Equine gastric ulcer syndrome diagnosis requires gastroscopy under sedation. Advances in non-invasive monitoring including biomarkers and behavioral scoring are improving welfare by enabling earlier detection.
Gastroscopy welfare involves the stress of fasting, the experience of sedation, and the physical discomfort of the scope procedure. For horses with regular diagnostic requirements, the cumulative welfare burden of repeated procedures is meaningful. Non-invasive monitoring methods that can guide treatment without repeated gastroscopy would significantly reduce this welfare cost. Currently, treatment response assessment provides a practical alternative in many cases - if a horse on omeprazole shows significant behavioral and performance improvement within 2-4 weeks, the diagnosis of active ulcers is supported without endoscopic confirmation. The welfare tension is between diagnostic precision (requiring invasive procedures) and treatment-based monitoring (less precise but less burdensome). For most horses, periodic monitoring with treatment response assessment is a reasonable welfare-balanced approach.