Because the incidence of GI neoplasia is low, other causes of weight loss should be investigated first. Diagnosis is usually made by exclusion of other causes of weight loss and by histopathologic examination of the tissue collected by duodenal biopsy after passage of a gastroscope into the proximal duodenum, rectal mucosal biopsy using a mare uterine biopsy instrument, or full-thickness intestinal biopsies retrieved during exploratory laparotomy or at necropsy. Squamous cell carcinoma of the stomach can be diagnosed by gastroscopy.
In horses with lymphosarcoma, enlarged mesenteric lymph nodes or thickened bowel may be detected by rectal palpation or by ultrasonographic examination. Concurrent masses in the liver or spleen may be more easily detectable than GI lesions on ultrasound, and may allow for less-invasive diagnosis if they are accessible for percutaneous biopsy. An exploratory laparotomy with biopsy of intestinal or other masses can provide a definitive diagnosis.
Treatment of GI neoplasia in horses is generally not attempted, and the prognosis is grave. There have been a few reports of surgical removal of the affected segment of bowel. Chemotherapy may be an option for some horses, and corticosteroid treatment may prolong survival time in some cases.