Misoprostol is superior to combined omeprazole‐sucralfate for the treatment of equine gastric glandular disease

Summary Background Previous studies have demonstrated a poor response to healing of gastric glandular lesions with oral omeprazole and other medications. Objectives To evaluate the efficacy of two novel treatments (misoprostol [M] and combined omeprazole‐sucralfate [OS]) in horses for gastric glandular disease. Study design Prospective, clinical study. Methods Sixty‐three sports horses with grade >1/4 glandular disease were identified by gastroscopy. Horses received either 5 μg/kg of misoprostol per os BID 1 h prior to feeding or a combination of 4 mg/kg enteric coated omeprazole per os SID and 12 mg/kg sucralfate per os BID where drugs were given 1 h prior to feeding and sucralfate given 60 min after omeprazole; allocation was dependent upon centre. Gastroscopy was repeated at 28–35 days. Evaluators of the gastroscopy images were blinded to the treatments the horses received and images were reviewed independently. Results The most common presenting sign in both treatment groups was poor performance (Overall – 65.1%; M – 60.5% and OS – 75%). Overall healing (P