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Discussion on Succeed- Equine Fecal Blood Test , do it yourself Ulcer sceening
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Member:
teddyj1
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Posted on Friday, Nov 23, 2007 - 8:34 am:
Hope everyone enjoyed their Thanksgiving 
Has anyone heard about, or better yet, used the new Succeed Equine Fecal Blood Test for detecting ulcers?
The new test sounds great; do it your self test strips that can detect minute amounts of blood in the stool which may be caused by gastric/colonic ulcers, parasites, post colic surgery.
They retail for about $40 through Veterinarians.
I haven't heard of any of my local Vets using this product, but if it's as accurate as Succeed claims, it sure would make diagnosing/treatment of ulcers, and other digest problems much faster, easier, and cheaper, than performing endoscopy.
the website is www.succeedfbt.com
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Member:
canter
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Posted on Friday, Nov 23, 2007 - 9:45 am:
Just read about this, somewhere. In the article, it had some cautions about it not being a definitive diagnostic tool...I'll have to dig up the article and post again so I get the details correct.
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Moderator:
DrO
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Posted on Sunday, Nov 25, 2007 - 8:27 am:
Hello TOD,
This is an interesting piece of new technology that awaits confirmation as to its usefulness in diagnosing ulcers and other bleeding conditions of the equine digestive tract. Traditional fecal blood testing in horses is very inaccurate a problem this test is claimed to have fixed and the technology should be capable of doing what they claim. On top of that it claims to be able to differentiate blood from the upper and lower gi tract. It is easy to see how this might be helpful in diagnosing ulcers but am uncertain how accurately it can do this.
The claim of detection of blood down to 10 x 7 dilution means that one DrOp of blood can be picked up in about 1,000 liters of diluent. If true of equine feces this is a very sensitive test.
But even if we assume the companies information is completely accurate important unanswered questions remain. Most species frequently have small amounts of gi bleeding in health which may lead to positives in healthy horses. What is the frequency of positive tests in horses showing no signs of disease? Looking at the other side of the coin do horses with clinical problems from gastric ulcers always release enough blood to be detected by the test?
So the question remains will this test's sensitivity and specificity differentiate disease conditions from healthy states of bleeding. I went to see if there were any published scientific papers on this new technology and cannot find any. For more on our recommendations on the use of this test and diagnosis of gastric ulcers in horses see the article, Gastric Ulcers in Adult Horses available off the navigation bar at the top of this page.
Here is the information Freedom Health has released to the veterinarians:
Freedom Health, LLC, Introduces SUCCEED Equine Fecal Blood Test
New Technology Detects Fecal Occult Blood to Help Identify GI Health Conditions in Horses
FOR IMMEDIATE RELEASE
Media Contact:
Equine Resources International, LLC
610-444-7554
cassie@equineresources.com
Aurora, OH (September 4, 2007)—Freedom Health, LLC, recently announced the launch of the SUCCEED® Equine Fecal Blood Test™. Available exclusively through veterinarians, this diagnostic aid allows practitioners to detect occult blood in an equine fecal sample, and identify the general location of its source within the digestive tract in horses. The SUCCEED Equine Fecal Blood Test can help veterinarians diagnose GI tract conditions, including both gastric and colonic ulcers. This is the only method available to detect occult blood from a source in the colon, which is one of the symptoms of highly prevalent colonic ulcers.
“After years of careful research and testing, we’re confident that we have brought a dependable and effective product for veterinarians to the equine market,” said John Hall – President, Freedom Health. “The SUCCEED Equine Fecal Blood Test provides veterinarians with a minimally invasive tool to help diagnose digestive conditions—including those that may be located in areas caudal to the duodenum. No other testing method currently available can reliably identify occult blood originating in this region, or distinguish between cranial and caudal occult blood sources in the equine GI tract.”
Studies have shown that 97 percent of horses involved in competition sports—from dressage to racing—suffer from either gastric or colonic ulcers, and 63 percent of these performance horses have colonic ulcers1. Many veterinarians currently rely on gross observation and treatment response for diagnosing many GI tract conditions, including ulcers. While gastric ulcers can be diagnosed via gastric endoscopy, this is a potentially expensive and invasive procedure, and few field veterinarians have a 3-meter endoscope. Further, no method has existed for confirming the presence of colonic ulcers in live horses.
