A look at ulcers

Imogen Burrows BVetMed CertAVP(EM) MRCVS RCVS Advanced Veterinary Practitioner in Equine Medicine

Imogen Burrows BVetMed CertAVP(EM) MRCVS RCVS Advanced Veterinary Practitioner in Equine Medicine

XL Equine Vet Imogen Burrows tells us all about one of her informative and educational clinics.

I had a change from the usual run of the mill veterinary practice day, as part of my goal as an XL Equine vet is to deliver excellence in practice. This can be defined in all manner of ways, but I believe part of delivering an excellent service is giving any equine owner the opportunity to learn more about the horse and diseases they may encounter.

XL Vets practices offer all animal owners a variety of opportunities, through Equine Matters magazines, factsheets, client evenings, lectures and demonstrations, Equine Skills workshops and many more events through the year. Recently, I was involved with organising and running one of my favourite events of the year at Cliffe Equine: the Gastroscopy Clinic.

This event is generously supported by Norbrook at our clinic, and is set out to raise awareness of Equine Gastric Ulceration. It's to make owners aware of just how prevalent a disease entity this is throughout our equine population and understand risk factors, management and treatment options that are available.

The fiberoptic camera picks up the internal image to detect whether the horse has ulcers,

The fiberoptic camera picks up the internal image to detect whether the horse has ulcers,

As in previous years, this event was hugely popular, and booked out quickly. I am fortunate enough to work in a facility where I have access to the specialist equipment required to diagnose gastric ulcers in the horse - a 3m long flexible fiberoptic camera and video monitor on which we can all see the view in glorious technicolor. The feeling I have when looking at the inner organs of the horse is that which sends me into a childhood reverie, as if I am Meg Ryan immersed in the 1980’s film ‘Inner Space’! I digress.

To maximise the benefits to all the people attending, we split everyone into two groups of six cases, running morning and afternoon sessions. The day started by me giving a brief introduction into the equine stomach and how it works, how is defends itself against its own acid environment and what goes wrong to allow disease to happen. We described the process of gastroscopy itself and then pressed on into the practical session.

The camera being inserted for the gastroscopy.

The camera being inserted for the gastroscopy.

Managing a yard with six horses that have been starved overnight for a minimum of 16 hours was no mean feat for our super efficient nursing team, but with lots of help and a dash or two of sedation things went very smoothly. 

Gastroscopy is not always easy - the equine body is famous for its ability not to align itself in a straight line. In fact, if a crow flies in a straight line, a horse’s intestinal tract is arranged more like a corkscrew!  As such, with the greatest sensitivity and a lot of mind over matter control, the scope is willed along the gullet, into the stomach and driven around the wall 360 degrees, as the exit is positioned directly on top of the entrance. Then we wait to be propelled out into the small intestine, minding the residual gastric fluid, which appears to coat the camera like the slime in ‘Ghostbusters’ when you get close up and personal with it!

We clearly had an excellent demonstration group, with 90% of the horses having some degree of ulceration, which shows us just how prevalent this disease is - even within the leisure/pleasure horse population. If you’re concerned about ulceration contact your vet. Signs to look out for are poor performance; recent behavioural changes, particularly aggression around eating; poor weight/muscling; recurrent mild colic episodes, resentment towards girthing when tacking up etc. 

The best news is of course, that since starting treatment, many of these cases have been re-evaluated with huge response to treatment - even a complete resolution from severe, extensive, bleeding ulcers to fully healed, with the owner reporting a much more chilled and calm horse to boot!