Equine Ulcers: The diagnosis nobody wants to consider.
By Rosi Hubbard Slater
While I am by no means an expert on this subject, I have recently been forced down the path of understanding about horses and ulcers. Of late it seems to be the buzz word with veterinary medicine. I must admit to having been quite skeptical. Sure, you think of high-powered competitive horses, stalled or horses being transported for extended durations, etc., all being susceptible to this stress-induced affliction, but sadly, it is much more common than you could ever imagine.
Studies show that 60% of all competition horses experience ulcers. However, ulcers are also prevalent in our recreational, seemingly stress-free horses, too. In my horse’s case, he developed low-grade colic symptoms. He would intermittently kick out or at his tummy and swish his tail vigorously. Otherwise he acted quite normally. It was perplexing. My initial thought was that he hadn’t been drinking adequately and was dehydrated, possibly mildly impacted? But his manure was not telling that story. Mild impactions usually result in either slimy, coated manure or dry manure. I put him on electrolytes and probiotics for a week with no change.
Having had no success, I called my vet, Dr. John Smart, DVM. We tested for sand and parasites in his fecal, blood work was normal, rectal exam was normal, no dehydration and all other vital signs were normal. The abdominal tap was normal and only slightly slowed gut sounds and secum contractions were noticeable. He had Banamine for 3 days also resulting in no change.
We did discuss the possibility of ulcers, but my horse is the least likely horse on the planet to have ulcers. He simply doesn’t fit the mold. He is calm, relaxed, quiet and easy about everything. He’s a complete marshmallow. He enjoys 24/7 turnout in a pasture with his buddies, lots of good quality hay and no changes in his diet. Nope, we really didn’t think that could be it.
However, after a round of IV fluids with no improvement, Dr. Smart did a fecal test for ulcers. Low and behold, my calm boy tested positive for both stomach and hindgut ulcers! He had albumin and hemoglobin in his fecal. We started him on a protocol of Stem Phase Gastro Boost, a prebiotic/probiotic, along with ulcer formula and enzymes 3 times/day for 2 weeks, then 2 times/day for 5 weeks. We could have dosed him with omeprazole (GastroGard or UlcerGard) but that only inhibits acid production in the stomach and we needed to treat him with something that would heal his entire GI tract. Mind you, omeprazole is the right choice if you are dealing with just gastric (stomach) ulcers.
The first week was rough. He didn’t want to eat anything but hay so I had to give him his meds orally. After a week, he started to feel better and ate the meds on moistened hay cubes. As he felt better, his normal appetite and twinkle in his eye returned and we all breathed a huge sigh of relief.
The cost for the 7 week ulcer treatment was $850. While this is a lot of money, the benefit was in treating both the stomach and hindgut ulcers. I believe a similar regimen with GastroGard runs over $1000. The tricky part now is knowing what to do to prevent future ulcers. In our case, I have changed the way I feed him, making sure he has access to smaller amounts of hay spread out across the day. He is also having a richer alfalfa blend added in because the calcium in alfalfa is a good buffer kind of like horsey Tums.
“Equine ulcers fall into two primary categories – gastric (stomach) ulcers and hindgut ulcers. By far the most common and easily diagnosed type of ulcer, gastric ulcers are caused by excessive amounts of stomach acid. Elevated acid levels compromise the stomach’s lining and eventually lead to the formation of painful lesions and sores. These sores are repeatedly irritated by stomach acid and can produce significant health issues, ranging from grouchiness to colic and, in severe cases, death.” “Hindgut ulcers occur when lesions form anywhere in the digestive tract behind the stomach. These sores are typically the result of a disruption in the pH balance, a condition known as hindgut acidosis.” Written by Mark DePaolo, DVM http://hl.depaoloequineconcepts.com/?q=node/5
Nobody wants to hear that their horse has ulcers, but it is manageable and a much better diagnosis than so many other possibilities. Listed below are several useful links to articles that have been helpful on this journey. I always tell people that all horses have something you will have to deal with, like people. Whether it’s a soundness issue, saddle-fitting, training challenges, or chronic health issues, we love them and do our best to make their lives and our partnerships with them the best we can!
http://hl.depaoloequineconcepts.com/?q=node/5
http://www.lunatunesfreestyles.com/horse_ulcers.htm
http://www.drkerryridgway.com/articles/article-ulcers.php
http://www.littleoasisequine.com/uploads/2/1/7/6/21760604/fact_sheet_hindgut_acidosis.pdf
