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Equine Gastric Ulcers
Gastric (stomach) ulcers in horses are much more of a problem than once thought.
Approximately 90% of racehorses and 60% of horses with other careers have
gastric ulcers. Most ulcers occur in the upper non-glandular portion of the
stomach, the squamous-lined proximal region (very similar to the human
esophagus), which is not normally exposed to the acids that sit in the bottom of
the stomach. In
the adult horse, the most common clinical signs of gastric ulcers include poor
performance, recurring colic, poor appetite (eat a few bites, then walk away),
poor body condition and hair coat, “tucked-up” appearance, change in attitude
(ears pinned back, trying to bite, etc.), and back soreness. Clinical signs in
foals include intermittent colic (laying down, rolling up onto back), diarrhea,
rough hair coat, poor hair coat and enlarged abdomen. There are a few reasons
why horses develop gastric ulcers. One reason is the over use of non-steroidals,
such as bute and banamine. These products are commonly used for pain control,
however, excessive use can result in irritation and eventually ulceration of the
mucosa (lining) of the stomach. Another reason horses develop ulcers is due to
an increase in the acidity of the stomach. A study that put pH electrodes in
horses’ stomachs showed that when horses ate hay and foals nursed, the acidity
of the stomach dropped drastically.
However, within ½ hour of when the horse stopped eating or the foal stopped
nursing, the acidity returned. This helps to explain why we rarely see gastric
ulcers in horses that are on pasture grazing all day. The continual grazing
helps to keep the acidity lower. Conversely,
horses that are stalled and fed 2 meals per day seem to be at a higher risk of
developing gastric ulcers. Horses in intense training are typically fed diets
high
in concentrates (grains) which increase the production of gastrin, a hormone
that stimulates acid production in the stomach. Exercise has also been
implicated in gastric ulcers. A study showed that when a horse increases from a
walk to a trot and certainly a gallop, the pressure inside the abdomen
increases, compressing the stomach and pushing the acid from the bottom of the
stomach to the top, where the acid-sensitive lining is located. Therefore,
horses in training are at a higher risk of developing
ulcers than our “pasture ornaments”. Horses that have gastric ulcers can
subsequently develop a sore back as a result of manipulating their bodies to
protect their stomachs. Currently, the only way to definitively diagnose gastric
ulcers is via an endoscopic examination of the stomach. Other helpful diagnostic
aids include a simple blood test to look at the packed cell volume, total
protein, and white blood cell count. Most horses with gastric ulcers will have a
low pcv, total protein and white blood cell count, however, if these values come
back normal, it doesn’t rule out gastric ulcers. A new test is currently being
worked on that will help diagnose gastric ulcers. The test measures sucrose, a
disaccharide sugar, which is not normally present in either the urine or blood
of horses because the molecules are too large to pass through healthy stomach
mucosa. When the stomach mucosa is
damaged or ulcerated, sucrose molecules can escape and enter the blood stream.
There are many options for treating gastric ulcers. The best confirmed treatment
to heal gastric ulcers is “Gastro Guard”, an omeprazol paste (similar to Nexium
for people), given once per day for 14 days. Ranitidine and cimetidine have also
been shown to heal ulcers; however, they require 3-4 treatments per day. There
are many herbal therapies on the market that seem to be beneficial, such as
aloevera
juice and slippery elm. Although no clinical trials have been done to show the
healing properties of the herbal therapies, horses seem to respond very
favorably to them. Calcium supplements, such as U-guard (like Tums for people)
are beneficial in maintaining horses that have been treated for gastric ulcers.
A new product on the market is Ulcerguard.
It is an omeprazol paste and is
designed to be given four days in a row to horses that are being used at a
weekend event to help prevent gastric ulcers.
If you feel that you have a horse at risk of developing gastric ulcers
here are a few preventative measures to take:
-Feed 4 small meals per day instead of 2 large meals -Add a small amount
of alfalfa, which is high in calcium, to your horse’s diet (the “Tums” effect)
-If your horse is entered in a race or a weekend event, consider treating with
Ulcer-guard
- Wendy Simmons, DVM
Block and Bridle Veterinary Service
32649 WCR 53
http://www.blockandbridlevets.com/