An 11-year-old mare presented with difficulty girthing as well as intermittent colic episodes. In the past, this had occurred sporadically, but regular bodywork and Veterinary Spinal Manipulation Therapy had relieved the issue in the short term. However, the problem recurred even with regular maintenance. The mare was reluctant to move forward with tack and began to leave some grain behind in her morning feed.

After a thorough discussion regarding concerns, history and symptoms, a gastroscopy was recommended.

A gastroscopy is an exam performed under light sedation using a video scope to determine if ulcers are present in the stomach. The scope enters through the nasal passage and is then swallowed to enter the stomach. If ulcers are deemed present within the stomach, they are then graded into categories based on their severity.

0= no ulcer lesions

1= the lesions appear to be superficial

2= deeper structures involved in the lesion

3= multiple lesions of variable severity

4= deeper structures involved and appears to be active as indicated by a darker colour

5= same as 4 with the addition of an active hemorrhage or blood clot

An ulcer can further be divided into squamous or glandular ulceration. Squamous ulcers are found in the upper part of the horse’s stomach. Glandular ulcers are found in the lower part of the horse’s stomach.

Gastroscopy revealed there was grade 2 squamous ulceration in the upper/squamous region. Discoloured mucosa was present in the squamous region which is consistent with the acid injury. The image below shows the area affected by acid injury:

Numerous hemorrhagic ulcers present in the glandular region of the stomach described as moderate ulceration

With these findings, it was likely that the ulcers were contributing to the mare’s behaviour and discomfort. The recommended treatment was to raise the pH within the stomach using GastroGard which acts to suppress acid in the stomach. Sucralfate was used to coat the ulcerated tissue and corn oil was given to increase the release of beneficial prostaglandin in the glandular portion of the stomach. Squamous ulceration often responds within 3-4 weeks from the start of treatment while glandular ulceration typically takes 8-12 weeks.

After 10 weeks of treatment, another gastroscopy was performed to see the status of the ulceration. It appeared the squamous ulcers were completely resolved and the previously-identified glandular ulceration improved tremendously in appearance with significantly less hemorrhage.

The image below is of resolved squamous ulceration site.

Image below of the previously identified glandular ulcers were partially healed with significantly less hemorrhage.

It was recommended that the mare continue the treatment to completely heal all of the ulcers; however, she has greatly improved overall and is working with a happy attitude.

Thank you to Dr. Kathryn Surasky and this mare's owner for the case!

G is for Gastric Ulcers

K is for Kissing Spine

D is for Dental Health