GASTROSCOPE EXAMINATION

Do you suspect your horse has equine gastric ulcer syndrome?

The best way to diagnose equine gastric ulcers is to have an equine veterinarian use a gastroscope to closely examine all parts of the stomach wall.

Our vets are on the road daily and we come to you.

  • The veterinarians in our clinic are knowledgeable and experienced in the area of equine gastroscopy.

  • A gastroscopic examination will ensure your horse receives an accurate diagnosis.

  • An accurate diagnosis will ensure appropriate treatment and a better outcome for your horse.

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For all emergencies please ring the clinic direct on 03 5977 5250.

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Equine gastric ulcer syndrome

Gastric Ulcers can be a big problem for many horses. The first part of diagnosing the problem is to quantify the severity of gastric ulcers.

Equine gastric ulcer syndrome can be broadly split into two types of disease based on the anatomical location of the pathology. The upper, white part of the stomach is called the squamous section and disease associated with ulcers seen in this location is described as Equine Squamous Gastric Disease (ESGD). The lower, pink part of the stomach is called the glandular section and disease associated with ulcers seen in this location is described as Equine Glandular Gastric Disease (EGGD).

The only want to truly ascertain whether your horse has one of the two types of equine gastric ulcers is by making an appointment for equine gastroscopy at which time your veterinarian will use their gastroscope to visualise all parts of the stomach wall. After fasting your horse for 12-14 hours your veterinarian will administer sedation after which they will pass a tube through the nose into the stomach. The gastroscope is passed through the tube and the stomach is inflated with air to facilitate examination of all surfaces. 

Normal Stomach

Normal Stomach

In this image we are looking at the greater curvature of the stomach. We can see a clean and healthy mucosa with no signs of gastric ulceration present.

 
Abnormal Stomach

Abnormal Stomach

In this image we are looking at the lesser curvature of the stomach. There are several small pimples/ red areas which are Grade 2 mucosal ulcers. This horse has had some management changes and treatment and these have now been treated. The horse also has shown a large improvement in the behaviour.

 

To perform a gastroscope we need the following:

To achieve a good image of the scope we need to make sure that the stomach is emptied of all contents to the best of our ability. We recommend withholding all food for 12-16 hours before the scope. Confining the horse to a small sand yard / stable is an ideal way to do this. The last meal should be a small meal and all hay removed also. 

At around 2 hours before the scope we recommend removing the water also to allow us to see inside the stomach. 

 FAQs

  • Do you suspect your horse is suffering from equine gastric ulcer syndrome? Clinical signs of this disease include;

    1. Changed feeding behaviours – reduced appetite, loss of apptetite, taking frequent breaks to eat hard feed, leaving uneaten feed, preference for hay over hard feed.

    2. Poor performance – episodes of reduced performance under saddle, increased lethargy or reluctance to work at previous level.

    3. Colic – usually mild intermittent to chronic colic that responds well to pain relief.

    4. Condition – drop or failure to put on condition, weight loss, poor quality coat.

    5. Behavioural – cribbing, flehmen response, sensitivity to girthing.

  • To properly visualise the lining of the stomach we need to ensure that the stomach is emptied of all contents. We recommend the following preparation;

    1. Withhold all food for 12-14 hours prior to the gastroscope examination.

    2. Confine the horse to a small sand yard or stable.

    3. Ensure the last meal is a small one. Ensure all hay is removed.

    4. Remove water 2 hours prior to the gastroscope examination.

  • The only way to accurately diagnose equine gastric ulcer syndrome is by using a gastroscope to closely examine all parts of the stomach wall. After fasting for 12-16 hours, under sedation a tube is passed through the nose into the oesophagus. The gastroscope is passed into the stomach, which is then inflated with air so we can better visualise all surfaces.

    We start at the exit point of the stomach, the pylorus, in the glandular part of the stomach. This is the most common site we see ulceration. The glandular fundus is then closely inspected for signs of ulceration. The upper part of the stomach, the squamous portion is finally inspected for signs of ulceration.

    Images and video footage are recorded and pertinent images are included in an individualised gastroscopy report for each horse.

  • If your horse is suffering from equine gastric ulcer syndrome it is essential that a treatment program is tailored to their particular diagnosis. Treatment depends on whether the horse is suffering from squamous, glandular or both types of ulceration.

    Squamous (ESGD) ulceration is treated using the drug Omeprazole which is administered by mouth once per day, 30 minutes prior to breakfast on an empty stomach.

    Glandular (EGGD) ulceration is treated using Misoprostol and/or Sucralfate which are administered by mouth twice daily with feed.

    The severity of ulceration often dictates the length of treatment, generally the more severe the ulceration the longer the course.

