Equine Gastroscopy – What to Expect During the Procedure

How to prepare your horse and what happens during a gastroscopy.

Updated July 23, 2024
A veterinarian performing an equine gastroscopy procedure
Image courtesy of Boehringer Ingelheim Animal Health USA Inc.

Detecting Stomach Ulcers in Horses

Gastric ulcers (formally known as Equine Gastric Ulcer Syndrome or EGUS) are lesions that occur when acid damages the sensitive stomach lining. These lesions can cause serious effects on your horse’s overall health and quality of life. Signs of your horse’s discomfort could result in them losing weight or not wanting to eat their meals, signs of colic, as well as subtle changes in their performance or behavior.

Not every ulcer is alike. Treatment plans can change depending on the ulcer’s exact location within the stomach and its grade (severity on a scale from 0 being healthy with no ulcers to 4 being extensive ulceration).

While your horse may show clinical signs, the only way to definitively know if ulcers are the root of the problem is to have a gastroscopy done.

What is Equine Gastroscopy?

Gastroscopy is an examination of the inside of your horse’s stomach. It is the only way to truly diagnose gastric ulcers. Performed by a licensed veterinarian, the entire gastroscopy procedure typically takes about 20 minutes in total.

The procedure involves use of an endoscope, which is a long tube with a tiny camera and light at the end. The camera gives your veterinarian a visual of the squamous and glandular portions of the stomach so they can assess the severity of any ulcers (or other abnormalities) and recommend the most appropriate course of treatment.

When endoscopy is used to see inside your horse’s stomach, the procedure is called gastroscopy. The procedure is also commonly referred to as “scoping a horse.”

Preparing Your Horse for a Gastroscopy

Two horses peeking their heads out of their stall windows.

Fasting

  • The day before: Plan to withhold feed for up to 24 hours before the procedure. This includes forage, like hay and grass pasture, as well as grain and/or supplements. Ask your veterinarian exactly how far in advance you should begin fasting your horse before the procedure.
  • The day of: Withhold water 2-3 hours before your appointment so your veterinarian will have as clear of a view of the stomach as possible.

Finding an Appropriate Location

This procedure can be done at a clinic or stall side if your veterinarian has equipment that they can bring with them to your barn. If at your barn, find an area where your horse can have a barrier on both their sides and behind, such as a wash stall or at the end of a barn aisle.

If at the equine hospital, your veterinary team may walk your horse into stocks before starting the gastroscopy.

What to Expect During Your Horse’s Gastroscopy

A veterinarian preforming a gastroscopy on a horse in the barn
Image courtesy of Boehringer Ingelheim Animal Health USA Inc.
  1. To start, your veterinarian will likely have a technician to assist them during the procedure. They may need you or another trusted handler to hold your horse.
  2. Then, your veterinarian will lightly sedate your horse. They may also use a twitch or other restraint in the very beginning.
  3. The endoscope (or “scope” for short) is passed through your horse’s nostril. It is then guided down the throat and into the stomach. You will be able to see exactly what they are seeing on the monitor as the endoscope moves inside. By shifting controls on the scope’s handle, your veterinarian can change views and explore more.
  4. Anything abnormal with the gastric tissues will be noted throughout, which may include:

    1. Ulcers
    2. Erosions
    3. Inflamed areas
    4. Thickening
    5. Abnormal coloring
    6. Parasites (specifically bots)
  5. Throughout the exam, your veterinarian may use the scope to capture pictures of abnormalities so they can further evaluate and grade the severity of the lesions, as well as document how the lesions heal in the future.
  6. Once the exam is finished, the scope will be slowly withdrawn from the stomach and back out the esophagus and nostril.
Gastroscopic image of normal squamous stomach lining of a horse
Gastroscopic image of normal squamous stomach lining. Image courtesy of Boehringer Ingelheim Animal Health USA Inc.
Grade 2 squamous ulceration identified through gastroscopy.
Grade 2 squamous ulceration identified through gastroscopy. Image courtesy of Boehringer Ingelheim Animal Health USA Inc.

Post-Procedure Care and Things to Keep in Mind

  • Many horses will resist when the scope is first inserted inside their nose. However, generally after the tube is successfully passed down the throat, horses tolerate the procedure quite well.
  • The cost of a gastroscopy can vary greatly depending on your area, the full medical services provided, insurance coverage, package deals, and other factors. Be up front with your veterinarian or clinic by requesting an estimate before the procedure.
  • Gastroscopy is generally a safe procedure; however, a mild nosebleed after the endoscope is pulled out is common. This can be caused by the scope irritating the nasal passages, and it’s typically more of a mess than a cause for medical concern. This will usually happen directly after the procedure, so your veterinarian will likely still be there and can assess whether it’s an issue.
  • Be sure to wait until the sedation has fully worn off before giving your horse food and water.

Equine Gastroscopy 101 Video

Watch this overview of what’s involved in gastroscopy for horses and its importance for a diagnosis of gastric ulcers in this video provided by Boehringer Ingelheim.

Treatment Options Following Diagnosis

After your veterinarian has evaluated the images taken during the gastroscopy, they will come up with a treatment plan that works best with your horse’s health and medical history. As mentioned earlier, treatments differ depending on where lesions are found in the lining of the stomach and their severity.

If your veterinarian does find stomach ulcers, they may recommend GastroGard® (omeprazole), an FDA-approved medication for treating equine gastric ulcers. The non-prescription version of omeprazole, UlcerGard is labelled for maintenance therapy and used to actively prevent stomach ulcers during times of increased stress, such as shipping.

Additional Horse Owner Resources

SmartPak strongly encourages you to consult your veterinarian regarding specific questions about your horse's health. This information is not intended to diagnose or treat any disease, and is purely educational.