Gastric Ulcers in a horse

The endoscopic images below are from a teenage gelding that presented for a complaint of aggressive  behavior while grooming. The gelding was not displaying any classic signs of colic nor was there a decline in food intake or a report of weight loss. When the stomach was examined, several bleeding ulcers were noted surrounding the pyloric sphincter. This region of the stomach includes the passage from the stomach into the small intestine. The gelding was treated with 45 days of Gastrogard and returned to normal behavior.

 The important message from this case is that gastric ulcers in horses can present like most anything! Classically, they present as low grade colic associated with feeding plus or minus weight loss. However, in my experience clinical signs associated with gastric ulcers have included poor performance, dull hair coat, excessive water intake, sour behavior under saddle, aggressive behavior while being groomed, colic, parking out, frequent posturing to urinate, teeth grinding, and weight loss.

I strongly recommend a gastric exam which includes visualization of the pyloris to determine if gastric ulcers are the source of the clinical complaint. This involves 24 hrs of fasting and a trained clinician with a 3 meter gastroscope. If ulcers are discovered, the only treatment proved to be effective is Gastrogard medication for at least 30 days! I typical recommend 30 days of a full dose followed by 2 weeks of a half dose.