abstracts
Misoprostol is superior to combined omeprazole‐
sucralfate for the treatment of equine gastric glandular
disease
G. Varley, I. M. Bowen, J. L. Habershon‐Butcher, V. Nicholls, G. D. Hallowell
Background
Previous studies have demonstrated a poor response
to healing of gastric glandular lesions with oral
omeprazole and other medications.
Objectives
To evaluate the efficacy of two novel treatments
(misoprostol [M] and combined omeprazole‐sucralfate
[OS]) in horses for gastric glandular disease.
Study design
Prospective, clinical study.
Methods
Sixty‐three sports horses with grade >1/4 glandular
disease were identified by gastroscopy. Horses received
either 5 μg/kg of misoprostol per os BID 1 h prior to
feeding or a combination of 4 mg/kg enteric coated
omeprazole per os SID and 12 mg/kg sucralfate per os
BID where drugs were given 1 h prior to feeding and
sucralfate given 60 min after omeprazole; allocation
was dependent upon centre. Gastroscopy was repeated
at 28–35 days. Evaluators of the gastroscopy images
were blinded to the treatments the horses received and
images were reviewed independently.
= 11 [2.8–45]) and improvement (P = 0.006; OR = 11
[1.9–59]) of lesions were associated with resolution of
clinical signs. Misoprostol was shown to be superior
to combined omeprazole‐sucralfate both for healing
(M – 72% [95% CI 43–67] and OS – 20% [95% CI
7–41]; P<0.001) and improvement (M – 98% [95% CI
90–100] and OS – 65% [95% CI 43–83]; P<0.001).
Main limitations
Relatively small, clinical study, reliance on client
questionnaire data, clients not blinded to the
treatments the horse received, diet could have affected
drug pharmacodynamics although mimics clinical
practice and no validated scoring system available for
glandular lesions.
Conclusions
These results suggest that gastric glandular disease
does indeed result in clinical signs. In this population
of horses, misoprostol was superior to omeprazole
and sucralfate and warrants further evaluation in a
large scale, multi‐centre trial.
Results
The most common presenting sign in both treatment
groups was poor performance (Overall – 65.1%; M –
60.5% and OS – 75%). Overall healing (P<0.001; OR
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