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Discussion on Question: could endoscopy prep. cause or aggravate ulcers?
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Member:
ekaufman
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Posted on Sunday, Dec 9, 2007 - 8:57 pm:
So I have a question about EGUS diagnostics. The context is that my current competition horse (a moderately hot Holsteiner mare) has seemed a little "off" to me. She is sound, eating, and bloodwork is unremarkable (except a slightly below normal platelet count). No clinical symptoms except that she is crabbier, less interested in her food, and generally less happy and more resistant than normal. Her general condition is very good, so this is all behavioral stuff.
Of course EGUS seems like a likely issue, but I am resistant to an endoscopy: won't the 24hrs off food and 12hrs w/o water required in advance of the procedure either cause ulcers or aggravate existing ones? Can they tell the difference? Isn't this just torture for a horse I already suspect to be uncomfortable?
I plan to treat her w/o an endoscopy, and watch for any improvement, but it would be nice to have a more humane diagnostic....
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Member:
teddyj1
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Posted on Monday, Dec 10, 2007 - 9:56 am:
Elizabeth,
maybe you could ask your Vet about the new Succeed Fecal Blood Test for ulcers? Dr. O' made an update of on the ulcer page re; this product. I'd say it's worth checking into, besides it's only $40, and you can do it your self.
I can totally relate- my Holsteiner is ulcer prone.
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Member:
ekaufman
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Posted on Monday, Dec 10, 2007 - 10:01 am:
Hi TOD,
I discussed that test with my vet. She is willing to try it, but it comes to her in a 20pack (at $10 cost each), so it takes more than one client for the test to make sense for her.
She also was concerned at the lack of testing that would support their accuracy as an EGUS diagnostic-- do all ulcer horses test positive? We don't know. Do non-ulcer horses test negative? We don't know. What other conditions can effect the test? Etc..
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Member:
teddyj1
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Posted on Monday, Dec 10, 2007 - 10:25 am:
Tell your Vet the only way to answer these questions is to start using it (LOL) 
Seriously, I totally understand all the questions surrounding the test, but I'd say if you used it and it came back positive, and you already suspect ulcers, then it would probably confirm your suspicions?
Maybe your Vet could contact the Rep; and explain her reluctance as to the reliability of the test, and ask for a "Sample Test" to try and see what she thinks about??
Just think how awesome this would be if this product really does work, I think until Vets start using it in the field then these questions will never be answered.
I'd try one just to see the results for myself if my guy starts acting "ulcery"- what harm could it really do?? If I thought he had ulcers and it came back +, then I'd go ahead with Gastrogard, if it came back negative, I might look at other possibilities, or consider Scoping him.
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Member:
ekaufman
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Posted on Monday, Dec 10, 2007 - 2:18 pm:
Hi TOD,
Yeah, but that's not science!
If we check horses only when they have symptoms, and do not follow up with scoping, we're selling little paper strips, but not proving anything about the horse or the test, I'm afraid. I think the company should do some real trials-- if they turn out well, I will buy fists-full of their little strips with confidence.
For less than $40 + a ziploc bag I can get a basic fecal exam at the CSU diagnostic lab, if we think occult blood is significant.
But my real question was whether scoping might cause or aggravate the problem it's intended to diagnose....
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Member:
stevens
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Posted on Monday, Dec 10, 2007 - 6:02 pm:
Elizabeth,
About a year ago there was some research done on a urine glucose test for ulcers. I couldn't find a local vet familiar with the protocol at that time, but you may want to do an internet search and see if anything new has happens in the elapsed time.
Good Luck,
Chris
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Member:
teddyj1
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Posted on Monday, Dec 10, 2007 - 8:10 pm:
Sucrose Permeability Test- my Vet told me that this test was way too complicated- first the horse gets tubed with sucrose, then you have to wait several hours and the horse is then catheterized to collect the urine, the horse is sedated during some of this process, and it is performed in clinic- so no advantage to the horse.
As for what stress does scoping cause; well let's think about this. The horse is transported to the clinic, where it is fasted 12 hours, then sedated and scoped, then not allowed to eat for several more hours, then finally trailered back home- hum seems stressful to me. My Vet had to perform 3 scopings last winter on my gelding- and I hated what he was put through- obviously if acid levels in the stomach DrOp in as little as 2 hours, then 12+ hours is definitely going to aggravate the stomach more. Then there's the question of trailering, and changing the horse's environment- both of which are linked to EGUS.
I don't think there's much doubt this is very stressful.
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Member:
ekaufman
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Posted on Monday, Dec 10, 2007 - 8:47 pm:
Hi TOD,
CSU requests a 24 hour fast with 12 hours off water prior to endoscopy. The horses get pretty stressed....
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Member:
teddyj1
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Posted on Monday, Dec 10, 2007 - 10:29 pm:
My Vet here in CT, only made us wait 12 hours, and we did 3 scopings in 3 months, but by the entire process was over it had been closer to 24 hours since he had eaten. I'm not sure why CSU requires 24 hours of fasting, at 12 hours my horse's stomach was empty, clean as a whistle. This is why I am really hoping this new Fecal Test is as accurate as they claim. I realize the jury is still out, but my goodness, if it's even 75% accurate, I think I'd go with that over another scoping.
The good news for me is that I'll never put my horse in the environment he was in when the ulcers occurred, so hopefully we'll never revisit this issue again.
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Moderator:
DrO
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Posted on Tuesday, Dec 11, 2007 - 6:45 am:
Hello Elizabeth,
From a health aspect the 24/12 hours without feed/water is an acceptable procedure and still the best way to diagnose the problem. The changes that occur over the 24 hours are minor and should be figured in to the baseline of normal.
If you are concerned about worsening the problem during this time you could discuss with the folks giving omeprazole or ranitidine during the preceeding 24 hours. I would thing that the less than one day course will not effect the results that much.
DrO
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