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A pilot study investigating the treatment of equine squamous gastric disease with long-acting injectable or oral omeprazole.

Abstract

BACKGROUND

Equine squamous gastric disease (ESGD) is a highly prevalent disease in horses, particularly in elite athletes. Some horses respond slowly, or fail to respond, to the licensed treatment, oral omeprazole (ORLO).

OBJECTIVES

To compare rates of ESGD healing and improvement between ORLO and a long-acting injectable omeprazole preparation (LAIO).

STUDY DESIGN

Retrospective clinical study.

METHODS

The case records and gastroscopy images of horses presenting to Rainbow Equine Hospital over a 12-month period were reviewed, with images being reviewed blind by one of the authors (David Rendle). Treatment responses were compared between horses that received 2 or 4 injections of 4 mg/kg LAIO at weekly intervals, and horses that received ORLO at 4 mg/kg PO SID for 4 weeks. Data were compared using a Mann-Whitney test with post hoc Dunn's test, chi-squared test or Fisher's exact test.

RESULTS

Fifty-six horses met the inclusion criteria: 29 received LAIO and 27 received ORLO. Treatment groups were comparable in terms of signalment and ESGD lesions. There was a difference in rate of healing when LAIO and ORLO treatment groups were compared at 28 days (LAIO-97%; ORLO-67%; p = .005; OR = 14(1.8-158)), but no difference between LAIO at 14 days and ORLO at 28 days (LAIO-86%; ORLO-67%; p = .12; OR = 3.1 (0.9-10)). Five localised and self-limiting injection site reactions were identified in 3 horses out of 98 injections (5.1%).

MAIN LIMITATIONS

The study was limited by its retrospective nature, absence of randomisation and limited numbers.

CONCLUSIONS

Four weeks of treatment with LAIO resulted in better rates of ESGD healing than 4 weeks of ORLO. Larger more robust studies of LAIO are warranted.

Authors+Show Affiliations

Rainbow Equine Hospital, Malton, North Yorkshire, United Kingdom.School of Veterinary Medicine and Science, University of Nottingham, Nottingham, United Kingdom.Rainbow Equine Hospital, Malton, North Yorkshire, United Kingdom.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31945806

Citation

Gough, Sarah, et al. "A Pilot Study Investigating the Treatment of Equine Squamous Gastric Disease With Long-acting Injectable or Oral Omeprazole." Veterinary Medicine and Science, 2020.
Gough S, Hallowell G, Rendle D. A pilot study investigating the treatment of equine squamous gastric disease with long-acting injectable or oral omeprazole. Vet Med Sci. 2020.
Gough, S., Hallowell, G., & Rendle, D. (2020). A pilot study investigating the treatment of equine squamous gastric disease with long-acting injectable or oral omeprazole. Veterinary Medicine and Science, doi:10.1002/vms3.220.
Gough S, Hallowell G, Rendle D. A Pilot Study Investigating the Treatment of Equine Squamous Gastric Disease With Long-acting Injectable or Oral Omeprazole. Vet Med Sci. 2020 Jan 16; PubMed PMID: 31945806.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A pilot study investigating the treatment of equine squamous gastric disease with long-acting injectable or oral omeprazole. AU - Gough,Sarah, AU - Hallowell,Gayle, AU - Rendle,David, Y1 - 2020/01/16/ PY - 2019/09/02/received PY - 2019/10/03/revised PY - 2019/10/26/accepted PY - 2020/1/17/entrez PY - 2020/1/17/pubmed PY - 2020/1/17/medline KW - gastrointestinal KW - horse KW - proton pump inhibitor KW - stomach JF - Veterinary medicine and science JO - Vet Med Sci N2 - BACKGROUND: Equine squamous gastric disease (ESGD) is a highly prevalent disease in horses, particularly in elite athletes. Some horses respond slowly, or fail to respond, to the licensed treatment, oral omeprazole (ORLO). OBJECTIVES: To compare rates of ESGD healing and improvement between ORLO and a long-acting injectable omeprazole preparation (LAIO). STUDY DESIGN: Retrospective clinical study. METHODS: The case records and gastroscopy images of horses presenting to Rainbow Equine Hospital over a 12-month period were reviewed, with images being reviewed blind by one of the authors (David Rendle). Treatment responses were compared between horses that received 2 or 4 injections of 4 mg/kg LAIO at weekly intervals, and horses that received ORLO at 4 mg/kg PO SID for 4 weeks. Data were compared using a Mann-Whitney test with post hoc Dunn's test, chi-squared test or Fisher's exact test. RESULTS: Fifty-six horses met the inclusion criteria: 29 received LAIO and 27 received ORLO. Treatment groups were comparable in terms of signalment and ESGD lesions. There was a difference in rate of healing when LAIO and ORLO treatment groups were compared at 28 days (LAIO-97%; ORLO-67%; p = .005; OR = 14(1.8-158)), but no difference between LAIO at 14 days and ORLO at 28 days (LAIO-86%; ORLO-67%; p = .12; OR = 3.1 (0.9-10)). Five localised and self-limiting injection site reactions were identified in 3 horses out of 98 injections (5.1%). MAIN LIMITATIONS: The study was limited by its retrospective nature, absence of randomisation and limited numbers. CONCLUSIONS: Four weeks of treatment with LAIO resulted in better rates of ESGD healing than 4 weeks of ORLO. Larger more robust studies of LAIO are warranted. SN - 2053-1095 UR - https://www.unboundmedicine.com/medline/citation/31945806/A_pilot_study_investigating_the_treatment_of_equine_squamous_gastric_disease_with_long-acting_injectable_or_oral_omeprazole L2 - https://doi.org/10.1002/vms3.220 DB - PRIME DP - Unbound Medicine ER -