B r a z : I v e t . R e s . a n i m . S c i . ,
S ã o P a u l o , v .
ZYXWVUTSRQPONMLKJIHGFEDCBA
3 6 ,zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA
1/. I ,XWVUTSRQPONMLKJIHGFEDCBA
p . 3 4 - 3 9 , 1 9 9 9 . DEARO,A.Quarter I
GFEDCBA
L e s i o n s ( u I c e r s a n d / o r e r o s i o n s ) a n d d e s q u a m a t i o n s
l o c a t i o n
i n t h e g a s t r i c
m u c o s a
f r o m
a s y m p t o m a t i c
Q u a r t e r
H o r s e
f o a l s :
e n d o s c o p i c
s u r v e y
C O R R E S P O N D E N C E T O :
A n t o n i o C e z a r d e O l i v e i r a D e a r o
D e p a r t a m e n t o d e C l í n i c a Number a
V e t e r i n á r i a . C e n t r o d e C i ê n c i a s age group A g r á r i a s . U n i v e r s i d a d e E s t a d u a l
d e L o n d r i n a .
C a i x a P o s t a l 6 0 0 1 . 8 6 0 5 1 - 9 7 0 - L o n d r i n a - P R e - m a i l : d e a r o a c o @ n p d . u e l . b r
Localização de lesões (úlceras e/ou erosões) e descamações
da mucosa gástrica em potros assintomáticos da raça Quarto
de Milha: estudo endoscópico
1 - D e p a r t a m e n t o d e C l í n i c a
V e t e r i n á r i a d a U n i v e r s i d a d e
E s t a d u a l d e L o n d r i n a - P R 2 - D e p a r t a m e n t o d e M e d i c i n a
V e t e r i n á r i a d a U n i v e r s i d a d e
F e d e r a l d e V i ç o s a - M G 3 - F a c u l d a d e d e M e d i c i n a
V e t e r i n á r i a e Z o o t e c n i a d a U N E S P - B o t u c a t u - S P
Antonio Cezar de Oliveira DEAR01
; Marco Aurélio Ferreira LOPES2 ; Waldir GANDOLFI 3
SUMMARY
Gastric ulcer accounts for an important cause of abdominal discornfort in young horses. Concerning either thc presence
or absence of clinical signs and their variations,the lesions location in lhe gastric mucosa ar.d complications resulting
from ulcerative lesions, four clinical syndromes have been described in foals: I ) Asymptomatic or silent ulcers; 2)
Symptomatic or active ulcers; 3) Perforated ulcers; and 4) Gastric or duodenal obstruction. With the airn of studying the
distribution of lesions (ulcers and/or erosions) and desquamations frorn the non-glandular epithelium in the gastric
mucosa of young horses and a possible relationship between both alterations (lesion/desquamation), sixty Quarter Horse
foals without signs of gastric disease underwent gastroscopy. Foals were divided by age in four groups of 1 5 animals as
follows: 1 to 30 days, 31 to 60 days, 61 to 90 days and 91 to 120 days. Lesions were most prevalent in the strati fied
squamous epithelial mucosa mainly adjacent to the m a r g o p l i c a t u s along the greater curvature followed by squamous
mucosa next to the cardia along the lesser curvature, glandular and non-glandular fundus and antrum. Regions of the
fundus and m a r g o p l i c a t u s were similarly affected by desquamations. There was no association between lesions and
desquamations occurrence.
UNITERMS: Stomach ulcer; Endoscopy; Foals; Stomach; Ecdysis.
INTRODUCTION
A
responsiblemong the for monetarysevera! gastrointestinallosses in the field of equinedisordersbreeding, gastroduodenal ulceration accounts for a
significant percentage of cases". Disease on continuing
investigation in human medicine, gastroduodenal ulceration
in horses mainly occurs in suckling foals up to 4 to 5 years
0 1 d3 3 , 3 7 , 4 S . 4 6 .
Even though its aetiololy is poorly understood, several
factors are believed to be important in its genesis7,20.44.4Ó.
