Gastroscopy is the only reliable test for stomach ulcers in the horse and this is the main reason for performing gastroscopy in horses.
The most common signs of gastric ulceration vary depending on what discipline the horse in working in but include:
In horses in training:
- Slow eating / poor appetite
- Failure to maintain adequate body condition when in work
- Poor performance
- Especially with increasing workload
In Sport and pleasure horses:
- Resentment of placing saddle and especially tightening girth
- Placing and adjusting rugs
- Kicking out when eating
- Resentment of grooming chest and abdomen
- Temperament change
- Sour, poor jumping performance
- Aggression toward handlers
- Resistance to leg aids and unwillingness to go forward under saddle
- Bucking, rearing, bolting
- Low grade recurrent colic but this is rare
Gastroscopy may also be used in the investigation of problems of the gullet such as recurring cases of “choke” or problems of the upper small intestine such as inflammatory bowel disease (IBD). Biopsies can be harvested from the bowel lining to assist diagnosis.
Gastroscopy can be performed either at our Bourton Vale Equine Clinic or at your home yard. Director and Equine Internal Medicine Specialist , Tim Brazil also provides as specialist gastroscopy referral service to other veterinary practices throughout the UK.
Our videogastroscopes are some 3.3m long allowing examination of both the stomach and upper small intestine of even the largest horses. The stomach is composed of two very distinct regions; the upper cream-coloured squamous lining and the lower glandular lining, which extends down to the level where the stomach empties out into the small intestine.
Prior to gastroscopy a period of approximately 15 hours of starvation whilst stabled on a bed that the horse will not eat is required. Ideally water should be withdrawn 1-2 hours prior to gastroscopy but this is not critical.
The horse is sedated and the gastroscope passed via the nostril. This procedure is most easily achieved with three people
Gastroscopy will determine which part(s) of the stomach are ulcerated and the extent and severity of any ulcers. These findings will guide the nature, dose and duration of treatment. It is very important to correlate the presenting clinical signs and gastroscopic findings.
Ulcer severity is graded on a scale of 0-4 (Grade 0: normal, Grade 1: minor inflammation and thickening due to wear and tear, Grades 2, 3 or 4 mild, moderate or severe depending on the number size, depth and extent of the ulcers). However it should be noted that all horses are individuals and vary hugely as to the severity of the clinical signs that they may show when suffering from a particular grade of ulceration.
The acid suppressant drug omeprazole is the mainstay of treatment of gastric ulceration but in some cases other treatment are used such a coating agents (sucralfate), antacid gastroprotectants and antibiotics. Some cases require several weeks of therapy, others many months to resolve and control the ulcers