Wednesday, May 29, 2024

How To Treat Stomach Ulcers In Horses

Grade 1 To : Stomach Ulcer In Horses Simply Explained

Equine Ulcer Treatment – Before and After by Mark DePaolo, DVM

3min. readWritten by Tanja Dietz

Stomach ulcers – they are one of the most common diseases in horses today. They usually come unnoticed and are only treated when they have already caused massive damage to the horse’s stomach lining. It should be mentioned here that a stomach ulcer is not just there, but develops over time.

How Do Ulcers Develop

The horse’s stomach is divided into two distinct areas by a structure called the . The upper portion of the stomach is non-glandular and lined with squamous cells while the lower portion is glandular. The latter produces mucus that coats the stomach lining to help prevent ulcers from the action of the gastric secretions, but the upper portion doesnt. Lesions and ulcers can develop in both portions of the stomach, but the mechanism of development and the predisposing factors are quite different.

The development of ulcers in the squamous portion of the stomach is directly related to intensity of training: the more intense the training of the horse, the more likely the horse is to develop ulcers. These ulcers are extremely common: up to 90 per cent of horses in some disciplines such as racing have ulcers, and even broodmares and pleasure horses can be affected by this condition. Researchers have proposed a new term to describe this problem: ESGUS .

Researchers havent identified the exact mechanism of ulcer development in the upper portion, but the link to training is well established. While training, gastric acid normally contained in the glandular portion of the stomach may splash up to the non-glandular squamous cell portion that does not have the same protective mechanisms as the lower portion to prevent acid injury.

Beware Of Subtle Symptoms

Sometimes horses, like people, just have a bad day, but if you notice consistent irritability and decreased athletic performance, ulcers could be suspect especially if your horse that normally vacuums up all his hay and grain has suddenly become a picky eater. Other signs of ulcers include depression, weight loss, hypersalivation and a rough hair coat.

I will always do a full physical and lameness examination to rule out any other problems, then recommend further evaluation for GI ulcers, DeHaan said.

The only way to know for sure if your horse has ulcers is through a gastroscopy. A small, three-meter-long tube with a camera on the end is inserted through the horses nostril, down the esophagus and into the stomach. This allows your veterinarian to visually inspect the stomachs interior.

I have heard of other tests available or coming soon that should be less invasive, but as of now, a gastroscopy is the only way to get a definitive diagnosis, DeHaan said.

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What Are The Clinical Signs Of An Ulcer

The clinical signs of EGUS can be hard to identify. Many horses may show no signs or mild signs such as poor performance, a change in attitude or behaviour, weight loss or poor condition. Some horses may experience recurrent colic, especially associated with a specific activity such as feeding.

In many horses that dont show obvious signs, an improvement in behaviour or performance can be seen after treatment. Its important to realize that while many horses do not show signs of pain, gastric ulcers are associated with discomfort and warrant treatment.

The better you know your horse, the more likely you are to notice subtle changes that may indicate the formation of a gastric ulcer.

What Causes Ulcers In Horses


Before you can successfully treat an ulcer its important to understand what caused it in the first place, knowing what can cause ulcers will also help you to reduce your horses chances, if not eradicate them completely. A recent study showed that 93% of all racehorses suffered from ulcers, while 63% of performance horses were likely to have an ulcer at some point in their life, reducing to just 35% for domestic horses. While these numbers may seem shocking at first it does give us an indication of what a possible cause might be. Most race and performance horses spend a lot of time stabled with little or no forage and a very controlled diet which is why their risk of suffering from ulcers is so high.

Knowing that a horses diet can change their susceptibility is only part of the matter, to fully recognize why its such a big factor you need to understand how a horses digestive system works. Unlike humans, who only produce stomach acid when eating , horses are continually producing acid which is why they spend so long eating and grazing. As a horse grazes the forage slowly moves through his digestive tract and stomach, this process actually reduces the amount of acid thats produced which is why grazing is vitally important for a horses wellbeing. The saliva thats produced while chewing will also act as a barrier, protecting the sensitive stomach lining against acid.

