Gastric Ulcers and Gastroscopy
Gastric (stomach) ulcers are more common than most people know. Research studies have estimated that 60 to 90 percent of performance horses have gastric ulcers. In addition, modern-day management practices can predispose all horses, even backyard companions, to development of ulcers.

So, what are the signs that your horse may have ulcers? Fact is, horses with gastric ulcers can display a variety of symptoms. In addition to problems with weight, coat, and behavior, an afflicted horse can also exhibit low-grade colic, diarrhea, or poor appetite. Any of these symptoms—and especially a combination of some—should trigger concern and a consultation with one of our veterinarians. McGee Equine Clinic now owns a state of the art portable 3.5 M video endoscope that we can use to perform gastroscopy of your horse on the farm!

Why do ulcers develop?
Horses develop gastric ulcers when excess digestive acid damages the lining of the stomach. The equine stomach has two distinct regions: an upper, non-glandular (or squamous) region and a lower, glandular (acid-producing) region. Food enters the squamous region, which comprises roughly a third of the stomach, and from there descends into the glandular region, where digestive acids and enzymes break it down into nutrients. Ulcers can form in either region, but most occur in the non-glandular tissue, which lacks certain protective features that line of the glandular region. Having evolved as grazers that eat throughout the day, horses continuously secrete stomach acid 24 hours a day, 7 days a week. Adult horses can produce up to 4 gallons of stomach acid per day! In the wild (or in the pasture), the potentially damaging effects of this acid are buffered by the nearly continuous intake of grass and the ongoing production of acid-neutralizing saliva.

Modern-day equine management often contributes to the development of stomach ulcers. High starch grain diets, less time spent grazing, low forage diets, stall confinement, and periods of fasting put our equine companions at significant risk for the development of gastric ulcers. Moreover, stress and traveling increase the production of stomach acid, ratcheting up the incidence of gastric ulcers. So, too, does the intense training and exercise of show horses. Research has shown that the size of the equine stomach decreases during exercise, which results in the delicate non-glandular portion of the stomach being in contact with acid for a prolonged period. Finally, the use of nonsteroidal antiinflammatory drugs (NSAIDs) such as Banamine (Flunixin) and Bute (Phenylbutazone) can also cause gastric ulcers.

Clinical Signs:
Horses react to gastric pain (or pain in general) in many different ways. Some are very stoic, particularly seniors, or certain breeds like drafts and Standardbreds. Others show dramatic responses, making it known to everyone that there is something wrong. Some signs that may or may not be present with stomach ulcers include: weight loss, change in attitude/behavior/work ethic, intermittent colic, dull hair coat, being a poor doer, displaying a change in eating patterns, abnormal posturing to urinate, reluctance to perform, stiffness, lack or response to leg, and being “girthy”. It is important to remember that many other conditions can cause the symptoms above, so just because your horse is displaying a particular clinical sign, does not necessarily mean that he has stomach ulcers.

Diagnosis and treatment:
While clinical signs can certainly be suggestive of stomach ulcers, they are not a definitive diagnosis. Currently, the only reliable method for diagnosing equine gastric ulcers is gastric endoscopy; that is, passing a tube with a small camera up the nose, down the esophagus, and into the stomach. This procedure allows us to directly visualize the stomach for the presence of ulcers or other abnormalities. Since food contents can interfere the examination, the horse should not eat for 18-24 hours nor drink for four hours preceding gastric endoscopy. Once diagnosed, most gastric ulcers are very effectively treated, most commonly with omeprazole-either in the oral form (Gastrogard), or with a newer product, injectable omeprazole. Once treatment is initiated, the horse should be re-scoped in 30 days to monitor the status of the ulcer healing.

Gastroscopy Questionnaire – Download & Print