If your veterinarian has recommended a gastroscopy, you may be feeling a mix of relief, worry, and curiosity. Relief that you might finally get answers. Worry about how your horse will cope with fasting, travel, sedation, or the procedure itself. Curiosity about what the inside of your horse’s stomach actually looks like.

Gastroscopy (often called a “gastric scope” or “stomach camera”) is the gold standard for diagnosing gastric ulcers. It is safe, quick, minimally invasive, and one of the most valuable tools we have in equine medicine. But because the process involves fasting and unfamiliar handling, owners naturally want to ensure their horse’s welfare throughout.

This article is designed to give you a clear, compassionate, practical guide. You’ll learn what really happens during a scope, why each step is necessary, what your horse experiences, and how to make the entire process as stress-free as possible.

Why Gastroscopy Matters

Gastric ulcers can cause:

• Girthiness
• Behaviour changes
• Weight loss
• Training resistance
• Poor performance
• Recurrent colic
• Irritability or anxiety
• Sensitivity around the girth or flank
• Reduced appetite

But here’s the important part:

Ulcers cannot be diagnosed accurately based on symptoms alone. Even experienced veterinarians cannot reliably predict ulcer severity without visually examining the stomach.

A gastroscope allows us to see:

• The squamous (upper) stomach
• The glandular (lower) stomach
• The pylorus
• The margo plicatus
• Any lesions, inflammation, bleeding, or abnormal patterns

Without a gastroscopy, you’re guessing. With one, you have clarity, direction, and a targeted treatment plan.

What a Gastroscopy Involves: Step-by-Step

Gastroscopy typically takes 10–20 minutes, but preparation is essential. Here is a clear breakdown of the process.

Step 1: The Fasting Period

To visualise the stomach lining clearly, the horse must arrive with an empty stomach.

Why fasting is necessary

• Food obscures the view
• Grain particles or hay can block the scope
• Excess feed can pool around stomach lesions
• The scope cannot navigate a full stomach safely

Typical fasting guidelines:

• No hay for 12–16 hours
• No grain for 12–16 hours
• Water allowed until 1–2 hours before (depending on the clinic’s protocol)

How your horse may feel

Healthy horses tolerate fasting well, but some may show:

• Mild frustration
• Pawing
• Calling out to other horses eating
• Increased interest in stable neighbours
• Increased saliva

These signs are normal but should be monitored with compassion.

Case example:
A pony that was scoped recently became anxious during fasting when his paddock mate was eating. Simply moving him to a different yard and giving him a companion nearby transformed his stress level. Small management changes make a big difference.

Step 2: Travel and Arrival

If the scope is performed at a clinic, travel itself can raise stress levels.

To reduce stress:

• Travel with a companion when possible
• Allow the horse to settle in a quiet area
• Avoid rushing – calm handling matters
• Keep familiar routines when possible
• Bring hay for after the scope for comfort

Some horses become dehydrated from stress during travel. That is another reason water is allowed until shortly before the procedure.

Step 3: Sedation

Horses are sedated for their comfort and safety – and yours.

Why sedation is used:

• Prevents head tossing
• Relaxes the throat muscles
• Reduces anxiety
• Allows the vet to pass the scope smoothly

Sedation is very safe and typically wears off within 45–60 minutes.

Step 4: Passing the Scope

A gastroscope is a long, flexible camera (usually 3 meters long) that passes through:

• The nostril
• The nasal passage
• Throat
• Oesophagus
• Stomach

Most horses tolerate this extremely well once sedated.

What your horse feels:

• Mild tickling in the nostril
• Light pressure at the throat
• A swallowing reflex
• Minimal discomfort

Horses are not in pain. They are relaxed, drowsy, and often curious.

Step 5: Examining the Stomach

The vet inflates the stomach slightly with air so the camera can see all surfaces clearly.

We examine:

• The squamous region
• The glandular region
• The margo plicatus
• The pyloric outflow
• Any lesions, redness, erosion, thickening, or bleeding

You may be surprised at how detailed the images are. Many owners find it reassuring to see the problem clearly.

