Gastric disease is common in horses and can affect horses of all ages, breeds, and disciplines. Performance demands, travel, changes in routine, diet, feeding practices, periods without forage, illness, and certain medications are among the factors that may contribute to the development of gastric disease.
Unfortunately, the signs of gastric ulcers can be subtle—and some affected horses show very few outward signs.
Jacksonville Equine Associates offers high-definition video gastroscopy, allowing our veterinarians to directly examine the esophagus and stomach and determine whether gastric disease is present.
Our team also includes a board-certified Large Animal Internal Medicine specialist with advanced training and experience in endoscopic procedures and complex gastrointestinal disease.
What Is Gastroscopy?
Gastroscopy is an endoscopic examination of the horse's esophagus and stomach.
A long, narrow, flexible video endoscope is carefully passed through the nostril, down the esophagus, and into the stomach. This allows the veterinarian to directly visualize the stomach lining on a high-definition monitor.
During a complete examination, we can evaluate the squamous and glandular regions of the stomach, the junction between these regions, and the pyloric area. In some horses, portions of the proximal duodenum may also be visualized.
Gastroscopy remains the most definitive method for identifying and characterizing equine gastric ulcer disease.
When Should You Consider Gastroscopy?
Gastric disease doesn't always look like obvious stomach pain. Depending on the horse, signs that may prompt further evaluation can include:
Recurrent or unexplained colic
Poor or inconsistent appetite
Weight loss or difficulty maintaining condition
Changes in attitude or behavior
Decreased performance
Girthiness or sensitivity
Reluctance to work
Changes in eating patterns
Poor body condition
Suspected gastric disease that has not responded as expected to treatment
These signs are not specific to gastric ulcers and can occur with many other medical or musculoskeletal conditions. Gastroscopy allows us to determine whether gastric disease is actually present rather than treating based on symptoms alone.
Preparing Your Horse for Gastroscopy
For us to properly examine the stomach, it must be sufficiently empty at the time of the procedure.
Your horse will therefore need to be fasted before gastroscopy, and water may also need to be withheld for a shorter period before the examination.
Our team will provide specific fasting and water-withholding instructions when your appointment is scheduled. It is important to follow these instructions closely because feed or fluid remaining in the stomach can prevent portions of the stomach lining from being adequately visualized.
We commonly schedule gastroscopy earlier in the day to make the fasting period as convenient as possible for the horse and owner.
What to Expect During the Procedure
Your horse will typically receive sedation to reduce stress and allow a thorough examination.
The flexible gastroscope is passed through the nostril and esophagus into the stomach. Air and water may be used during the procedure to improve visualization of the stomach lining.
The examination is viewed in real time, allowing our veterinarian to identify abnormalities and document findings with digital images or video when appropriate.
Most horses tolerate gastroscopy well. After the examination, your horse will be monitored while the sedation wears off, and our team will tell you when it is safe to offer feed and water again.
Equine Gastric Ulcer Syndrome
Not all equine gastric ulcers are the same.
Two important forms of gastric disease are Equine Squamous Gastric Disease (ESGD) and Equine Glandular Gastric Disease (EGGD). Distinguishing between them is important because they involve different regions of the stomach and may require different management and treatment approaches.
Equine Squamous Gastric Disease
ESGD affects the upper, non-glandular or squamous portion of the stomach.
The squamous mucosa has less protection against gastric acid than the glandular portion of the stomach. Management and feeding factors that increase exposure of this region to acidic stomach contents can contribute to disease.
Exercise, prolonged periods without forage, feeding practices, and other management factors may influence an individual horse's risk.
Equine Glandular Gastric Disease
EGGD affects the glandular portion of the stomach, including areas near the pylorus.
Glandular disease is more complex, and its development is not completely understood. It should not simply be considered the same disease as squamous ulceration in a different location.
Gastroscopy allows us to determine which region is affected and characterize the lesions present, which is important when developing an appropriate treatment plan.
Why Diagnose Before Treating?
It can be tempting to assume that behavioral changes, poor performance, girthiness, or recurrent mild colic are caused by ulcers and simply begin medication.
The problem is that many different conditions can cause the same signs.
Gastroscopy allows us to see whether gastric lesions are actually present, determine which portion of the stomach is affected, assess their severity and appearance, and develop a treatment plan based on what we find.
It can also identify other abnormalities, including certain gastric impactions, masses, foreign material, or abnormalities involving the pyloric region.
Treatment After Gastroscopy
Treatment is individualized based on the type, location, and severity of disease, as well as the horse's diet, workload, medications, management, and other health concerns.
Depending on the findings, treatment may include acid-suppressive medication, mucosal-protective therapy, dietary and feeding modifications, management changes, and other medications when appropriate.
Omeprazole remains an important medication in the management of equine gastric ulcer disease. Other medications, including misoprostol or sucralfate, may be considered in selected cases depending on the type of disease and the individual horse.
There is also growing veterinary interest and research involving long-acting injectable omeprazole formulations for certain cases. Whether these are appropriate depends on the individual patient, available formulation, and veterinarian's treatment plan.
Rather than using one treatment protocol for every horse, our veterinarians tailor therapy to the gastroscopic findings and the individual patient's needs.
Follow-Up Gastroscopy
Improvement in behavior or performance does not necessarily tell us whether gastric lesions have completely resolved.
For certain horses—particularly those with significant disease, glandular lesions, persistent clinical signs, or an incomplete response to treatment—our veterinarians may recommend repeat gastroscopy to assess healing and determine whether treatment should be continued or modified.
Gastroscopy at Jacksonville Equine Associates
Jacksonville Equine Associates provides high-definition equine gastroscopy as part of our comprehensive internal medicine and diagnostic imaging services.
With advanced endoscopy, in-house laboratory testing, multiple ultrasound platforms, digital radiography, and the expertise of a board-certified Large Animal Internal Medicine specialist, we can evaluate gastric concerns as part of the horse's overall medical picture rather than treating symptoms in isolation.
To schedule a gastroscopy or discuss whether your horse may benefit from an examination, contact Jacksonville Equine Associates at (904) 387-3330.