Horses can suffer from ulcers if they dont have regular, small meals.

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Diagnosis Of Ulcers In Horses

If you suspect your horse has a gastric ulcer, make an appointment with your veterinarian. An ulcer can be serious, and sometimes fatal if medical attention is not given in time. Your medical professional will ask questions pertaining to his health history, look closely at his clinical signs, perform blood work, urinalysis, biochemistry profile, and other laboratory testing in order to rule out any other illnesses and come to a preliminary diagnosis.

Your doctor may perform specific diagnostic testing using enhanced diagnostic equipment. He may use a gastroscope, which is an approximately 2 meters-long endoscope into the stomach of your horse. This is currently the most accurate and definitive diagnostic test used to confirm the presence of a stomach ulcer or ulcers.

This test will confirm the specificities of the ulcers, such as size, severity, and precise location. Typically, ulcers are found in the upper portion of the organ however, ulcers can also be found in the lower section, including the duodenum. The ulcer will be classified between the areas of 0-4, with a 4 having severe lesions. He will communicate with you the extent of the ulcer and let you know the options for treatment.

What Are Gastric Ulcers Or Equine Gastric Ulcer Syndrome

Gastric ulcers or EGUS can be caused by prolonged exposure of the stomach lining to gastric juices resulting in ulceration and sometimes bleeding. The horses stomach can broadly be divided into two sections the upper non-glandular region where food enters the stomach, and the lower glandular region where hydrochloric acid is produced. Although the lower region is constantly exposed to acid, it generally has adequate protection and lesions are most commonly found in the upper region. Lesions in the lower region are unlikely to be diet related and may be more common in foals and older horses.

Get in touch with our expert nutritionists for more information on gastric ulcers in horses.

  • How nutrition plays a role

    Long term nutritional management plays a key role in helping to reduce the risk, frequency and severity of gastric ulcers. New research in collaboration with SPILLERS is the first to show that changes in the diet can help to manage gastric ulcers post omeprazole treatment. In this study, a change in diet maintained the beneficial effects of omeprazole 6 weeks after treatment had stopped. In contrast, horses in the ‘no diet change’ group had regressed and at the end of the study, there was no significant difference between pre and post treatment gastric ulcer scores.

  • Base as much of the diet on forage as possible, maintaining a high fibre, controlled starch diet
  • Ensure water is available at all times
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    Why You Need To Intervene

    A horse cannot remove these undesirable grasses from their mouth. These grasses have spines on them pointing in one direction: in. When their feed has a lot of them, they build up in the lower lip, piercing the tender flesh, embedding themselves in their lip. Once one has penetrated the flesh, its really easy for more to pile into the hole. One after another, as the horse picks up his hay with his lips, the undesirable grasses drop off their spiny arrows, that in turn, they embed themselves into his lips.

    The horse will continue to eat until he is in so much discomfort he cannot pick up another mouthful of the hay. At this point, it is too painful to hold his lips together and swallow his saliva. He will then stop eating, stand with his lips apart, drooling profusely. The drool will sometimes extend from his lip all the way to the ground.

    Squamous Gastric Ulcers In Horses

    Main Cause for Stomach Ulcers in horses

    Equine Squamous Gastric Ulcer Syndrome refers to ulcerative lesions specifically affecting the squamous portion of the equine stomach, or roughly, the upper third of the stomach. An ulcer in the squamous region is believed to occur when the mucosal lining becomes damaged, likely by bacteria, parasites or a constant barrage of stomach acid. The squamous region is particularly susceptible to damage as it lacks the protective mechanisms of the glandular region to defend its mucosal lining from gastric acid.

