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Medical Index
First Posted: Sept 20, 2008
Dec 17, 2012

Gastric Ulcers in Horses

Bismuth to Treat, Prevent Equine Stomach Ulcers?
Diseases that may be caused from dietary origins
Preventing Equine Gastric Ulcers
Diagnosing and Treating Gastric Ulcers in Horses

The following e-mail that was sent to me. It is posted with the permission of Dr. Pete Gibbs. The article was released December 13, 2007. His reply: "You bet, go ahead. We'd probably use a term besides 'therapeutic effect', but in the interest of time, go ahead and post it on your website. Best regards. Pete" Thank you, Dr. Gibbs, for granting your permission. It is my privilege to post this on HorseHints.

Horse Gastric Ulcer Syndrome can be Controlled with Diet
December 13, 2007 Contact(s): Dr. Pete Gibbs, 979-845-3579, PGibbs@ ag. tamu.edu

Research from Texas A&M University showed that feeding alfalfa to horses that have the potential to be high performers either prevented or was therapeutic in treating stomach ulcers.

"Something in alfalfa hay tends to buffer acid production," said Dr. Pete Gibbs, Extension horse specialist.

"Thirty percent of the 1 million horses in Texas are used in racing, showing and competitive performance," Gibbs said.

"Up to 90 percent of racehorses and more than 50 percent of arena performance horses have ulcers of varying severity,"he said.

When they have ulcers, horses "don't eat as well, work as well and don't feel as good," Gibbs said.

"Feeding grain, confinement, exercise and overall environmental stress factors are thought to cause ulcers," he said. Studies have shown that horses will heal if provided less acidic diets.

The recent research project in the department of animal science's equine science program was part of Travis Lybbert's master's degree thesis in collaboration with the College of Veterinary Medicine. Gibbs served on Lybbert's academic research committee.

In the research, 24 quarter horses from 12-16 months old were separated into two treatment groups. One group was fed Bermuda grass hay and the other fed alfalfa hay to meet the daily roughage needs. The yearlings received forced exercise during the study.

The horses were examined internally with an endoscope at the beginning and end of two 28-day trials.

"It's commonly thought that horses turned out on pastures are better off than those that are confined. However, if grass hay is the only hay they are fed, horses can still get gastric ulcers," he said.

In this study, ulcer scores increased when alfalfa was removed from the horses' diets, and they were turned out on pasture. Under the ulcer-scoring system, 0 signified no ulcers, with severity increasing to level 4.

"Horse owners - especially those with performance horses - have one of two options," Gibbs said.

"They can give their horses a pharmaceutical product that will decrease acid production" he said. "Or they can manage horses' diet.

The second option does not stop acid production but offers buffering capabilities," Gibbs said. Further work is needed to look at horses with varying degrees of ulceration in order to better determine the full extent to which alfalfa or alfalfa-based products might help from a feeding management standpoint.

"Based on what we know right now - for horses that are kept in confinement, eating feed and getting forced exercise - it makes sense to consider some alfalfa as part of their diet," he said.

Until further research is done, he recommends, horses weighing between 1,000-1,300 pounds should be fed about 1 pound of alfalfa after a grain meal.

"This isn't the first research conducted on gastric ulcers in horses, but it lays the groundwork for further research at Texas A&M," Gibbs said. "The next study will investigate what it is about alfalfa and alfalfa products that lessens the occurrence and severity of horses' ulcers."

Equine Gastric Ulcer Syndrome is much more common that I ever realized. I knew that ranitidine is often given when a horse has to go on bute or banamine for an extended period of time. Given at the same time as the NSAIDS (non-steroidal anti-inflammatory drugs as opposed to steroids) it is suppose to reduce the incidence of gastric ulcers. However, I did not realize how prevalent gastric ulcers are until a friend sent me some info on them. The above web site is an excellent learning site-complete and thorough.

Non-steroidal anti-inflammatory drugs

"Non-steroidal anti-inflammatory drugs, usually abbreviated to NSAIDs or NAIDs, are drugs with analgesic, antipyretic and, in higher doses, anti-inflammatory effects - they reduce pain, fever and inflammation. The term 'non-steroidal' is used to distinguish these drugs from steroids, which (among a broad range of other effects) have a similar eicosanoid-depressing, anti-inflammatory action. As analgesics, NSAIDs are unusual in that they are non-narcotic. NSAIDs are sometimes also referred to as non-steroidal anti-inflammatory agents/analgesics (NSAIAs) or non-steroidal anti-inflammatory medicines (NSAIMs). The most prominent members of this group of drugs are aspirin, ibuprofen, and naproxen partly because they are available over-the-counter in many areas. (Paracetamol (acetaminophen) is classified as having antipyretic and analgesic properties, and is not an NSAID.)

