Ulcer Diagnosis Simplified With Sucrose

Diagnosing equine gastric ulcers might soon be a procedure that's short and sweet. Until recently, ulcer detection depended on using an endoscope to peer at the stomach lining. Now, a team of researchers at Texas A&M University, led by Noah Cohen, VMD, PhD, in collaboration with J. B. Meddings of the University of Calgary's Gastrointestinal Research Group, says gastric ulcers can be identified and assessed for their severity using a simple test for sucrose in the urine, which has already proved reliable in diagnosing ulcers in humans, rats, and dogs.

Sucrose, a disaccharide sugar, is not normally present in either the urine or the blood of horses because the molecules are too bulky to pass through healthy stomach mucosa (lining) and are almost immediately broken down once they hit the small intestine. But when the stomach mucosa is damaged or ulcerated, sucrose molecules can escape through the damaged tissues and into the bloodstream. Eventually, they’re filtered from the blood by the kidneys, ending up in concentrated form in the urine.

In their study, the Texas and Calgary teams induced ulcers in 13 catheterized horses by putting them on a stressful feed schedule, and confirmed the presence of lesions by endoscopy. Then the horses were fed a meal consisting of one kilogram of grain concentrates, followed by about two cups of a 10% sucrose/water solution administered by nasogastric tube. Urine was collected two hours and four hours after the administration of the sugar solution.

Sucrose values in the ulcerated horses' urine were significantly higher two hours after administration--especially when the ulcers were severe (scoring a two or three on a scale of zero to three)--and dramatically lower after their ulcers had been treated for 21 days with omeprazole (GastroGard). The severity of the ulcers could be accurately evaluated by the sucrose levels, potentially giving us a new barometer for evaluating cases most in need of treatment.

With results this conclusive, and a testing protocol established, it should take very little time for veterinarians to incorporate urine testing--a much simpler, cheaper, and less invasive technique--into their diagnostic routine for gastric ulcers.

There's also potential to use sucrose levels in the blood of suspected ulcer cases to indicate the presence of ulcers. This convenient possibility is currently being explored by Texas A&M and Mississippi State University researchers.

Furthermore, researchers at the University of Adelaide in Australia are investigating the use of a sucrose breath test, which has successfully detected gastric ulcers in humans and dogs. Essentially, an individual who doesn't absorb sucrose properly should have detectably higher levels of hydrogen and methane in his exhaled breath. If this holds true for horses, it could provide another simple, efficient, and inexpensive way to diagnose gastric ulceration and, with any luck, help veterinarians catch ulcers faster and treat them earlier.

About the Author

Karen Briggs

Karen Briggs is the author of six books, including the recently updated Understanding Equine Nutrition as well as Understanding The Pony, both published by Eclipse Press. She's written a few thousand articles on subjects ranging from guttural pouch infections to how to compost your manure. She is also a Canadian certified riding coach, an equine nutritionist, and works in media relations for the harness racing industry. She lives with her band of off-the-track Thoroughbreds on a farm near Guelph, Ontario, and dabbles in eventing.

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