  • Engaging the services of a veterinarian experienced in the diagnosis and treatment of equine gastric ulcer disease will help achieve a better outcome for your horse. We recommend repeating the gastroscopy at the end of the treatment period to confirm complete healing of ulceration prior to stopping treatment.

  • Provide a small feed of hay (ideally Lucerne) 30 minutes prior to exercise to act as a fibrous mat within the stomach. This will help reduce splashing of gastric acid onto the squamous mucosa during exercise.

    Provide consistent daytime fibre intake (grazing grass or eating hay) and constant provision of water. This is key for the prevention of ulceration. The use of slow-feeder nets or feeders can provide a steady source of hay throughout the day and also serve to reduce boredom.

    Providing rest days (2-3 days of no exercise) has been shown to be protective against the development of equine glandular gastric disease.

    Supplementation with small volumes of vegetable oils (e.g. corn, soybean, canola, rice) may help to reduce the risk of gastric ulcer disease and provide a good energy source.

  • Gastric ulcers can occur in horses, and if left untreated, can cause pain and discomfort. Unfortunately, equine gastric ulcer symptoms can be vague because they are also associated with other conditions. However, the good news is that it is possible to diagnose and treat the disease and prevent the pain and discomfort resulting from equine gastric ulcers. A gastroscopy exam allows us to visualise the stomach and make good decisions about equine gastric ulcer treatment.

    What Are Gastric Ulcers in Horses?

    Gastric ulcers are caused by prolonged exposure of the stomach lining (gastric mucosa) to gastric juices resulting in ulceration and, occasionally, bleeding.

    Equine Gastric Ulcer Syndrome

    Our approach to treat gastric ulcers in horses is firstly to conduct an equine gastroscopic exam to make an accurate diagnosis. Veterinarians treat equine gastric ulcers in horses by using medication to reduce acid production and allow the ulcers to heal. If you would like to discuss gastric ulcers in horses, the best person to talk to is your veterinarian.

    Your veterinarian will also be able to discuss with you the causes of gastric ulcers in horses so you can minimise these risk factors in your day to day management. If owners are aware of what causes gastric ulcers in horses they can make better choices for their horses and ensure their horses stay happy and healthy.

    It is advisable to watch out for subtle changes in disposition and if changes are noticed it is a good idea to discuss them with your vet. Early diagnosis of gastric ulcers in horses can significantly improve long term health outcomes.

    Some of the subtle clinical signs to be aware of are:

    ● Irritability

    ● Loss of hunger

    ● Weak body condition

    ● Poor coat

    ● Tucked up look

    ● Teeth grinding

    ● Crib-biting

    ● Chronic diarrhoea

    ● Pot-bellied appearance

    ● Poor overall performance

    If the horse displays any of the above symptoms, it might be time for a horse gastroscopy. Speak to your vet and determine if an equine gastroscopy is necessary. If the vet advises in affirmative, get the horse ready for the procedure.

    Prerequisites to Performing a Gastroscope Exam

    A gastroscope exam is the best way to identify cases of gastric ulcers in horses. However, to successfully conduct a gastrocope exam to identify cases of gastric ulcers in horses, specific patient preparation is necessary. The patient preparation for an equine gastroscope is outlined as follows :

    ● The stomach must be emptied of all contents

    ● Food must be withheld for 12-16 hours before the procedure

    ● The last meal before the scope should be a light meal and all hay should be removed

    ● Removing water 2-hours before the scope to allows clear vision inside the stomach

    Once the prerequisites for performing a gastroscope exam have been completed, the vet will conduct horse gastroscopy accordingly and be able to make an accurate diagnosis.

    Book an Appointment

    Call us on (03) 5977 5250 during office hours (9 am-5 pm, Monday to Friday) for advice on gastric ulcers in horses, treatment and prevention. One of our veterinarians will be happy to answer any of your gastroscope and equine ulcer treatment related questions.

Example: Severe Gastric Ulceration

Example: Severe Gastric Ulceration

The owners of this horse reported behavioural changes. The horse had become increasingly difficult to deal with and had become very anxious during ridden exercise. This horse was diagnosed with severe ulceration of one area of the greater curvature of the stomach

Example: Full Stomach

Example: Full Stomach

Despite the best intentions of the owner, this horse had, in the absence of food spent the night eating shavings in the stable. This image illustrates why the stomach needs to be empty in order for us to properly visualise the lining. In this image we see a large mass of shavings in the stomach.

Example: Pyloric Ulceration

Example: Pyloric Ulceration

Our veterinarians will always make every effort to examine the pylorus in addition to the gastric mucosa. It is the experience of our clinic that pyloric ulcers can be very painful for horses. This horse had several reddened areas around the pylorus in addition to ulceration of the glandular part of the stomach. Identifying these ulcers is very important because they will often not respond to traditional gastric ulcer medication alone.