Endoscopic Finding of Gastric Ulcer in Rural Horse and Relation with Gasterophilus spp

Document Type: Infectious agents- Diseases- Surgery

Authors

Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Tabriz, Tabriz, Iran

Abstract

BACKGROUND: Gastric ulcer is one of the most common diseases in racehorses. Colic, weight loss and poor performance are some of the clinical signs. The second and third larval stages of the bot fly Gasterophilus spp live in the stomach of the horse. This parasite is often found in large numbers of horses in all of the countries.
OBJECTIVES: The aim of this study was assessment of gastric ulcer in the rural horse and relation with
Gasterophilus spp.
METHODS: In a cross-sectional study twenty rural horses were randomly selected for endoscopic finding for gastric ulcer. Gender, age, keeping situation, type of feed, history of colic, hair coat condition, deworming plan and presence of GasterophilussSpp. were recorded in a sheet. The horses were kept fasted for 12 hours before endoscopic examination by a VET3M OLYMPUS (Japan). Sedation was done by injection of Detomidine (Detomo Vet ® ceva-Spain) 0.1ml/100kg to look for presence of gastric ulcers with grading and Gasterophilus spp. Statistical analysis of the data was performed with 95% confidence interval and P RESULTS: Out of 20 horses, 13(65%) horses were mares and 7(35%) were males and Mean±2SE of age was 8.9±4. Endoscopic observation showed 9 (45%) of the horses suffered from gastric ulcer. All of the ulcers were in non-glandular part and near the margo plicatus. Overall, 4 (20%) head of the horses had Gasterophilus spp. and all of them were present in the horse with no deworming plan. Based on the results, there was no associ- ation between presence of Gasterophilus with occurrence of Gastric ulcer (P>0.05). Further study with high sample size is proposed.
CONCLUSIONS: There was high frequency of gastric ulcer in non-glandular portion of stomach in rural horse and there was not any association between presence of Gasterophilus and gastric ulcer.
 

Keywords


Article Title [Persian]

یافته های آندوسکوپیک زخم معده در اسبهای روستایی و ارتباط آن با لارو گونه های گاستروفیلوس

Authors [Persian]

  • فریدون رضازاده
  • یاشار قره آغاجلو
گروه علوم درمانگاهی، دانشکده دامپزشکی دانشگاه تبریز، تبریز- ایران
Abstract [Persian]

خلاصه
زمینه مطالعه: زخم معده یکی از بیماریهای شایع در اسبهای ورزشی است. کولیک، کاهش وزن کاهش کارایی ورزشی برخی از نشانه های بالینی این بیماری است. لارو مرحله دوم و سوم خرمگس یا گونه های گاستروفیلوس در معده اسب می توانند زندگی نمایند. اگرچه پیدان شدن این انگل در معده اسب در بسیاری از کشورها و در جمعیت زیادی از اسبها مشاهده شده است. هدف: از مطالعه حاضر یافتن فراوانی زخم معده در اسبهای روستایی و ارتباط آن با لارو گونه های گاستروفیلوس بوده است. روش کار: در یک مطالعه مقطعی 20 رأس اسب روستایی بصورت تصادفی برای ارزیابی زخم معده مورد آندوسکوپی قرار گرفتند. جنس، سن، وضعیت نگه داری، نوع خوراک، تاریخچه رخداد کولیک، وضعیت پوشش خارجی، برنامه ضد انگلی و حضور یا عدم حضور لارو گاستروفیلوس در یک برگه ثبت گردید. 12 ساعت قبل از آندوسکوپی با استفاده از دستگاه VET3M Olympus (Japan)، اسبها ناشتا بوده و آرام بخشی با استفاده از دتومیدین (Detemo vet®, Ceva- Spain) به میزان 1/0 میلی لیتر/100 کیلوگرم وزن بدن صورت گرفت. آنالیز آماری داده ها با استفاده از نرم افزار SPSS نسخه 24 انجام شد و سطح اطمینان 95% انجام شد. نتایج: 13 (65%) رأس از اسبها ماده و 7 (35%) رأس آنها نر بودند. سن اسبهای مورد مطالعه4±9/8 سال بود و 9 (45%) رأس از اسبها در آندوسکوپی زخم معده را نشان دادند. تمامی زخمهای مورد مشاهده در بخش غیر غده ای معده و نزدیک مارگو پلیکاتوس قرار داشت. چهار (20%) از اسبها لارو گونه های گاستروفیلوس را نشان دادند و در هیچکدام از اسبها برنامه ضد انگلی اجرا نشده بود. بر اساس آنالیز آماری صورت گرفته در مطالعه حاضر ارتباطی بین حضور انگل و زخم معده بدست نیامد (P>0.05). مطالعه دیگری با جمعیت زیادی از اسبها بایستی صورت بگیرد. نتیجه گیری نهایی: فراوانی زخم معده در جمعیت اسبهای روستایی بالاست و ارتباطی بین حضور انگل در معده و زخم های موجود در آن یافت نشد.

