EGUS: clinical signs, diagnosis, treatment and prevention

Gastric mucosal disease is frequently recognised in equine practice, especially, but not exclusively, in actively performing race and competition horses. Although true ulceration is commonly seen in squamous mucosal disease (Figure 1), its subjacent glandular mucosal neighbour is affected more frequently by inflammatory and erosive lesions (Figure 2). Research efforts have helped provide us with a better understanding of the aetiology of many of these cases, although some remain mysterious. Similarly, treatment and management changes with a sound evidence basis can be implemented with a high degree of success in many, but not all, horses suffering from the syndrome. Initial suspicions of gastric mucosal disease are often based on signs such as poor performance, picky appetite, mild weight loss, sensitivity to girthing, poor coat, temperament changes or even colic, although none of these are very sensitive or specific for gastric disease.