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Equine Gastric Ulcer Syndrome (EGUS) is a disease that has been widely discussed and gained more attention and understanding in the equine world over recent years. It is a significant problem affecting the pleasure horse, sport horse and racehorse industry, with a prevalence of 11%/30%/90% respectively in our population of horses in the UK. Therefore, it is no surprise that owners and vets alike are concerned about this condition and the effect it can have on our horses’ well-being.

Common signs of EGUS include weight loss, aggression, bad behaviour, sensitivity when girthing, dull coat, poor performance, lethargy, bucking when ridden, recurrent colic.

EGUS is a term that describes two distinct diseases of the equine stomach.

The lower half of the stomach is termed the glandular part, this is the portion of the stomach where acid is in abundance in the normal horse, but it is lined with a protective epithelium to protect the stomach wall from this acid. When this protective epithelium or lining of the glandular part of the stomach fails to protect from normal levels of acid exposure, it results in Equine Glandular Gastric Ulceration, or ‘pyloric ulcers’.

The upper half of the stomach is the squamous portion, this is the portion of the stomach that acid should not usually be in contact with and therefore it does not have a protective lining to safeguard against acid contact. When there is an increase in acid production and therefore acid splashing up to the squamous region of the stomach it can become damaged and the result is Equine Squamous Gastric Ulceration.

Gastroscopy is performed for the investigation of gastric ulcers in horses. A long endoscope (camera) is passed up the nostril, down the oesophagus and into the stomach of your horse and a detailed examination of the stomach wall can be carried out and images recorded. If ulcers are present, we record their location, extent and severity and with that information can develop a treatment plan. If required, we can also take a biopsy of the stomach wall through the gastroscope.

Horses are sedated for the procedure to ensure they are not stressed during the gastroscope. We require the horse to have been starved overnight in order for their stomach to be empty, otherwise we cannot visualise the stomach walls in their entirety. Gastroscopes can be performed at your yard or in the clinic for an all- inclusive price which includes sedation and stabling, if they are staying at the clinic overnight.

We occasionally run sponsored gastroscope clinic days, where we offer gastroscopes at a discounted price. Please get in touch with the clinic if you are interested in finding out if there are any upcoming gastroscope days.

If gastric ulcers have been diagnosed on gastroscope, a specific treatment regime is formulated based upon the location, severity and type of ulceration found. We will also provide information on management practices and nutritional advice that will improve your horse’s gut health and the prevention of recurrence of ulcers.

Gastrointestinal work ups
Gastrointestinal workups are required in cases of recurrent colic, weight loss or ill thrift.

Significant unplanned weight loss can be a consequence of serious underlying disease. It is important that these cases are fully investigated to diagnose the inciting cause of the weight loss. Diagnosis will commence with a thorough history and clinical examination of your horse, which may offer an indication of the path to follow with investigations, which would include:

  • Gastroscopy
  • Abdominal ultrasound scan
  • Peritoneal sample analysis
  • Blood work
  • Faecal evaluation
  • Oral exam
  • Rectal exam.

If your horse has suffered from recurrent episodes of colic in the past, investigation is required to understand whether there is an underlying cause that is responsible for the colic symptoms your horse has been displaying. Depending on the individual case, gastrointestinal investigations similar to that for weight loss would be carried out.

In the case of an acute colic episode, where your horse is currently displaying colic signs, immediate investigation including rectal exam, blood work, peritoneal tap and abdominal ultrasound will be performed if required to aid in treatment options for your horse.

Respiratory investigations

Respiratory diseases in horses are regularly encountered and have a variety of different causes. Respiratory diseases can be infectious or non-infectious in origin.

Infectious causes of respiratory disease most commonly encountered include equine influenza, equine herpes virus and strangles.

Common non-infectious respiratory diseases of the lower respiratory tract include Recurrent airway obstruction (RAO-formerly known as COPD) and Inflammatory Airway Disease (IAD).

Clinical signs vary from a mild intermittent cough at exercise as seen with low grade IAD, to labored breathing and heave lines seen in severe cases of RAO.

It is important to investigate respiratory disease no matter how mild the signs are, in order to increase the athletic potential of your horse and improve their quality of life.

Because many equine respiratory diseases can look alike on clinical examination, diagnostic tests may be required to establish the precise cause.

We commonly use the following diagnostics to investigate respiratory disease:

  • Endoscopy - involves inserting a long flexible camera up the nostril into the upper airway. We can perform a detailed examination of the upper airway with the endoscope and then move down the trachea to the lower airways and the main stem bronchi. The endoscope is also used to take samples that will aid in the diagnoses of different diseases
  • Tracheal Wash – involves the placement of the endoscope in the trachea and flushing through saline then collecting samples of fluid for cytological and bacteriological examination in the laboratory
  • Guttural pouch wash – the endoscope is inserted into the guttural pouches in the upper airways to collect a sample, usually to investigate strangles
  • Bronchoalveolar lavage – involves inserting a tube down the airway to retrieve a sample of fluid from the lungs which is analysed in the lab. This is particularly useful in the diagnosis of RAO or IAD
  • Nasal or Nasopharyngeal swabs – these are submitted to a laboratory for testing for bacteria and viruses.
  • Thoracic ultrasound – scanning of the lungs is useful in the investigation of pneumonia or localised lung problems such as abscesses.

Laboratory work

Laboratory work is invaluable in the investigation of many different equine diseases. At Walnut Hill we have our own in-house lab which means we can rapidly analyse samples and usually expect same day results. For urgent cases we can get results within minutes of the sample arriving at our laboratory.

Our in-house lab investigations include:

  • Haematology
  • Biochemistry
  • Liver profiles
  • Lactate
  • Serum Amyloid A
  • Fibrinogen
  • Immunoglobulin G levels (IGG)
  • Faecal worm egg count
  • Microbiology
  • Microscopic evaluation of slide samples for skin/blood/bodily fluids.

For any samples that we cannot analyse in our clinic, we send the samples via next day post to a number of recognised specialist equine laboratories in the UK.