Beginning in 1829, with the isolation of salicin from the folk remedy white willow bark, NSAIDs have become an important part of the pharmaceutical treatment of pain (at low doses) and inflammation (at higher doses). Part of the popularity of NSAIDs is that, unlike opioids, they do not produce sedation or respiratory depression and have a very low addiction rate. NSAIDs, however, are not without their own problems (see below). Certain NSAIDs, including ibuprofen and aspirin, have become accepted as relatively safe and are available over-the-counter without prescription..."

Update: Question of the Month (Taken from AAEP's Ask the Vet with Dr. Doug Thal) "From the Horse's Back" - February 2010, Volume 4, Number 2

((After the seminar last week, I've had several questions on ulcers. Most of them related to weight gain, so I pulled this question from AAEP's web site. Enjoy! -SP))

Our first ever horse is a handsome 7-year-old, 16.3 hand, off-the-track Thoroughbred. He is doing well in eventing and seems happy. He is fed three times a day (including ultium, rice bran oil, beet pulp, electrolytes, glucosamine, good hay, 8-hour turnout, works 5-6 days a week) but is having a lot of trouble gaining weight because he stall walks all night. The veterinarian has placed him on one tube of gastroguard/day for a week and then cut it down to 1/4 tube per day for the next 6 months. Will treating/healing the (probable) ulcers result in increased absorption of calories and weight gain? Will the ulcers return when we stop giving him the Gastroguard? Do probiotics help with ulcers? Note: The vet says he weighs about 1,000 lbs and should be closer to 1,200 lbs. We have been battling the weight issue since we got him 1 1/2 years ago. Your advice is greatly appreciated.

The question is: does he have gastric ulcers now? He should have a gastroscopy to determine that. If he still has gastric ulcers, it may take 28 days of treatment with gastrogard at full dose (versus 7 days) to get those to actually heal, and then some sort of maintenance like the 1/4 dose gastrogard for a variable length of time. In cases in which gastric ulcers are the primary problem, treatment of the ulcers can make a tremendous difference to general health and body condition (in this case, could help weight gain). In some cases, the ulcers do return. The most important thing is to know whether or not they are gone now after this long course of treatment. I can't emphasize enough the need to learn as much as you can about his condition before speculating about treatment, and a gastroscopy provides important information, along with other diagnostics, which your vet has likely provided. If everything else is ruled out, it may simply be the energy expenditure of his stall vice of walking constantly that is causing him to lose weight. Trying to manage this is key. He is on a low carb, high fat diet, which is important. The fat component should be maxed out and carbs minimized. Some propose the use of various herbals to help calm nervous horses. I have not had much luck with these but do not know that much about them. I do not think that there is evidence for their effectiveness in horses. Trying different management techniques like feeding long stem grass hay at night might reduce the walking. As far as I know, probiotics have not been shown to help gastric ulcers.

COLLEGE STATION - A change in diet can be good for what ails you - even if you are a horse.

Update: Apr 16, 2010 Equine Stomach Ulcers Still at 60%

For the second year, a nationwide series of more than 160 gastroscopy events showed 60% of horses were identified with stomach ulcers, according to a press release from Merial.

"This is the second year that these scopings were able to show horse owners the type of potentially painful stomach ulcers that their horses have been dealing with," said April Knudson, DVM, manager of Merial Veterinary Services. "Many times, horses are suffering in silence from stomach ulcers due to their natural tendencies as a prey animal to mask pain."

Veterinarians evaluated the horses' stomachs using gastroscopy. Throughout the year, 1,532 horses across the country participated. Overall, 922 horses from 37 states had some ulceration as identified by gastroscopy.

There are many triggers for stomach ulcer development, and stress is an important factor, Knudson said. Horses may experience stress when exposed to such situations as competition, training, travel, lay-up due to sickness or injury, shows or events, limited turnout or grazing, and trailering. Because stress is one of the leading causes of stomach ulcers and travel can lead to stress, horse owners should take precautions when traveling.

Ulcers can develop quickly, too. One study showed that horses can develop stomach ulcers in as little as five days.

Update: Oct. 13, 2012:

"...Guard against the development of equine stomach ulcers. Equine stomach ulcers are very prevalent, with studies showing that two out of three non-racing competitive horses have them at any given time. Because stress is one of the leading causes of stomach ulcers and travel can lead to stress, horse owners should take precautions when traveling.

Changing a horse's routine, including his feeding schedule, turnout schedule, and surroundings, can be very stressful,' says Knudson. 'Travel introduces all those changes--plus a trailer ride that may or may not be enjoyable depending on weather and road conditions. All of these things can contribute to creating a scenario in which ulcers are likely to develop.' To help prevent them from developing and threatening the horse's health and its ability to perform, horse owners can consider administering omeprazole (marketed as an FDA approved product as UlcerGuard , which is designed to help prevent equine stomach ulcers. ..." "Guard against the development of equine stomach ulcers. Equine stomach ulcers are very prevalent, with studies showing that two out of three non-racing competitive horses have them at any given time. Because stress is one of the leading causes of stomach ulcers and travel can lead to stress, horse owners should take precautions when traveling." Safety and Healthy Equine Travels Start at Home

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