Behavioral Signature of Equine Gastric Discomfort? Preliminary Retrospective Clinical Observations

Gastric ulcer disease and other potentially painful gastric conditions are among the most common afflictions adversely affecting the welfare of domestic equids. A large percentage of affected animals may not display the classic signs of gastric disease, such as unexplained weight loss, poor hair coat, and inappetence until the disease becomes severe. As a clinical service within our equine referral hospital, we routinely evaluate 24-h video recorded samples of horses to assist clinicians in identifying subtle discomfort and potential sources or to scan for infrequent neurologic or cardiac-related behavioral events. Empirically, we have recognized discomfort behaviors that appear to be uniquely associated with gastric disease. These include frequent attention to the cranial abdomen (nuzzling, swatting, nipping, and/or caudal gaze focused on the abdomen caudal to the elbow) and/or deep abdominal stretching, often within the context of eating, drinking, and/or anticipating feeding. To systematically evaluate the reliability of these purported gastric discomfort behaviors, we reviewed 30 recent 24-h video behavior evaluation cases for which (1) the clinical video behavior evaluation had been carried out without knowledge of the history and presenting complaint and (2) direct gastric examination had confirmed gastric disease status at the time. Twenty-four of the thirty cases showed gastric discomfort behavior, and all twenty-four had either gastric ulcers (n = 21) and/or gastric impaction (n = 3). Of the six cases not showing gastric discomfort behaviors, four were free of gastric disease, while two had mild lesions. Comparing horses with and without gastric disease, gastric discomfort behaviors were reported in 24 of the 26 (92%) with gastric ulcers or gastric impaction, compared to none of the four gastric disease-free horses. Although a larger prospectively designed study is needed to confidently estimate the sensitivity and specificity or the associations of behavior with the type or severity of gastric disease, these results confirm our long-held clinical impression of a behavioral signature for gastric discomfort in the horse.