Several microorganisms, such as E s c h e r i c h i a c o l i ,
S a l m o n e l l a sp, C l o s t r i d i u m sp, P r o t e u s sp, E n t e r o b a c t e r
sp, C a m p y l o b a c t e r j e j u n i , C a n d i d a sp, R o t a v i r u s etc., have
been isolated from affected foals, however is assumed that
these organisms play a secondary role in the pathogenesis of
ulcerationsI,15,20,45.46,Opposed to human beings, it hasn't been
isolated H e l i c o b a c t e r p y l o r i ( C a m p y l o b a c t e r p y l o r i ) from
horses with gastric ulcersI3.14,35,39. Other causes include
trauma b y either foreign bodies orG a s t e r o p h i l u s i n t e s t i n a l i s
larvae" and nonsteroid anti-inflammatory dmgs9,17,40,41,42.
Murray e t a i .30 suggested that desquamations from
the squamous mucosa (non-glandular mucosa) could expose
the deep epitheliallayers to the action of aggressive factors
(HCI and pepsine) bringing about deeper lesions such as
ulcers.
Currently, pathogenic pathways of gastric and duodenal
ulcers in foals and adults horses remain unknown, however
an imbalance between protective and aggressive factors is
considered IX,26,2X,36,although Baker' refers that neither an
excess of aggressive nor a deficiency of protective factors
could be established in horses as yet.
Concerning either the presence or absence of clinical
signs and their variations, the lesions location in the gastric
Non-glan
mucosaa four clini
1 )
2)
3)
4)
T h
an amne: gastroscc
and accu
W "asymptc
under Br
establish erosions) and apos desquam
120 days
Equipm
G,
fiberopt diameterand suct
through :
AnimaIs
W 120 days
"l-l.Ozawa
DEARO, A.C.O.; LOPES, M.A.F.; GANDOLFI, W. Lesions (ulcers and/or erosions) and desquamations location in the gastric mucosa from asymptomatic
Quarter Horse foals: endoscopic survey. Braz, J.veto Res. animo Sei., São Paulo, v.36,n. I,p.34-39, 1999.
Table 1
Number and rate ofQuarter Horse foals with gastric lesions (ulcers and/or erosions) in different regions of gastric mucosa according to
age group.
XWVUTSRQPONMLKJIHGFEDCBA
a r o
i c a
it e s
NMLKJIHGFEDCBA
'u a l
ZYXWVUTSRQPONMLKJIHGFEDCBA
R e g io n s
'J r
1 - 3 0
A g e G ro u p (d a y s )
9 1 - 1 2 0
3 1 - 6 0 6 1 - 9 0
i c a
l d e N o n -g la n d u la r
G la n d u la r
N o n -g la n d u la r a n d G la n d u la r
N o n -g la n d . fu n d u s
N o n -g la n d . M P
N o n -g la n d . L C
G la n d .fu n d u s
G la n d .a n tru m
3
O
1
O
4
1
1
O i n a
l d e
i n a d a
6 5
1
O
O 4
4 2
2 5
3 3
1 3
1 2
4
1
1
1
3 3 2 O
Non-gland. = Non-glandular Gland. = Glandular M P = M a r g o p l i c a t u s LC = Lesser curvature.
mucosa and complications resulting from ulcerative lesions,
four c1inical syndromes have been described in foals:
1) Asymptomatic or silent ulcers;
2) Symptomatic or active ulcers;
3) Perforated ulcers; and
4) Gastric or duodenal obstruction4.5.I~.25.2X.
The diagnosis of gastric ulceration should be based on
anamnesis, clinical signs, response to therapy and
gastroscopic examination, being the last the most objective
and accurate means of diagnosisX,IO,20,23,24,25.2Y,35,37.4ó.
With the aim of finding out the behavior of
"asyrnptomatic or silent ulcers" syndrome in horses breeded
under Brazilian conditions, this work has the purpose of
establishing the distribution of gastric lesions (ulcers and/or
erosions) and desquamations from the squamous mucosa
and a possible relationship between both alterations (Iesion/
desquamation) in asymptomatic Quarter Horse foals up to
120 days old.
GFEDCBA
M A T E R I A L A N D M E T H O D
1m de
t is E q u i p m e n t
1m ,se
irs
as
Gastroscopic examination was performed with a
fiberoptic endoscope, 1.75 m long and 9.5 mm outer
diameter*, light source with air/water pump (250W/24Vr
and suction unir'. Gastroscopic findings were recorded
through a photographic camera'.
