A horse who has an unusual change in attitude or becomes touchy around their abdomen may have an ulcer.
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You’ve read the ads, seen the endoscope studies results and heard the talk:
Gastric ulcers are incredibly common in domesticated horses. The incidence is
higher in heavily stressed horses, like racehorses and endurance horses, but
ulcers are being found in quiet horses that seem to have a plain, ordinary, easy
life, too.
If your horse doesn’t quite seem like himself at times, not colicky, but
definitely somehow uncomfortable, he may be battling an ulcer. Or maybe he
doesn’t eat with the enthusiasm he used to have, or just lacks the "spirit" he
used to have. You’ve ruled out other possibilities and are left to face the fact
that you may well be seeing the symptoms of a chronic gastro-intestinal
(GI)-related problem, such as an ulcer.
Risk factors for developing ulcers include:
• Stall confinement.
• Sporadic feeding rather than constant access to grass.
• Exercise faster than a walk. (This causes enough rise in abdominal pressure
to cause some acid movement into the unprotected areas of the stomach. The
faster the horse moves, the more pressure and back wash of acid.)
• Feeding processed feeds rather than whole grains.
• Prolonged fasting (e.g. long trips, long period of time between last feed
of the day and the morning feed).
• Any problem elsewhere in the gastrointestinal tract.
• Use of nonsteroidal anti-inflammatory drugs and corticosteroids.
The only way to definitively diagnose gastric ulcers is to examine the
stomach directly with an endoscope at a veterinary clinic or do a
sucrose-absorption test (see page 13). However, most horses are "diagnosed" by
symptoms only.
Signs most suggestive of gastric ulcer include:
• Grinding of the teeth.
• Belching noises.
• Slow eating, often walking away without finishing meals all at once.
• Picky appetite that includes the horse refusing foods or supplements that
were consumed readily before.
These symptoms aren’t diagnostic of ulcers, but they do suggest discomfort
associated with the upper GI tract/stomach. Less-specific signs frequently
attributed to ulcers are:
• Sour, sulky attitude.
• Poor coat.
• Weight loss.
• Poor performance.
• Irritability.
• Sensitivity to touch around the horse's lower belly/sternum area.
Since the signs and symptoms are nonspecific—and overlap quite a bit with
other causes of low-grade intestinal-tract discomfort and with pain from any
cause—ulcers may be blamed when another problem is actually the cause. It’s
important to involve your veterinarian in the diagnosis and treatment.
While horses can develop some degree of gastric ulceration easily and under a
wide variety of conditions, ulcers can and do heal spontaneously. On a scale of
1 to 3, with 1 being only obvious reddening of the stomach lining and 3 is a
deep ulcer, a horse with a grade 3 ulcer is more likely to actually have
symptoms as a result and definitely requires treatment, while a grade 1 stomach
irritation could be symptom-free and resolve on its own.
| Sucrose Test For Ulcers |
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A simple urine test originally developed to screen for stomach ulcers in
people may work in horses, too. The "sucrose permeability test"
measures the
amount of the sugar sucrose found in the urine after a
test dose is given
orally.
Sucrose is not synthesized in the body, so if it shows up in the urine it
must have been absorbed intact through an erosion/damage in the
intestinal
lining. Hence, the ulcer detection. This test could prove to
be a fairly
reliable way to screen suspected ulcer cases at home and
limit the number of
endocsopic examinations required for diagnosis
.
Be Proactive (Think Ahead!)
If a horse has a known history of problems related to gastric ulceration, or
shows typical symptoms when stressed by transport, showing or racing,
anticipating high-risk situations and treating accordingly may prevent
the
problem.
Frequent watering and constant access to hay when in transit is a start, but
many competitors are leery of working the horse on a full stomach,
which can
make them sluggish. Horses that aren’t drinking well in
transit also should not
be given unlimited access to hay. If hay isn’t
a workable solution, or something
you prefer to do only on the ride
home, consider oral dosing with an antacid,
beginning four hours after
the horse last ate, continuing at four-hour
intervals.
We tried this with five racehorses that shipped to race, with a strong
history of refusing grain after shipping home and for one to three days
afterward. Four of the five responded by finishing 75 to 100% of the
offered
grain when they got home, on full feed by the next day. The
fifth horse
continued to prefer hay on race day, but was also back on
full grain by the
following day.
Long-Term Anti-Ulcer Drugs
Merial’s GastroGuard for horses, and other human antiulcer medications, can
work extremely well and should be the first line of treatment for
severe ulcer
disease. However, every drug comes with a down side. In
addition to being
expensive, the suppression of stomach acid isn’t
necessarily a good idea long
term. One of the important functions of
stomach acid is to destroy bacteria that
could cause intestinal tract
infections, such as salmonella. The extremely low
pH of the stomach
will also kill viruses and fungi. Prolonged acid suppression
causes
vitamin B12 mal-absorption in people, but it’s unclear whether or not
this could occur in horses. Exposure to stomach acid is the first step
in the
breakdown/digestion of protein, leading to poor utilization of
dietary protein.