    Skippy may very well be suffering from ESGUS, as his current lifestyle and diet fit the typical profile of a horse likely to develop squamous ulcers. These risk factors often include:

    • Limited turnout
    • Intermittent feeding

    Hes also displaying all of the classic symptoms, including loss of appetite, difficulty maintaining weight/weight loss, changes in hair coat, poor behavior, underperformance and wood chewing. If he is suffering from ESGUS, continuing his high-concentrate, low-roughage diet and intensive training schedule could make matters even worse for him.

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    What Are The Symptoms Of An Ulcer

    Every horse is different and will display different symptoms but the common things to look out for are:

    • Reduction in performance
    • Lying down more than normal

    Some horses will continue to eat the same amount of food but will change the way they eat. Instead of eating all of their feed in one go, theyll eat a little bit of it then walk away and come back to it later. This is because theyre in pain when they eat but are still hungry.

    In more serious cases horses have been known to grind their teeth due to the pain and lie on their backs. Its more common in foals, but its thought that they lie on their backs as that position offers some relief from the pain. If your horse is producing brown gastric fluid then its possible that he may have a bleeding ulcer and veterinarian assistance is crucial.

    Examine The Potential Risk Factors Of Your Horse

    The first step to addressing better hindgut health in your horse is to examine current risk factors in their diet, routine and health history.

    Think about your horses history in regard to gut health and behavioural changes. A few questions to review include:

    • Is your horses prone to gastric ulcers?
    • Has your horse shown signs of colic or has colicked in the past?
    • Is your horse known to react to dietary changes or be sensitive to changes in diet/routine?
    • Has your horse developed any stereotypic behaviour recently such as weaving, pacing, cribbing, etc.?
    • Is your horse overly stressed?

    Reviewing the history of your horses gut health will help your veterinarian diagnose if your horse could be at risk of hindgut acidosis.

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    Riding A Horse With Ulcers

    A horse can be ridden while recovering from and receiving treatment for gastric ulcers. An exception to this would be that if your horse has been suffering from the illness for an extended period before diagnosis and is suffering considerably from bad health. If your horse is physically weakened, then riding is not recommended.Ride with less intensity.

    It is important to note that stress can intensify the effects of stomach ulcers and inhibit their healing. Therefore, how you ride your horse while treating stomach ulcers is an important factor in their healing.

    In other words, You should alter the intensity of your riding during the thirty-day treatment cycle. If you are preparing your horse for competition or working through foundational training, it is recommended to adjust your training program to eliminate as much stress from your riding sessions as possible. You should consider postponing your training during treatment and focus on just enough riding and movement to maintain conditioning.

    Keep in my mind a healthy horse will always perform better. So, slowing down to allow your horse to heal from gastric ulcers may speed up your efforts later, once your horse is back to 100%.

    What Are The Most Common Horse Ulcers

    Stomach Ez (Gastric Ulcer Treatment) Product Bundle

    ESGUS Ulcers in the upper region of the horses stomach which is called the Squamous, really the lower end of the oesophagus lining and the most common of the two types of ulcer Weight loss this is so easy to attribute to other factors such as time of year, poor grazing or the stress of competition.

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    Ulcer Prevention & Diet Consultations

    We offer diet and nutritional consulting for those of you supporting or suspecting a horse with ulcers or looking to prevent ulcers from developing. Consultations are available in the following increments. First time customers who book an hour consultation receive $25 off your first order of $100 or more.

    • 30 minutes $45

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    Key Times To Use Omeprazole For Horses With Ulcers

    Managing the ulcer-prone horse can be tricky due to the fact that once a horse has developed ulcers, they are now at higher risk of recurring incidences of ulceration.

    Franklin explains that UlcerGard, which contains a lower dose of omeprazole than GastroGard, is commonly used to maintain ulcer-prone horses. However, it can be expensive to give on a long-term basis, so instead, Franklin often recommends that UlcerGard be given to performance horses, as needed.

    For example, if someone is hauling their horse to a big show where they plan to be for a week or so, Franklin will often recommend that the horse be given UlcerGard before they leave and stay on it while at the show.

