Oral Mosapride Attenuates Gastrointestinal Dysmotility During Experimental Endotoxemia in Horses: A Randomized, Blinded Crossover Study

Endotoxemia is a major contributor to gastrointestinal hypomotility and postoperative ileus in horses. This study investigated whether oral mosapride retained prokinetic activity during acute lipopolysaccharide (LPS)-induced endotoxemia. Seven healthy adult horses were enrolled in a randomized, blinded, three-period crossover trial and received LPS alone, mosapride alone (MOSA), or LPS plus mosapride (LPS + MOSA), with a 14-day washout interval between periods. Mosapride was administered orally at 2 mg/kg, whereas endotoxemia was induced by an intravenous infusion of Escherichia coli O55:B5 LPS (0.03 µg/kg) over 30 min. Clinical variables, hematologic parameters, abdominal auscultation, and transabdominal ultrasonography were assessed from baseline to 6 h. LPS induced tachycardia, hyperthermia, leukocyte alterations, marked gastrointestinal hypomotility, gastric distension, and increased intestinal wall thickness. Mosapride alone increased gastrointestinal motility without clinically relevant abnormalities. During endotoxemia, mosapride partially restored gastrointestinal motility, reduced intestinal wall thickening and gastric distension, and was associated with a less pronounced hematologic inflammatory response than LPS alone. These findings indicate that oral mosapride retains clinically relevant prokinetic activity during acute experimental endotoxemia and support further investigation of its use as an adjunctive treatment for inflammation-associated gastrointestinal hypomotility in horses.