Stomach ulcers: focus on management

Het viel op dat de Friese merrie Rinske veel gaapte. (Foto: iStock)


November 15, 2021
Optimisation of (nutrition) management is important in the treatment and prevention of stomach ulcers (Photo: iStock)
Via Instagram, veterinarian Iris van Gulik received a message from Marjon, owner of the 14-year-old Friesian mare Rinske: ’‘Iris, can you please help, I’m at my wits’ end! My horse is not her usual self and we are faced with highly dangerous situations.’

Problem behaviour

The next day a phone consultation shed light on the matter. Over the last few months Rinske had started to exhibit a growing range of problem behaviour. It began with gnawing of the fencing around the arena. Next thing we noticed was that Rinske was digging pretty deep holes in the arena, something she had never done before. On top of that, Marjon had also fallen off twice in the past week. Rinske always used to be very well-mannered under saddle but now she had become too dangerous to ride. She reared, bucked and did everything she could to dismount her rider. It was obvious that something serious was the matter. Iris van Gulik asked questions about her feeding behaviour and found out that Rinske was yawning a lot when feeding, even after eating a little horse snack.

Stomach endoscopy

Rinske’s owner took her to the clinic for a thorough examination. The symptoms pointed at stomach ulcers, but according to Van Gulik it is important to exclude other causes first, like for instance back pain: ‘We noticed that Rinske’s coat was dull and she was a bit on the lean side.’ Van Gulik decided to carry out a stomach endoscopy on Rinske. To be able to make a good assessment of the stomach wall, the horse needs to have an empty stomach. So prior to the examination Rinske was not allowed to eat any food for a period of sixteen hours and drink no water for six hours.


The next day Rinske was lightly sedated and Iris used a three-metre-long tube fitted with a camera to look into the stomach. Her comment: ‘I carry out lots of stomach endoscopies but this time I was really shocked at what I saw. The entire stomach wall was covered with deep stomach ulcers. This must have given her so much pain and clearly explains the recent changes in behaviour. Three months earlier Rinske’s stable mate had been moved to another yard. Marjon then noticed that Rinske was losing a bit of weight and so started to feed her considerably more amounts of hard feeds. The combination of stress and more hard feeds had triggered the development of stomach ulcers in Rinske.’

Medication and management

Horses suffering from stomach ulcers are treated with medication. This medication reduces the acidity in the stomach which activates and speeds up the healing process of the ulcers. Along with medication it is just as important however, to optimise the (feeding) management: sufficient amounts of roughage is the basis of every equine feeding scheme. Four weeks later Rinske returned to the clinic for a stomach endoscopy check-up: ‘While I was carrying out the endoscopy I saw a nice, pinky and smooth stomach wall and no more ulcers. So we could stop the medication and Marjon could slowly start riding Rinske again,’ says a pleased Iris van Gulik.

Read the full real-life story by veterinarian Iris van Gulik in the December issue of Phryso

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