    You can do the same thing whenever your horse is in intensive training, says Franklin. The idea is that youre going to treat them with GastroGard and then, because you havent been able to take the horse out of that high-risk environment, you need to maintain them on UlcerGard so that the ulcers dont come back.

    But he also notes that the coming back is the main problem that he and other veterinarians tend to see.

    We can treat this condition–it may take four to eight weeks–but we can treat it. The problem is that horse owners and managers often make no management changes to prevent ulcers from returning. Thats where the right supplements can be beneficial–they are a relatively easy tool for the horse owner to implement while also greatly impacting horse health.

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    Minimize The Use Of Nsaids

    Non-steroidal anti-inflammatory drugs are administered to horses to reduce pain and treat certain conditions.

    Phenylbutazone is a common NSAID used for pain management in skeletal muscles. Firocoxib is more commonly used to reduce pain associated with osteoarthritis or bone injuries.

    NSAID use may be necessary at times. When advised and monitored by a veterinarian, NSAIDs can benefit your horse.

    However, outside of these circumstances, the use of NSAIDs should be limited.

    NSAID use has been directly associated with increased ulcers in the digestive tract of horses. These ulcers occur in the squamous and glandular regions of the stomach, as well as the hindgut.

    By inhibiting prostaglandin synthesis, NSAIDs reduce mucous production. They may also lower gastric pH levels below the normal pH of 2.

    In healthy adult horses, administering phenylbutazone negatively impacted the mucosal barrier of the gastrointestinal tract. This increased ulcers and reduced overall digestive health.

    Gastric Ulcers: New Thoughts On Treatment

    Prevent / Reverse Stomach Ulcers in Horses Naturally!

    Equine gastric ulcer syndrome is a condition associated with the inner lining of the oesophagus, glandular and non-glandular parts of the stomach and the initial portion of the small intestine . Gastric ulcers are a common problem particularly among racehorses and elite competition horses, were they can be found in horses of all ages and types. As many as 70.6% of domesticated horses have been found to have ulceration, compared with 29.6% of horses that are allowed to be more feral. Foals are particularly susceptible with one study reporting as many as 50% of neonatal foals had ulcers.

    The clinical signs of gastric ulceration can be very vague and can include poor performance, mild recurrent colic signs, weight loss or poor condition. The diagnosis of gastric ulceration is confirmed definitively using a gastroscope a three-meter-long camera, passed up the nose and down the oesophagus of a starved, sedated horse in order to visualise the stomach wall.

    Pharmacological Therapy

    Once a diagnosis of gastric ulceration has been made, the treatment options include changes in the management of the horse, which will be discussed later in the article. The best way to promote healing is using pharmaceutical therapies as it has been demonstrated that only 4-6% of ulcers have been shown to heal spontaneously.

    Management Changes

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    Feeding Practices To Reduce Risk Of Squamous Ulcers

    While omeprazole will help heal existing squamous ulcers, successful management and prevention of future ulcers requires a combination of both medication and nutritional management. Some nutritional management steps include:

  • Feed multiple, smaller grain and/or concentrate meals throughout the day. By rationing the grain into 3 or 4 meals per day, the increased acidity of the stomach that follows a large grain meal can be avoided. When horses eat a grain meal, they do not chew as much and thus not much saliva will be produced to buffer the stomach acid.
  • Ensure your horse has constant access to forage. Provide at least 1.5% of a horse’s bodyweight in dry matter of forage per day. For example, a 1,000-pound horse should receive at least 15 pounds of forage per day . Forage requires more chewing and thus more saliva is secreted compared to a grain or concentrate meal. In addition, the long fiber particles form a mat that floats on top of the stomach contents, helping to prevent the acidic layer from splashing up into the squamous section. If possible, a horse should have 24/7 access to forage. By providing forage throughout the day, both the saliva and forage act as a buffer against stomach acid and can decrease the risk of squamous ulcers developing. If free access to forage is not possible, the use of a slow feed hay net can be used as it increases the horse’s time spent foraging and chewing.
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