Unfortunately,
gastric issues in the horse are relatively common, especially the
high incidence of gastric ulceration. It doesn’t help that environmental changes and performance schedules add another layer of stress. Our doctors encourage horse
owners to look for any signs of a potential issue early so that we
can properly perform an examination of the stomach, known as
gastroscopy so treatment can be started quickly. Dr. Weldon is a
trained internal medicine specialist and highly skilled at endoscopic
procedures.
What is Equine gastroscopy:
- gastroscopy is a procedure where a 10 foot long, very narrow, 1 cm diameter tube which has a small digital camera in the end is inserted in the horse’s nose and passed all the way down the esophagus to evaluate the inside of the horse’s stomach. This is the same as passing a nasogastric tube. Your horse will be mildly sedated so that there is no discomfort. Additionally, we will discuss with you prior to the procedure that your horse will need to be fasted approximately 12 hours before the gastroscopy. Water is also withheld 4 hours prior to the procedure. This way there is no food material or water inside the stomach which could obstruct our ability to image areas that might be abnormal. Typically, this means withholding all feed and hay after midnight and performing the procedure first thing in the morning that way they are not without food for a prolonged period of time.
- High-definition video it will be obtained which allows a complete examination of the esophagus, squamous and glandular portions of the stomach as well as the pylorus and duodenum which is the proximal portion of the small intestine.
- Once the procedure is completed, which takes approximately 30 minutes, you will be able to feed your horse again in about one hour.
How does your horse feel during gastroscopy?
- The procedure is not painful for your horse. They will receive in mild sedative to ease any potential stress or discomfort. As a result, the insertion of the tube only feels like a tickling sensation and no different from the typical passing of a nasogastric tube. Your horse may receive an anesthetic in his or her nose to minimize the discomfort as well.
What gastroscopy can diagnose:
- Gastroscopy
is a procedure are doctors used to diagnose gastric ulcers because
it is the only way to ocular diagnose an ulcer and determine the
type. The two main types of ulcers are squamous ulcer disease and
glandular ulcer disease. These two forms are treated differently and
have different causes. Squamous ulceration is caused by acid
splashing, and can be associated with stress and certain medication
use. Glandular ulcer disease is different in that it is a disease of
unknown ideology and responds poorly to the typical anti-ulcer
medication. It can only be diagnosed via gastroscopy. The use of
stool sample ulcer testing is highly unreliable. Additionally,
lesions on the pylorus and in the proximal small intestine can also
be imaged, as well as foreign bodies and gastric impactions.
Treating issues after gastroscopy:
- After our veterinarians confirm any issues, your horse will receive treatment. For gastric ulcer syndrome, standard treatment is medication or a combination of medications. Some examples include omeprazole and misoprostol. Omeprazole, sold under the brand-name Gastrogard (Prilosec for humans) is a proton pump inhibitor. It reduces the amount of acid in your Horses stomach produces. Omeprazole is destroyed by stomach acid therefore the proprietary formulation of Gastrogard must be used, generic formulations of this drug are ineffective. Misoprostol is an additional medication used to treat gastric ulcers as well as it is a prostaglandin which increases the health of the mucin layer protecting the stomach lining.
- New research has shown more successful treatment of glandular ulcer disease with a long-acting injectable form of omeprazole which can provide a much longer duration of acid suppression.