The importance of Gastroscopy

Two weeks ago we discovered stomach ulcers in one of our patients by performing a gastroscopy. Interestingly the horse did not show specific signs of gastric ulceration. We decided to perform a routine gastroscopy since the horse recently moved yards and underwent a stressful journey. To our surprise we discovered quite severe glandular  (grade 3/4) and non-glandular (grade 2/4) ulceration (shown in the videos beneath).

==> in this video you can see the clear separation between the glandular part of the stomach (pink) and the non-glandular part (white/beige). The separation between the two parts is called the “margo plicatus” and this particular region is very prone to ulceration. In this horse you can see bleeding ulcers along the margo plicatus.

==> in this video you can see the “Pylorus”, this is the exit of the stomach towards the small intestine and is part of the glandular part of the stomach. Glandular ulceration is visible all around this exit (orange coloured).


Gastric ulcers can either cause obvious clinical signs such as: reduced or selective appetite,lethargy,  being sensitive to girth up, losing weight, colic (scraping, flank watching/biting) or yawning. Unfortunately the signs can also be very subtile such as: being of colour, losing condition, dullness of the coat, behavioural problems and more.

This condition is quite easily treatable with Omeprazole (for squamous ulcers) and Sucralfate (for glandular ulcers) for usually at least a month. Another important factor is the management of the horse. Reducing stress, giving multiple meals a day, ad libitum hay/haylage and a feed high in protein (13-14 %) are the main changes you can apply.

The horse will be re-scoped in a month's time to check whether the treatment has been success. An update will follow with the results.

Foal Wound and skin graft

A Progress update from the foal who tried to jump a fence.

The wounds remained closed for a few weeks, this was vitally important to keep to exposed bone covered and prevent sequester formation. Sequestration is where an area of bone dies and becomes like a foreign body in need of surgical removal.

The skin around the wound began to die back and the wound contracted - this is a normal phase of wound healing. Over the next month the foal underwent regular bandage changes. The wound took time to fill in and when it did there was exuberant granulation tissue - proud flesh.

Proud flesh is common in equine wounds, especially on the distal limb. It is treated by excising the tissue that is above (proud) to the skin - thus allowing the skin to epithelialise over the top.

In this case as the wound was so large, the decision was taken to take skin grafts from the neck and place them in the wound. These islands of skin promote skin growth over the top of the wound.

As you can see from the photos the wound is closing up well and in a few weeks we should have a completely healed leg.

As you can see from this last photo, there is a different texture to the tissue between the islands of graft - this is skin beginning to heal over the top


Blackthorn Injury

Six weeks ago a hunter had a small cut on his leg after a days hunting. It all healed well with good hygiene and rest.

However, over the last few weeks it has been becoming swollen, discharging a small amount of pus and then going down again. Tim examined him this morning and saw an acoustic shadow on ultrasound scan indicating the presence of a foreign body. This afternoon the horse came into the Clinic and had a HUGE blackthorn removed.

All well in the end, and so lucky that the blackthorn didn’t penetrate any joint or tendon sheath.

Farewell to Ray

Tonight we are all raising a glass to celebrate the life of Ray Imberger MRCVS. Tim Galer attended a memorial service today at Our Lady and St Alphonsus Church, Hanley Swan, Worcs. to pay his repects to Ray along with many parishioners, friends and grateful clients. The Church was full to capacity and many people having to listen to the service outside. Ray graduated from Sydney Veterinary School in 1965 and came to England to develop his skills. He gravitated to Upton on Severn in 1968 and never left the area. Ray was an enormously popular man and a great vet with a close affinity for all the animals he treated. He will be greatly missed but never forgotten. Our thoughts are with his wife Trish at this sad time.

A severe wound

This horse was found in a neighboring field after having jumped across the fence. There was a deep wound to the left axilla (armpit) which went through several layers of muscle. After assessing the depth and severity, the wound was cleaned thoroughly, partially stitched closed and the horse started on antibiotics and pain relief.

Due to the area of injury there was no possibility of placing a bandage but with box rest to keep it clean and limit the amount of movement these injuries usually do very well. Over the next few weeks the outer tissue layers gradually died back (as expected) allowing the wound to heal by second intention.The deeper muscular layers healed very well. These injuries tend to look worse before they look better - but this is the body removing any dead and necrotic material to then be able to heal properly.

He is now back in work and doing well.

BEVA congress 2018

All three of our vets spent time at the British Equine Veterinary Conference at the ICC in Birmingham last week. This is an annual event over three days where lectures and workshops in all different aspects of equine veterinary medicine and surgery are presented by the world leaders in their respective disciplines. So rest assured our vets are all up to speed with the latest developments and ideas to keep your horses performing at their very best!

Liver Biopsies

Today we have had Professor Andy Durham in the Clinic, to scan and biopsy the liver of one of Emilie’s cases. The patient was one of a group of horses that have recently shown signs of liver disease or hepatopathy. The condition was diagnosed via a metabolic blood profile that we run in our lab here at Peasebrook. All the horses showed markedly raised liver enzymes. Hepatopathy is a reasonably common but very worrying condition, partly because it is very difficult to pinpoint the cause. The usual suspects are mycotoxins from feedstuffs other plant toxins or viral infection.

Fortunately, the liver has great powers of recovery following a toxic event so if the cause is removed, most animals will recover. Removing the cause, because it is difficult to ascertain, usually means changing grazing and feed. The biopsy is taken to assess the degree of inflammation and any more chronic pathology. This information allows us to instigate appropriate treatment as soon as possible. The ultrasound scan can identify problems with the liver and it shows the size of the organ but its main usage with these cases is to ensure the correct path of the biopsy needle so that we obtain a diagnostic sample. This is a skilled technique and so we get Andy to perform the procedure as there is nobody more experienced.

We will get the histology results in 48 hours and hopefully the prognosis will be favourable.

New website for Peasebrook

We are delighted to publish our new clinic website @ Our previous website was hacked last Autumn and still remains in the clutches of Russian robots it seems. We have learned a lot about cyber crime in the interim and the bottom line is that it's pretty difficult to do much about it, so be warned and make sure you are secure! What anybody wants with a second hand equine clinic website beats me, but it's a strange old world!

So our new site is totally run by us and is extraordinarily easy to play about with, Tim has largely created it, so it must be! We will be updating things regularly and posting stuff as often as possible.