Recognising Equine Gastric Ulcers: Clinical Signs and Diagnostic Challenges

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Equine Ulcer Diagnosis Gastroscopy Gastric Ulcer Symptoms Equine Performance

Recognising Equine Gastric Ulcers: Clinical Signs and Diagnostic Challenges

One of the greatest challenges in managing equine gastric ulcer disease is that many affected horses show subtle or no obvious clinical signs.

More Than Just Colic

Classic signs associated with gastric ulceration include:

Recurrent mild colic

Reduced appetite

Weight loss

Poor body condition

Girth sensitivity¹

However, behavioural changes may be equally important indicators.

Behavioural Clues

Affected horses may display:

Irritability

Aggression

Nervousness

Teeth grinding

Self-mutilation

Poor coat quality¹

Because these signs are often attributed to temperament or training issues, gastric disease may be overlooked.

The Performance Connection

Both ESGD and EGGD have been associated with reduced athletic performance².

Experimental studies demonstrated measurable reductions in aerobic performance in horses with induced gastric ulceration¹.

Gastroscopy Remains the Gold Standard

Definitive diagnosis requires gastroscopy using an endoscope at least 2.5–3 metres long to allow visualization of both squamous and glandular regions¹.

Gastroscopy not only confirms disease presence but also enables lesion grading and treatment monitoring.

Limitations of Current Diagnostics

Although gastroscopy is highly valuable, it may underestimate lesion severity compared with histopathology¹.

Alternative diagnostics such as:

Sucrose permeability testing

Faecal occult blood testing

Serum biomarkers

have been investigated, but none currently match the diagnostic accuracy of gastroscopy¹.

Conclusion

Equine gastric ulcers often present with subtle clinical signs that extend far beyond gastrointestinal discomfort. Gastroscopy remains essential for definitive diagnosis and accurate assessment of disease severity.

References

van den Boom R. Equine gastric ulcer syndrome in adult horses. The Veterinary Journal. 2022 May 1;283:105830. https://doi.org/10.1016/j.tvjl.2022.105830

Sykes BW, Bowen M, Habershon-Butcher JL, Green M, Hallowell GD. Management factors and clinical implications of glandular and squamous gastric disease in horses. Journal of Veterinary Internal Medicine. 2019 Jan;33(1):233-40. https://doi.org/10.1111/jvim.15350