The SUCCEED Equine Fecal Blood Test provides additional, objective information to aid in the veterinarian’s diagnosis. The test features Freedom Health’s proprietary SmartSignal™ Technology, which detects occult blood in horse manure as an indication of GI tract conditions. Two separate test strips in each kit detect two different protein markers unique to equine blood, which can distinguish occult blood from a source cranial or caudal to the duodenum. This distinction can help veterinarians to determine whether the horse may be suffering from gastric or colonic ulcers.
The test kit is a simple rapid field dip test. A fecal sample is collected from the subject horse, placed in the provided container and mixed with water. The two test strips are dipped into the mixture, and results are evident in ten minutes. Freedom Health is releasing the SUCCEED Equine Fecal Blood Test only to veterinarians—who are the best resource for diagnosing and treating equine health issues. However, because the test is easy to use and read, veterinarians are likely to allow their clients to administer the test themselves, and contact the veterinarian with the results.
The SUCCEED Equine Fecal Blood Test can detect occult blood diluted into a sample at the lower limit of 10-7. Both test strips A and B have a zero percent of false positives compared with the Guaiac acid test, which results in false positives in 65 percent of the tests.
For more information on the SUCCEED Equine Fecal Blood Test Kit, including in-depth articles on digestive tract health and interactive presentations, visit www.SucceedFBT.com. Information may also be obtained by calling toll-free, 877-734-6558.
The SUCCEED Equine Fecal Blood Test and SUCCEED® Digestive Conditioning Program® are produced and distributed exclusively by Freedom Health, LLC of Aurora, Ohio. This company is focused on finding, perfecting and delivering superior, innovative products that address real and significant health-related issues for animals and the people who care for them.
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1. Pellegrini, Franklin L. Results of a Large-Scale Necroscopic Study of Equine Colonic Ulcers. J Equine Vet Sci 2005; 25 (3) 113-117.
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Member:
teddyj1
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Posted on Sunday, Nov 25, 2007 - 10:52 am:
Thanks for your insight Dr. O.
I guess if I were going to use this test, it would be if the horse were showing clear Ulcer symptoms, and then depending on the outcome of this test, plan endoscopy to confirm, or perhaps in a horse already confirmed as being ulcer prone, use it to decide when to more accurately use Ulcergard/Gastrogard.
Please keep us informed if you have any success with Succeed EFBT, or if it proves a total waste of time.
Thanks
TOD
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Member:
kamibroo
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Posted on Sunday, Nov 25, 2007 - 7:46 pm:
I just read a post elsewhere where someone and their vet was attempting to use it in a suspected ulcer case (chronic colic episodes). She is hoping to avoid a 3hr drive to get the horse scoped.
There apparently are two different tests for fore gut and hind gut? She posted that the hind test worked (or developed) as negative and they did not suspect ulcers in that area.
She posted that the fore test did nothing. A normal test would develop 1 or 2 lines depending on if blood is or is not detected. The test did not develop any lines at all. Then, they tried a second one and it also did nothing.
They are now waiting for the company to send replacement strips so they can attempt the test again.
I'm glad this has been brought up here because I'm having trouble understanding how upper GI bleeding can be accurately detected and what a positive means. I'm taking it as what the name implies "fecal blood test"... now what you interpret from a positive or negative result is another thing.
I think this is one of those 'nice added tools' but don't think its going to replace diagnostics that are already out there. Especially if they are shooting for 0% false positive, that makes me think they'd rather miss a real problem that mistakenly identify one that isn't there.
As a rule, I always assume ulcers and manage (with diet/hebals (sorry)) the horses for them.
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Member:
teddyj1
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Posted on Monday, Nov 26, 2007 - 3:06 pm:
I was only thinking it would be useful as a "screening test", not for a definitive diagnosis, because I think putting a horse, and more over the owner of the hassle of a scoping when this might tell you you shouldn't bother, or when you suspect a relapse, I'm thinking it would be best not to medicate for something that's not the problem, along with the cost of Ulcergard/Gastrogard your money could be better spent in other diagnostics.
Having said this, I too am skeptical as to how this test can differentiate where and why there is blood in the stool.