Ial er
IS
an
irs
A n i m a i s
Were utilized sixty Quarter Horse foals aged one to
120 days, of both sex, from four breeding farms located in
.al
different towns of São Paulo State - Brazil.
Foals were divided in four age groups of 15 animaIs
as follows: one to thirty days, 31 to sixty days, 61 to ninety
days and 91 to 120 days.
The animaIs were not randomly selected but rather
obeying either the veterinarians or farm manager indications
according to foals availability and in agreement with the
foIlowing criteria: do not have presented until the time of
examination clinical signs compatible with gastric ulcer
(bruxism, excessive salivation, dorsal recumbency etc.), do
not have been submitted to antiulcerogenic therapies
(antiacids, acid secretion inhibitors etc.) and were not older
than 120 days.
Information such as identification (name or number,
sex, age, breed and weight) and location of gastric lesions
and desquamations were recorded in a protocol way.
By means ofmuzzling, animaIs were submitted to 12
or 16 to 18 hours of fasting before examination, except foals
in exclusively milk feeding, which were submitted to four
hours of fasting.Four people were utilized to perform the
examination where two of them physically restrained the
foal, one passed the endoscope through the foal's nostril and
one was the endoscopist. Chemical restraint was carried
out by injection of Rornif'idine" (0.04 to 0.08 mg/kg)
intravenously, after routine antisepsis of jugular vein, five
minutes before starting the examination. Gastroscopic
technique was performed according to Brown e t a l , " ,
Adamson; Murray/, Cudd; Wilson!' and White'".
P r o c e d u r e
T o ta l
N u m b e r a n d ra te
1 8 (6 9 .2 )
2 (7 .7 )
6 (2 3 )
7 (2 6 .9 )
1 4 (5 3 .8 )
1 0 (3 8 .4 )
7 (2 6 .9 )
DEARO, A.C.O.; LOPES, M.A.E; GANDOLFI, W. Lesions (ulcers and/or erosions) and desquarnations location in lhe gasnic mucosa frorn asymptornatic
Quarter Horse foals: cndoscopic survey. Braz ..T.veto Res.animo Sei., São Paulo, v.36,n. I,p.34· 39, 1999.
Gastroscopic Findings Classification
Gastroscopic findings were cJassified according to
location in: non-glandular fundus, non-glandular adjacent to
the
NMLKJIHGFEDCBA
m a r g o p l i c a t u s along the greater curvature, non-glandu larnext to the cardia along the lesser curvature, glandular fundus
and glandular antrum (Fig. I).
RESULTS
The majority of foals stood well the examination. In
spite of sedation, they showed little reluctance to passage of
the endoscope through the nasal cavity. None ofthem showed
ZYXWVUTSRQPONMLKJIHGFEDCBA
a n y sign of abdominal discomfort to gastric insufflation.
Fasting time was insufficient in 18examined foals. About 10
Duodcnum
Figure 1
Cross-section of the equine stomach and duodenum illustrating
the gastric regions.
to40%of glandularmucosacouldn'tbe inspected in 14 (47%),
3 (25%) and I (5%) foals submitted to 12, 4 and 16to 18
hours of fasting respectively.
Of the 60examined foals, 26 (43.3%) showed lesions
(ulcers anel/or erosions) in the gastric mucosa. Non-glandular
mucosa (squamous mucosa) was the most affected by lesions
(92.3%), mainly along the greater curvature adjacent to the
m a r g o p l i c a t u s (53.8%). Eight anirnals (30.7%) showed
lesions in the glandular region (Tab. 1 ).
Lesions located in the non-glandular region presented
themselves as mucosal defects with cJear edges and reddish
bottom, in linear, circular and irregular shapes. Sometimes
when a great deal of lesions adjacent to each other were
located next to the m a r g o p l i c a t u s they resembled to flow
together giving rise large lesions. Bleeding lesions at the lesser
curvature were presented in two animais between 61to ninety
days old. Glandular lesions presented themselves as mucosal
defects with raised edges, hyperemic, and reddish bottom,
sornetimes with a fibrin cover. They had linear or circular
shapes and most of them presented haemorrhagic. In an
87-day-old foal, were noted linear, haemorrhagic lesions placed
radiately around the entire pyloric sphincter looking like lesions
of human beings with reflux gastritis.
