How is a gastric ulcer diagnosed?
This is how a gastroscopy is carried out on your horse!
Even with prevention, the figures mentioned at the beginning suggest that there is still a lot of room for improvement.
A gastroscopy is often the only way to find out for certain whether a horse suffers from gastric ulcers.
The examination involves an endoscope being inserted into the horse's stomach to check the lining for gastric ulcers or lesions.
The stomach must of course be empty in order for the examination to go smoothly, so forget for a moment the recommendations for prevention discussed above.
For horses, such an examination means no eating 12-24 hours before the procedure and no drinking 2-3 hours before.
These are the basics.
While at first glance a gastroscopy appears to be the best path to a diagnosis, another challenge lurks here.
Gastric ulcers come and go, sometimes very quickly.
If the gastroscopy turns up no abnormalities, that doesn’t mean everything is in perfect order.
Gastric ulcers may have been present a few days before the examination and have since disappeared – or they may occur two days after this "satisfactory" examination.
This is exactly why it is so important to observe the horses closely for any of the symptoms mentioned above.
One should also know the individual characteristics of one’s healthy animals, in order to spot behaviour changes that may arise.
A further challenge lies in the simplified presentation of gastric ulcers in all stages.
Some studies have shown, in fact, that bacteria in the stomach will colonise those areas affected by the ulcers, thus preventing or at least significantly slowing down the healing process.
Rats have been used for research in this area because their stomachs are similar to those of horses.
In rats, there was no obstacle to the healing process of gastric ulcers after the administration of the antibiotics streptomycin and/or penicillin.
The review paper, which we refer to here, is listed at the end of the blog article and is freely accessible.
We cite here an important excerpt due to the relevant sources mentioned:
Once gastric ulcers are present, other bacteria have been implicated in inhibiting ulcer healing.
Bacteria, including E. coli, were cultured from the stomach of horses (Al Jassim et al. 2006).
In rats, which have a compound stomach similar to horses, E. Coli administered orally, rapidly colonised acetic acid-induced gastric ulcers and impaired healing (Elliott et al. 1998).
Oral antibiotic treatment with streptomycin and/or penicillin suppressed bacterial colonisation of ulcers and accelerated ulcer healing.
Also, oral administration of lactulose resulted in an increase in Lactobacillus spp. growth and colonisation of the ulcer bed.
Accelerated ulcer healing was seen in the rats compared to placebo treated controls.
Thus, bacterial colonisation of gastric ulcers in the stomach of horses may delay ulcer healing and in this case treatment with antibiotics may be indicated.
Far more common than the treatment of gastric ulcers with antibiotics is the use of so-called inhibitors, which stop the production of gastric acid and/or protect the mucous membranes.
However, this type of treatment is not recommended as a permanent solution. Stomach acid basically fulfils the important function of killing microbes that were previously formed and thus making protein digestion possible.
Worst case, the suppression of gastric acid production long-term can lead to bacterial infections.