Step 6: After the Procedure

After the scope:

• Sedation wears off in 30–60 minutes
• The horse can eat once fully alert
• Most horses are calm and comfortable
• Your vet discusses findings and treatment options

Many owners describe the process as “much easier than expected.”

Understanding the Fasting Process More Deeply

Horses are trickle feeders, so fasting can feel unusual for both horse and owner. Here’s what’s actually happening inside the body.

What changes during fasting:

• Acid production continues
• Chewing stops (so less saliva buffering)
• Gut motility slows
• The horse’s mental state changes slightly
• The stomach becomes less protected without fibre

For these reasons, fasting should be as short as possible – and followed by gentle refeeding.

How to Make Fasting Welfare-Friendly

Here are practical steps to keep your horse comfortable:

1. Use Deep Bedding

Shavings or sawdust prevent the horse from eating bedding. Avoid straw; most horses will gorge on it.

2. Maximise Social Comfort

Place the horse where they can see neighbours but won’t watch others eating.

3. Keep Water Available

Unless instructed otherwise.

4. Reduce Workload Before Fasting

A tired, hungry horse is more stressed.

5. Provide Enrichment

Horses can have:

• Grooming sessions
• Attention from familiar people
• Light hand walking
• Turnout in a no-grazing yard

6. Avoid Punishing “food seeking” behaviours

This is natural during fasting. Redirect, don’t reprimand.

Supporting Your Horse Emotionally During a Gastroscopy

A horse’s emotional state affects their physical recovery and perception of veterinary care.

Key stress-reducing strategies:

• Stay calm – horses mirror your emotions
• Use the same handler for all procedures if possible
• Speak softly and move quietly
• Bring a familiar rug or halter
• Allow your horse time to observe the environment
• Reward calm behaviours with scratches or attention

A relaxed horse scopes more easily and recovers more quickly.

Common Myths About Gastroscopy

Myth 1: It’s painful

False. Sedation ensures comfort. Discomfort is minimal.

Myth 2: Fasting is dangerous

Fasting for short periods under veterinary guidance is safe.

Myth 3: Supplements can diagnose ulcers

No supplement can diagnose or rule out ulcers.

Myth 4: All girthy or cranky horses have ulcers

Not always –  but it should be checked.

Myth 5: Gastroscopy stresses horses too much

When managed correctly, stress remains low and manageable.

How to Prepare for a Gastroscopy: A Practical Checklist

The day before:

• Confirm fasting instructions
• Remove all hay from 6–8 pm (depending on appointment time)
• Keep bedding low-risk for eating
• Allow water overnight
• Check travel arrangements
• Keep the routine predictable

The morning of:

• No feed
• Water if permitted until instructed to remove
• Allow the horse to stretch legs
• Keep them calm and comfortable

During transport:

• Drive smoothly
• Avoid unnecessary noise
• Keep horses with familiar companions

After the scope:

• Reintroduce hay slowly
• Monitor hydration
• Give the horse time to fully wake
• Follow veterinary ulcer management advice carefully

What If Ulcers Are Found?

Your vet will explain the grade, type, and severity of ulcers and recommend a treatment plan, which may include:

• Omeprazole
• Sucralfate
• Diet changes
• Management changes
• Stress reduction plans

The most important thing is that ulcers are now identified and can be treated precisely.

What If No Ulcers Are Found?

This is excellent news – but it doesn’t mean your horse was imagining symptoms.

Other conditions that mimic ulcer signs include:

• Dental pain
• Hindgut acidosis
• Muscular soreness
• Poor saddle fit
• Stress-related behaviours
• Inadequate forage access
• Pain elsewhere in the body

A clean gastroscope is a starting point, not the end.

The Takeaway

Gastroscopy is one of the most valuable diagnostic tools in equine medicine. It helps us understand exactly what is happening inside your horse’s stomach so we can treat them effectively and compassionately.

With careful preparation, slow fasting, calm handling, and welfare-first management, the procedure can be an entirely stress-free experience for your horse.

Knowledge is empowering for owners. Comfort is essential for horses. Gastroscopy gives you both.

Disclaimer

This article provides general information only and does not replace veterinary advice for your individual horse. If you’re concerned, contact your veterinarian promptly.