Keywords [Persian]

  • زخم
  • اسب
  • گاستروفیلوس
  • گاستروسکوپی

Introduction

Gasterophilus is from Gasterophilidae fam- ily and has 9 species that could cause a myia- sis in gastrointestinal tract (Zumpt, 1965). They are distributed worldwide and especially in Afrotropical and Palearctic and could live   in the equids about 10 months (Akele et al., 2018). Clinically, myiasis have been divided into 5 groups; sangvinivorous myiasis, dermal and subdermal myiasis, nasopharyngeal myia- sis, intestinal myiasis, and urogenital myiasis (Zumpt, 1965). Numerous larvae of Gaster- ophilus could cause pathologic reaction in host. First stage of Gasterophilus is not a myia- sis infection but with the formation of inflam- matory reactions, it will become myiasis. Al- though larvae that have been swallowed with feed and indirectly pass way with feed wheth- er they were alive or not, have not been cause of true myiasis and biological larvae of para- site have not been parasite temporarily mode  of life (Zumpt, 1965). Larvae of stage 2 and    3 of Gasterophilus intestinalis live in equine gastric and have outspreaded worldwide, how- ever, there were a few reports about cause of death for this species (Sc and Ph, 1972a). First stage of Gasterophilus larvae were drowned blood from host dermal and continued his way to oral cavity and finally reached the gastro- intestinal tract (Zumpt, 1965). Diagnosis of clinical findings about stage of migration and stage of maturing are difficult but could cause harmful disorders in different species (Tavas- soli and Bakht, 2012). Overall, Gasterophilus could cause problem in swallowing, ulcers in gastric and duodenum, obstruction in intestine, volvulus, rectal prolapse, anemia, diarrhea and digestion problem (Otranto et al.,  2005).

Materials and Methods

Population study

Twenty  rural horses with different  gender


 

and age near Tabriz were selected by sim-  ple random method. Rural horses are most-  ly used in carrying heavy staff and passing long distances and they do not have basic care like horses in horse breeding centers or Jockey clubs. The type of feed consumed by horses was alfalfa, barley and grain which was given in four meals. All horses belonged to private owners and gastroscopy and all of the clinical examinations in the field were done with their permission. After study, all animals were returned back to their owners  in the village. Specifications such as gender, age, circumstance of keeping, type of feed, History of colic, coat condition,  deworm-  ing plan and time of using were recorded in pre-designed table. For facilitation of study, age was aggregated in 1-3, 4-6, 6-8 and 9 years and up.

Gastroscopy

The horses were kept fasted for 12 h be- fore endoscopic examination by VET3M OLYMPUS (Japan). Before the gastroscopy each of the horses was sedated by injection of Detomidine (Detomo Vet ® Ceva-Spain) 0.1ml/100kg via IV. In video  endoscopy right part of gastric around Margo plicatus, dorsal part of fundus, great curvature around Margo plicatus, less curvature around Margo plicatus and glandular part of stomach were examined.