I've just become ultra paranoid, as my horse developed ulcers while at an indoor 2 winters ago, I decided after that we would take the dead of winter off, rather than live like a caged animal all winter long. The farms up here are stingy with their hay, and turn out during the winter.My horses live at home(no indoor) with access to 24/7 turn out if they choose, and "free choice" hay
Believe me, hauling a horse for a scoping when it's -10 below, with 30mph winds really sucks, I know because I've done it
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Moderator:
DrO
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Posted on Monday, Nov 26, 2007 - 3:14 pm:
Hello USHO,
The test comes with two strips and I understand that one test detects blood released above the level of the pancreas and the other detects blood released below that level. Since these are immunoassays I presume that the blood exposed to the environment above the pancreas develops different antigenic markers on the surface than those below. This is credible though I look forward to learning more about the details. Interesting to hear about the problems they are having with the test. The test strips have two test area bands. The first changes color if blood is present The second band acts as a control and if it does not develop color the test is not working properly.
Your question of the significance of the presence of gi blood remains and this is going to require some fairly large studies that correlate the tests results not with the presence of blood, but with the presence of disease. Since many clinically normal horses have ulcers and the degree of ulceration does not correlate well with clinical signs, I think you can see that, with our current state of knowledge, it will be difficult to accurately test the test. After all it remains uncertain what the results of an endoscopic exam are and must be interpreted in light of signalment, history, and clinical signs.
Adjusting dietary and other management factors to ameliorate the effect of ulcers makes perfect sense, see the article for our recommendations. But I am unaware of any herbs that have shown a positive effect on Equine Gastric Ulcer SynDrOme. I know there is some research into herbs and ulcers but the very different mechanism of EGUS type ulcers and those of humans (and mice) make it impossible to extrapolate those results. It really is two different diseases with similar pathology.
DrO
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Member:
sbower
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Posted on Friday, Feb 8, 2008 - 8:37 pm:
Well, I don't quite know what to think but I just did this test on my horse and both sticks were negative. I was very surprised as I thought he had relapsed. I treated him a year ago with gastroguard with very good results (weight gain, better performance and appetite and overall a MUCH happier horse).
Recently he had showed similar signs as before so I figured the ulcers were back. He stopped gaining weight (still skinnier than he should be especially given the amount of food he gets). Plus he's picking at his food and eating very slowly. Just not his normal self. The vet said even his back pain could be related to having ulcers.
So right now I have a horse that isn't thriving with back/hock pain, poor appetite, under performing and still too thin..... but I guess no ulcers! Vet suggested we do a fecal and Lyme test so that's next. We did inject his hocks as he had a positive flexion test on both sides (both 3/5). I have some question about lyme so I'll post that separately. I know some of you are thinking EPM but that was negative too.
Meanwhile I see no literature that suggests false negatives on the Succeed test? Is is possible that he has ulcers and yet no blood in his manure?
As to correlating the test with the presence of the disease (not the presence of blood) ... they apparently did necropsy on 85 horses and published it. It was difficult to find on their website so I'm wondering if Dr O saw it and could comment on its validity?
https://www.succeedfbt.com/Necropsy%20Study%20071127.pdf
I did find it interesting that at their website
https://www.succeedfbt.com/resources.asp they list a Equine and Horse Advice discussion about "Ulcers and post colic surgery" .... guess they read here!
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Member:
sbower
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Posted on Tuesday, Feb 12, 2008 - 3:45 pm:
Dr O
I'm having trouble interpreting this study.
https://www.succeedfbt.com/Necropsy%20Study%20071127.pdf
Is it really saying that it only predicts 77% of gastric ulcers? Is it inaccurate because the blood could be from other sources? And is it possible to tell from this study what the incidence of false negatives is?
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Moderator:
DrO
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Posted on Wednesday, Feb 13, 2008 - 8:32 am:
Actually none of the information you ask about is available in this study Shelly. Since the study is on dead horses the research needs to be correlated in horses that actually have problems. The study does indicate that this test may have a useful part in the diagnosis of ulcers however.
On the dead horses studied it finds:
A positive Hg detection will correctly predict ulcers in the colon AND/OR stomach 77% of the time. It also says a positive Alb detection will correctly predict compromise of the colon 95% of the time. It does NOT say how accurately this test predicts ulceration of the stomach since you cannot differentiate ulcers in the colon from ulcers in the stomach (Hb and Alb both positive).
If we suppose that these results can be applied to your negative findings in your horse and assuming the test is working (see notes above) the number of horses that had significant stomach ulcers and a negative test for both is less than or equal to 8/54ths or about 15% (I don't have a calculator).
DrO
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