Discussion

Sykes, B.W., Hallowell, G.D.
Aims: To compare the efficacy of 2 doses of omeprazole, and to report the healing rate of glandular EGUS with omeprazole. Methods: Thoroughbred racehorses in training with grade II/IV or greater glandular EGUS were identified on gastroscopy. Horses were randomised to either 2.0 g (high dose) or 0.8 g (low dose) omeprazole per os s.i.d., equivalent to 4.0 and 1.6 mg/kg bwt per os s.i.d., respectively for a 500 kg horse. Repeat gastroscopy was performed at 33 plusminus 7 days. Results: Twenty-four affected horses were randomised equally. No differences between the groups were present. One horse in the low dose group was lost to follow-up for unrelated reasons. All horses, except one in the high dose group, had grade II/IV or greater squamous ulceration at Day 0. Ulcer healing (defined as a return to grade 0 - I/IV) occurred in 67% and 44% of the squamous, and 50% and 11% of the glandular ulcers in the high and low dose groups, respectively. A dose effect and P = 0.13 for improvement, for high and low dose respectively). Conclusions: Healing of EGUS is commonly incomplete at 33 days. A dose dependent response exists in the healing of squamous ulceration. Healing of glandular ulceration is inferior to healing of squamous ulceration. Practical significance: A reduction in the dose of omeprazole prior to control gastroscopy is likely to result in inadequate healing, even when 28 days of therapy is completed. Investigation of complimentary and/or alternative therapies for glandular EGUS is warranted.