Statistical Analysis

Data was analyzed by IBM SPSS statis- tics 24. Statistical analysis of the data was performed with 95% confidence level and p

 

 

 

Results

Gastroscopy

                        20 horses were studied, 13 (65%) were males and 7 (35%) were mares. All of the horses did nothave colic history and were kept in stables and had good coat. Accord- ing to endoscopic observation 9 (45%) of the horses,3 mares and 6 males, had gastric ulcer and 11(55%) of the horses, 4 mares and 7 males, did nothave gastric ulcer[Table 1].I In video endoscopic  examination  all  of the ulcers were in squamous portion of stomach, 4 (45%) of the ulcers were in great curvature of squamous portion, 4 (45%) ulcers were in less curvature of    squamous

 

 

 

 

 

 

 

 

 

 

 

 

Figure 2. 12 years old mare with gostric uncer    (severity

2) and Gasterophilus spp.(botfly)


portion and 1 (10%) ulcer were in both less and great curvature of squamous portion of stomach [Table 2]. Based on Macalister and Andrew’s pattern frequency of ulcer score  in this study is: 0 score 70%, 1 score 5%,

3 score 15%, 4 score 10% and by ulcer   se-

verity frequency: 0 (55%), 1(15%), 2(15%),

3(5%) and 4(10%) [Table 3]. Overall, 4 (20%) head of the horses had Gasterophilus spp. and all of them showed presence in the horse with no deworming plan  [Figure1-2].

Statistical Analysis

There is not any relation between pres- ence of Gasterophilus spp. using anti-para- site drug (p=0.20) and gastric ulcer  (p=0.8)

 

 

 

Figure 1. 12 years old mare with gostric uncer (severity 2)

and Gasterophilus spp.(botfly)

 

 

 

 

 

Table 1. Frequency of gastric ulcer in both mare and male

 

Female (n)

Male (n)

Healthy

Have a ulcer

Healthy

Have a ulcer

4

3

7

6

7

13

 

 

Table 2. Portion of ulcers in non-glandular part of stomach

 

 

Frequency

Percent

Valid Percent

Cumulative   Percent

Healthy

11

55.0

55.0

55.0

non-glandular   portion of greater curvature

4

20.0

20.0

75.0

non-glandular   portion of Lesser curvature

4

20.0

20.0

95.0

Both Great   and Lesser curvature

1

5.0

5.0

100.0

Total

20

100.0

100.0

 

 

Table 3. Frequency of scoring of ulcers that found in the endoscopic exam- ination: 0 score 70%, 1 score 5%, 3score 15%, 4 score 10%

 

Score

Frequency

Percent

Valid Percent

Cumulative   Percent

.0

14

70.0

70.0

70.0

1.0

1

5.0

5.0

75.0

3.0

3

15.0

15.0

90.0

4.0

2

10.0

10.0

100.0

Total

20

100.0

100.0

 

 

 


and, based on the results, there was no asso- ciation between presence of Gasterophilus with occurrence of Gastric ulcer  (P>0.05).

 

Discussion

Equine gastric ulcer syndrome (EGUS) terminology is divided in 2 parts, non-glan- dular ulcer and glandular ulcer (Sykes and Jokisalo, 2014). Factors mentioned above cause ulcer in non-glandular portion that could be increased in gastric acid secretion and excessive contact of gastric acid with squamous part and increased in VFA secre- tion (Sykes and Jokisalo, 2015). In glandu- lar portion ulcer might be Helicobacter spp, overuse of NSAIDs such as phenyl butazone, but cause of ulcer in this part is not clarified ( Sykes and Jokisalo, 2015). There are a lot of


clinical findings for gastric ulcer, for exam- ple, recurrent and sever colic, diarrhea, bad hair coat condition, anorexia, weightloss, change in behavior like a crib biting, depres- sion, decrease in performance and (Malm- kvist et al., 2012; Videla and Andrews, 2009; Wickens et al., 2013) and the best way for diagnosis of EGUS is endoscopy. Climate of Iran has suitable ecological factors and Ta- briz, Iran specifically, has a best weather for growing and spreading Gasterophilus, also most of the Gasterophilus spices have been recognized (G.intestinalis, G.haemorrhoid- alis, G.nasalis, G.inermis, G.pecorum, G. meridionalis G.nigricornis). The difference between spices, prevalence and larval bur- den of Gasterophilus in our study and other overseas studies may be because of  different

 

 