Desquamations were found out in 17foals (28.3%)
mainly those aged Ito 30 (60%) and 31 to 60 days (40%).
The regions ofthe fundus and m a r g o p l i c a t u s showed similar
rates of desquamations (Tab. 2 )
All foals aged 1to30days with squamous mucosa lesions
also showed desquamations, whilejust in two foals aged 61to
120days lesions were associated with desquamations (Tab. 3).
Table2
Number of Quarter Horse foals with squamous epithclium desquamation in differcnt gastric regions according to age group.
D e s q u a m a tio n s (R e g io n s ) A g e g ro u p (d a y s ) T o ta l T o ta l
1 - 3 0 3 1 - 6 0 6 1 - 9 0 9 1 - 1 2 0
F u n d u s 4 2 1 1 8
XWVUTSRQPONMLKJIHGFEDCBA
M a r g o p l i c a t u s 4 2 O O 6
F u n d u s a n d m a r g o p l i c a t u s 1 2 3
Table3
Number of Quarter Horse foals with gastric lcsions (ulcers and/or erosions) in the non-glandular region along with desquamation or
alone, ac.iording to age group.
L e s io n s in th e n o n g la n d u la r re g io n
---~~~~~~~---
T o ta l1 - 3 0
A g e g ro u p (d a y s )
3 1 - 6 0 6 1 - 9 0 9 1 - 1 2 0
W ith d e s q u a m a tio n
W ith o u t d e s q u a m a tio n
4
O
2 1
4 8
1
4
8 1 6
DEARO,A.
Quarter
Fa:
Nappert I
hours to'
deal of at
Wilson"
hours toy
gastric er
Fasting p
the mean:
could del:
ofthe gla
limiting f
this regioi
by gastros
of the gl.
glandular enabled tI
T h o
papers re
the locatir
0 0 the se
along the
in adult
predispos
aod/or er
m a r g o p l r e s i s t e n t u
haven't b
of follow
notice the
the lesser
regioos d
lesioos as
T h l
fundus ai
AC
loco de sile obj esti ses: sub 3 1 ; agl:
m e l d e i
DEARO, A.C.O.; LOPES, M.A.F.; GANDOLFI, W. Lesions (ulcers and/or erosions) and desquamations location in lhe gastric mucosa
ZYXWVUTSRQPONMLKJIHGFEDCBA
fr o r n nsyrnptornaticQuartel' Horse foa!s: endoscopic survey. Braz, J.veto Res, animo Sei., São Paulo, v. 36, n. I, p. 34-39, 1999.
natlc
desquamation process occurs in a regular way along the whole
squamous mucosa without preference for one or another region.
Even possible, the findings achieved do not aIlow to establish a
relationship between lesions a n d desquamations occurrence as
proposed by Murray
NMLKJIHGFEDCBA
et a l . " . Despite 100% of animais with lesionsaged 1 to 30 days have also presented desquamations, the majority
of foals from superior age grcups mainly that aged 6 1 to9 0 days
even carrying gastric lesions, didn't show desquamations (Tab.
3). It must be emphasized that lesions not always occurred at the
same region of desquamations (Tab. I and 2 ).
Even though several information concerning the gastric
ulcers in foals have been recorded in the past few years by
virtue of using long fiberoptics endoscopes and
videoendoscopes as a diagnostic method, many points such
as the preference of gastric lesions to locate at the squamous
mucosa adjacent to m a r g o p l i c a t u s along the greater
curvature remain to be c1eared up.
With the aim of c1earing these and additional issues,
mainly those involving the pathophysiology of uJcers and
erosions in foals and adult horses, thorough studies about
histology, physiology and aggressive and protective factors
from equine gastric mucosa must be emphasized .
'%), ) 18
ions ular íons , lhe
wed
ated dish mes vere Iow .sser
n e ty
osal :om, ular 87-iced .ions
3%) l%). rilar
to n s
ilto
1 .3 ).
GFEDCBA
D I S C U S S I O N
Fasting periods indications according toPalmer" and
Nappert e t a i .
1\
of 1 2 hours to foals in solid feed and 4hours to those in milk feed, showed insufficient in a great
deal of animaIs. Lower fasting periods according to Cudd;
Wilson!' of 2 to 8 hours and Adamson; Murray? of 6 to 10
hours to young suckling foals on solids will result incomplete
gastric emptying and partial inspection of gastric mucosa.