One study in mice showed that the presence of larger,
poorly digested proteins
in the small intestine also led to food
allergies. The undigested protein is
then presented to the cecum and
large bowel, where fermentation can cause
bloating, discomfort and
distinctly more foul smelling manure. |
| Put it in Use |
| • Be sure the product you use long-term doesn’t upset dietary balances.
• Work to rule out other potential problems that can cause similar signs.
• For purely symptomatic relief, use antacid-type products.
• Anticipate high-risk situations with treatment.
• Maximize your horse's hay and turnout. |
Exercise As A Risk Factor
Studies performed at the University of Florida have shown that horses moving
at a rate faster than a walk experience increased abdominal pressure
that
essentially back flushes highly acidic stomach contents from the
lower,
acid-producing (glandular) portion of the stomach back to the
nonglandular
portion. The Florida researchers found that when a horse
is standing or walking,
the pH of the stomach just inside the junction
with the esophagus is in the
range of 5 to 6, but as soon as the pace
is picked up the acid back flow can
drop it to as low as 1.
The more time the horse spends moving around faster than a walk, the greater
the exposure of these portions of the stomach to highly acidic
conditions. It’s
a small wonder that a preliminary study looking for
gastric ulceration in
endurance horses found lesions in 67%. Most
lesions were located in the
nonglandular portion, same location as in
other performance horses, but 27% also
had ulceration in the glandular
portion, a condition that is usually only seen
in horses following a
critical illness of some type.
Given the prolonged, strenuous exercise it was surprising that more horses
did not show ulcers, but common practices on rides may be why. Many
endurance
riders feed alfalfa, which has an excellent buffering effect
in the stomach.
Beet pulp is another favorite and remains in the
stomach longer than other types
of feed. Allowing the horse to stop for
water at every opportunity will also at
least temporarily dilute the
acidity.
Our Trial
Our field-trial horses included both horses with a documented history of
gastric ulcerations and horses with symptoms suggestive of ulcers. As
we stated,
symptoms alone aren’t enough to make an ulcer diagnosis. In
addition, other
digestive upsets, particularly from high grain feeding
or poor digestive
efficiency, may cause similar symptoms. However,
since poor digestive efficiency
or overfeeding will likely result in
drop in pH in the large intestine and some
irritation of the mucosa
there, it’s possible that many of these products could
be of benefit
under those conditions as well. (The response to these products
was
judged solely on the basis of symptomatic control and doesn’t necessarily
correlate with actual healing.)
We found the antacid products were the most consistently effective in
providing symptomatic relief for the greatest number of horses. Best
results are
obtained when using liquids given by oral syringe for the
first one to two
weeks, minimum of two times/day, before each feed,
preferably three to four
times/day, as well as immediately before work.
The appetites of the horses
improve within one to four days and most
rapidly with intensive treatment.
Studies on the use of antacids in horses usually call for much higher doses
than we found effective for control of symptoms. However, those studies
are
focusing on the dose required to decrease acidity in a horse that
has been
fasted, while our horses were allowed constant access to hay
and offered
concentrate on their regular schedules. Since the presence
of food in the
stomach also has a buffering effect, this may explain
the lower effective
doses.
It’s important in choosing a product for long-term use that it doesn’t upset
your horse’s nutritional balances/intake. For example, magnesium is a
common
ingredient in many of these formulations. While low dietary
magnesium can be a
cause of excitability/nervousness in horses,
overdoing magnesium can cause the
same symptom, as it inhibits the
absorption of calcium. Too little calcium can
also cause nervousness,
bone weakening, achy and weak muscles and abnormal heart
rhythms. The
proper Ca:Mg ratio is 2.5:1.
As with any illness/disorder, always consult with your veterinarian first
before instituting any treatment program.
Bottom Line
Our favorite liquid antacid was U-Gard Solution. Other liquids performed
similarly at equivalent or higher dosages, but U-Gard then beat them on
price.
Similar rapid results were obtained with Stomach Soother (use
cautiously if
horse is showing severe symptoms and largely off feed),
G.U.T. paste and Rapid
Response.
These are much more expensive than the liquid antacids, and they avoid the
possible calming effect seen with the high-dose calcium or
calcium/magnesium
products. The G.U.T. is less costly than Rapid
Response, but Rapid Response
doubles as an effective joint
supplement.
If liquids/pastes aren’t a good choice, and for follow-up after a course of
liquids or paste once the horse is eating well, powders are convenient.
Again,
the U-Gard 2X gets the nod for effectiveness and being most
economical.
When prolonged symptom control is needed, effects of the antacids on the
calcium/phosphorus/magnesium balance of the diet should be considered.
To avoid
the possible need to correct for mineral imbalances, consider
using G.U.T powder
or one of the herbal formulations.
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