It has been widely known for many years that stomach ulcers are a significant cause of poor performance in sport horses.More recently, it has been discovered that they can be found throughout the equine world and also cause other nonspecific symptoms. Horses that are under many varied types and degrees of stress may develop gastric ulcers.
Signs may include: recurrent colic
change in attitude/behavior
weight loss/ poor hair coat
teeth grinding
inappetance (food and/or water)
Unfortunately, the only way to diagnose these ulcers is by direct visualization with a flexible fiber-optic scope: a gastroscope.
At Buckeye Veterinary Service, we have a 3.1 meter gastroscope that allows us to examine the entire stomach, as well as a short portion of the duodenum (beginning of the small intestine). Horses are required to be off food for 20-24 hours (they can have water) to allow unobstructed viewing. Generally the horse is sedated, the gastroscope is passed through the nostril into the stomach (just like a nasogastic intubation) and the process is completed in less than an hour. All of the pictures below were taken at our hospital.
In the body of the stomach, or "fundus", we see two types of tissue. The nonglandular portion is pale, and the glandular portion is darker. The line that divides the two is called the "margoplicatus". (The image on the left is rotated clockwise 90 degrees). Frequently ulcers are found just above this line.
These are images from a normal gastroscopic exam.
As we enter the esophagus, the normal longitudinal folds, saliva, and peristaltic movement can be seen.
After examining the fundus, the scope is directed into the fluid and the "greater curvature" is followed. Stomach wall is seen through the saliva and stomach acid in the views below.
Once through to the pylorus (the exit), we are seeing the typical tan-grey appearance of the proximal duodenum (small intestine). Frequently green bile will be found, and the opening to the bile duct can be seen.
Now for the abnormal (ulcerated) stomach images.
Here again is the pale, nonglandular portion of the fundus with pitted ulcerations in the most common place to find them: just above the margoplicatus.
Gastroscopy
This is a more dramatic abnormality affecting the same region. Many scattered angry red lesions are seen across the mucosal surface. The margoplicatus is seen at the bottom of the picture.
Moving past the stomach fluid and entering the fundus (identifiable by the tan-grey color), we can identify some pale streams of blood. In the distance, above the opening to the duodenum, we can see a dark red ulcer.
This is a close-up of the ulcer in the previous picture. This horse had chronic intermittant colic, irregular eating habits, change in attitude and behavior (uncooperative and unhappy), and was mildly anemic. The normal images of the fundus (seen above) are this same horse after treatment with 28 days of Gastrogard (and some feeding changes).
