A recent article was published in the Equine Veterinary Journal was titled, "Misoprostol is superior to combined omeprazole‐sucralfate for the treatment of equine gastric glandular disease." The authors of this paper were Varley, G.; Bowen, I. M.; Habershon-Butcher, J. L.; Nicholls, V.; Hallowell, G. D.
Horses were enrolled onto the study if they presented with clinical signs consistent with equine gastric disease and were subsequently found to have grade >1/4 glandular disease identified by gastroscopy.
Horses were assigned to one of the two treatment groups (5 μg/kg misoprostol orally twice daily or 4 mg/kg enteric coated omeprazole plus 12 mg/kg sucralfate orally twice daily) based on the hospital at which they were initially examined. Gastroscopy was repeated 28–35 days after the initial examination and images were reviewed by clinicians blinded to the treatment received. Owners/keepers were not blinded to the treatments and were asked to complete a questionnaire prior to both gastroscopy examinations. Lesion healing was defined as improvement to a grade 0, and horses were considered to have improved if the score decreased by at least one grade.
A total of 63 horses met the inclusion criteria, with poor performance being the most common presenting sign. All horses had lesions involving the pylorus and/or pyloric antrum, and there was an overall reduction in lesion score in both treatment groups.
Of those treated with misoprostol, 72% of lesions healed, compared to 20% of the omeprazole‐sucralfate group. In addition, 98% of horses in the misoprostol group improved, compared to 65% in the omeprazole‐sucralfate group. Overall healing and improvement of lesions were associated with resolution of clinical signs.
Bottom line: Misoprostol was superior to combined omeprazole‐sucralfate treatment both for improvement and healing of gastric glandular lesions.
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