 

climate, management factors (anti parasite schedule), hosts (for example shade of ge- netics and irritant of host)  and differences  in genetics and population composition of parasite (Mashayekhi and Ashtari, 2013). Excess of larvae that presented in stomach may cause obstruction and colic and excess larvae that damaged the tissue of stomach or mucosa of intestinal and were limited vital nutrient may cause health problem in host ( Waddell, 1972). Ulcers and lesions studied  by Waddell revealed  similarity  with  ulcers in pigs that had a gastric  ulcer.  The ulcers  in pig stomach had bleeding but there was not any bleeding in ulcer site of horse gas- tric. Although this disease has high mortality in pigs, this disease  has less  pathogenicity  in horses (Waddell, 1972). In our study, no bleeding ulcer was observed in endoscopic finding. Depth of ulcers  caused  by  larvae do not have any association with thickness  of gastric and duodenum. Moreover, ulcers which were caused by larvae can affect thickness of layer. Cells proliferation under gastric ulcers and duodenum ulcer do not have any relation with depth of ulcers. Cells proliferation under gastric ulcer had more significant progress than ulcers in duode- num part. Histopathologic findings revealed severe fibrosis in ulcers and this finding in affected duodenum revealed severe dam-  age in submucosal glands around and below lesions. Fibrosis of the underlying lamina propria mucosa and tunica submucosa was distinctive but was not able to renew thick- ness of duodenum (Cogley and Cogley, 1999). The horse was necropsied and stom- ach adjacent to spleen had a gastritis, ulcers with 1cm were presented and all the ulcers were in non-glandular part  of gastric  (Dart et al., 1987). The study of Sequeira and his colleagues  was performed  in 95 horses  that


16.84% of which had a Gasterophilus nasa- lis and the lesions site of larvae attachment both microscopically and macroscopically was examined. Erosion, ulcers of stomach and proximal duodenum were mostly rec- ognized macroscopic. Based on microscopic findings, lesions of spectrum ranged from inflammatory reactions to necrosis and ul- ceration. Macroscopic findings revealed that lesions were scattered in duodenum and am- pulla part of proximal duodenum and lesions shape was circular  and  punctiform.  Also,  at higher levels of infestation, lesion had a different type (Sequeira et al., 2001). None  of our cases necropsy during the period of study, so we did not have any information about type of lesion in necropsy or histopa- thology. In study of 16 horses that were clin- ically suspected for gastric ulcer, five of the horses had presented both gastric ulcer and Gasterophilus and all of the horses died be- cause of cachexia. Gasterophilus was found in post mortem findings of three horses (Ma- shayekhi and Ashtari, 2013). We could not send the samples for parasitological study because all of the horses were alive and sam- ples were randomly selected without a histo- ry of colic. Nine mares of 80 horses in one herd that were fed in pasture died. Necropsy of gastrointestinal tract revealed a lot of bot flies that had adhered to esophagus mucosa and non-glandular part of gastric. Parasi- tological tests revealed 3rd stage larvae of Gasterophilus pecorum (Moshaverinia et al., 2016). Fortunately, none of the animals died during the period of our study. Also, in the study of 330 horses was done in Belgium during one year, 193(58%) horses had Gas- terophilus. Size of lesions was between 1cm2 and 17cm2 and most of the larvae were seen in Margo plicatus (Agneessens et al.,   1998).

S.R Felix et al   reported prevalence of  Gas-

 

 

 

terophilus in Brazil in which 395 horses were slaughtered, 126 of the horses were infested with Gasterophilus,100 horses (25.32%) had G.inestenalis and 47(11.90%) had G.nasalis (Felix et al., 2007). Bucknell and his col- leagues demonstrated presence of parasite was affected by age of horses and in their study  Gasterophilus  nasalis  was   present in horses that were more that 20 years old (Bucknell, 1995). However, in our study and based on statistical analyses, the mentioned results were not acquired. The study of gross necropsy on 10 donkeys in Spain, due  to their lack of proper nutrition, showed that 30% had Gasterophilus and histopathology studies showed damage to stomach and sub chorionic edema with parakeratotic hyper- keratosis (Briceño et al., n.d.). In summation, in our study we could not find any relation between horses and presence of Gasterophi- lus and it may due to the small amount of our samples for study of gastric ulcer.

Acknowledgments

 

The authors thank Vice-president of re- search in the University of Tabriz and all of the horse owners, especially, Mr. Jabraeil Mollaei Sefidan for his  collaboration.

 

Conflict of Interest

The authors declare that there is no con- flict of interest.

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