Fasting periods insufficiency perhaps may be attributed to
lhe means of which it was carried out inasmuch as muzzling
could delay gastric ernptying-. Incomplete gastric inspection
ofthe glandular mucos a in these animais must be faced as a
limiting factor in evaluation of location of gastric lesions in
thisregion as eventuallesions presented, couldn't be detected
bygastroscopic examination. Apart from the partial inspection
of the gla dular mucosa, the same cannot apply to n o n
-glandular mucos a as ali fasting periods employed in this study
enabled thorough inspection ofthe mentioned gastric region.
The unanimity of information between several scientific
papers reviewed and that achieved in this study, concerning
lhe location of lesions in the gastric mucos a, with an emphasis
on lhe squamous mucosa adjacent to the m a r g o p l i c a t u s
along the greater curvature, either in foals 1.12.22.30.3U2JXor
in adult horsesI6.21.27, suggests this region as highly
predisposed to the development of lesions such as uJcers
and/or erosions. According to Rooney", the region of the
m a r g o p l i c a t u s could represent an anatomic l o e u s m i n o r i s r e s i s t e n t i a e . Although changes in lesions location along time
haven't been analysed as done by Murray e t a l , " by means
of follow up gastroscopic examinations, where he could
notice that the older foals the higher prevalence of lesions at
lhe lesser curvature and lower at the m a r g o
XWVUTSRQPONMLKJIHGFEDCBA
p l i c a t u s , bothregions didn't show significantly changes in prevalence of
lesions as older foals were examined (Tab. 1 ).
The similarity in occurrence of desquamations between
fundus and m a r g o p l i c a t u s regions (Tab. 2 ) suggests the
CONCLUSIONS
According to the results obtained some conclusions
could be established:
I) non-glandular rnucosa adjacent to the m a r g o
p l i c a t u s along the greater curvature was the most affected
region by lesions followed by non-glandular region next to
the cardia along the lesser curvature, non-glandular and
glandularfundus and antrum;
2 ) desquamations are ordinary findings during the
gastroscopic examination of young foals and are distributed
along the entire non-glandular mucosa;
3)desquamations occurrence didn't show relationship
to lesions occurrence.
RESUMO
A úlcera gástrica figura como uma importante causa de desconforto abdominal em eqüinos jovens. De acordo com a
localização das lesões na mucosa gástrica, a presença ou ausência de sinais clínicos e possíveis complicações resultantes
de sua ocorrência, quatro síndromes clínicas são freqücntemente descritas em potros: I) Ulceras assintomáticas ou
silenciosas; 2 ) Úlceras sintomáticas ou ativas; 3 ) Úlceras perfuradas; e 4) Obstruções gástrica ou duodenal. Com o
objetivo de se verificar a distribuição de lesões gástricas (úlceras e/ou erosões) e descamações do epitélio aglandular no
estômago de eqüinos jovens assim como uma possível relação entre as alterações mencionadas (lesão/descamação)
sessenta potros da raça Quarto de Milha não-portadores de sinais clínicos compatíveis com úlceras gástricas foram
submetidos à gastroscopia. Os potros foram divididos em quatro faixas etárias de 15 animais cada uma, sendo: I a 30 dias,
31 a 60 dias, 61 a 90 dias e 91 a 120 dias de idade. As lesões ocorreram em ordem decrescente de freqüência nas regiões
aglandular próximo aom a r g o p l i c a t u s ao longo da curvatura maior, aglandular próximo à cárdia ao longo da curvatura
menor, fundo glandular e aglandular e antro. As descamações do epitélio aglandular ocorreram de forma similar nas regiões
de fundo em a r g o p l i c a t u s . Não houve associação entre a ocorrência de lesões e descarnações.
DEARO, A.C.O.; LOPES, M.A.F.; GANDOLFI, W. Lesions (ulcers and/or erosions) and desquamations location in lhe gastric mucos a from asymptomatic
Quarter Horsefoals: endoscopic survey. Braz, J.veto Res. animo Sei., São Paulo, v. 36, n.
ZYXWVUTSRQPONMLKJIHGFEDCBA
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XWVUTSRQPONMLKJIHGFEDCBA
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Received: 20/08/1997
