Ulcers can have a dramatic effect on all aspects of your horse from weight management, behaviour, training ability the list goes on.
I went through the issue of stomach ulcers with one of my mares and thought I would post my experience and allow you guys to have a discussion regarding ulcers
What’s important is knowing your horse’s normal behaviour and being able to notice even the slightest change. My mare Sasha who I bred and have had for 20 years didn’t show much in the way of symptoms the only thing I noticed was her trying to bite when her rugs or girth was done up. She has never tried to bite before.
Some of the symptoms can be weight loss, lethargy, loss of appetite, girthiness, dull coat, poor behaviour, underperformance etc. Your horse may not show all of the symptoms and in Sasha’s case she only showed one.
I can’t stress enough how important it is to get ulcers diagnosed properly from scoping by a vet before just treating. You need to know what you are dealing with before treatment and also to know if treatment works. Just treating and seeing symptoms improve doesn’t mean the issue is solved and without a scope you can’t know if they are properly healed.
You also need to know what type of ulcers and where before you can give the right treatment.
✦ TYPES OF ULCERS ✦
They could be Squamous Gastric Ulcers which are ulcerative lesions specifically affecting the squamous portion of the equine stomach, or roughly, the upper third of the stomach.
They could be Glandular gastric ulceration which is found in the lower part of the stomach where the acid resides and is factors cause the integrity of the mucosal lining to deteriorate. These can be caused by high dosages or long-term use of non-steroidal anti-inflammatory drugs (NSAIDs), such as Bute, may reduce the blood supply to the lining and so contribute or a bacterial infection.
These two types of ulcers require different treatment is its best to know what type you are dealing with. There are also hindgut ulcers (colonic ulcers) which are harder to diagnose as they can’t be scoped. They have several possible causes, ranging from overuse of NSAIDs, parasite burden, or hindgut acidosis usually as a result of being fed large grain feeds.
Diarrhea, intermittent or acute, and recurrent mild colic episodes can be a sign of colonic ulcers present.
Now I admit that I did not initially do a scope as one of the vets I spoke to said it did sound like ulcers and prescribed Sasha to go on a course of Ulcerguard Oral Paste (active ingredient: Ranitidine). She had the full course which was 1 litre on correct daily dosages as stated on packaging and I noticed a big improvement of her symptoms with less biting and sensitivity around her girth and stomach. Once the course was finished within a week her symptoms returned.
I then organised a scope and the vets found Grade 2 Squamous Gastric Ulcers, she was then put on a 45 day course of Ulcershield (active ingredient: Omeprazole) at 6ml per day. Now the funny thing was I didn’t really see any improvement while on this treatment in her symptoms, she was still trying to bite whenever we did her rug or girth up. On the 45th day of treatment she had a re scope done to show her ulcers had completely healed. Her symptoms did not disappear until about a week later which just goes to show that you really can’t rely on the symptoms to tell you if the problem still exists or not.
What I learnt from this experience is don’t take short cuts, I guess I was trying to save some money by skipping the initial scope and just putting her on medication but this failed and ended up costing more money in the long run. Also if I had just put her on Ulcershield in the first place yes it may have saved me money by healing them but what if it wasn’t ulcers in the first place or a different type that it wouldn’t have treated. It is a very expensive treatment to just guess and hope works.
I also highly suggest doing the re scope to see if the treatment has worked because they may need a longer course and if not completely healed and you stop the treatment you will just end up back at stage 1.
Now its fantastic news that Sasha is all healed and her stomach looks great, she’s behaving much better and not in pain but what caused the ulcers in the first place.
✦ CAUSES OF ULCERS ✦
If you don’t fix the cause then you will just have the ulcers return. In Sasha’s case I completely blame myself as she is suspected to be Insulin Resistant and is locked up 95% of the time. I do make sure she has plenty of low sugar hay and her diet is completely low sugar, low starch and no grain but where I made the mistake is with her exercising. I was not filling her stomach with enough roughage prior to lunging or exercising which results in the stomach acid being able to splash around (the 2nd image shows the stomach anatomy and what happens when a stomach is empty vs full).
Exercise itself can lead to a higher ulcer risk with an increase in intra- abdominal pressure that can push more fluid, acidic contents in the lower glandular portion of the stomach and ‘splash’ it up to the more sensitive squamous upper region. This basically turns the stomach into a washing machine of acid.
So what I have done to fix this issue is prior to exercise she now gets half a biscuit of Lucerne hay to fill her stomach and prevent the stomach acid from splashing around and causing ulcers in the upper section of her stomach.
Several studies have also demonstrated that alfalfa/lucerne hay decreases the prevalence of ulcers, possibly due to its calcium and protein content as buffers.
Please do NOT feed your hard feed/chaff etc prior to exercising as you may cause colic, it is best to feed hay prior to exercising and leave your hard feeds to after.
There are several other causes of ulcers and not just the exercising on an empty stomach. Causes such as high grain diets, stress, diet or routine change, limited roughage/forage, NSAID use, infrequent feeding, intensive exercise etc.
✦ GRADE OF ULCERS ✦
Grading of ulcers can only be done via a stomach scope by a qualified veterinarian. Determining the grade of Ulcers is very important as it will allow a proper diagnosis, type of medication needed and the length of treatment needed.
If a proper diagnosis is not performed and horse is treated without a scope you run the risk of the ulcers not being healed in the treatment prescribed. This will end up wasting your time, money and causing longer discomfort to your horse. If they ulcers are not healed by the end of treatment and you stop the ulcers will still be present and high risk of all symptoms returning. Then they whole process will start again.
Grading of ulcers
Grade 1 – The stomach lining is in tact but there are areas of yellowing.
Grade 2 – There are small single or multiple superficial ulcers.
Grade 3 – There are large single or multiple superficial ulcers.
Grade 4 – There are extensive ulcers with areas of deep ulceration and usually active bleeding.
Pictured is a mare from my agistment who showed no signs of having ulcers other than on the very odd occasion turning and nipping at her stomach during meal times. She was sent for a scope which results in grade 4 actively bleeding ulcers
✦ TREATMENTS ✦
There is a lot of people online claiming that simple treatments work and I see people advising others to skip the vet prescribed drugs for these cheaper options. My suggestion is DON’T DO IT!
Most of these things being suggested such as aloe vera, lecithin and other herbal mixtures and concoctions made and by companies claiming to heal ulcers don’t actually achieve getting rid of the ulcers. While they maybe a great addition to your horse’s daily diet to aid the prevention of ulcers they should not be used as a treatment. In most cases your horse will require going on a vet prescribed medication such as Omeprazole to heal the ulcers and then follow up with one of these more natural supplements to prevent them returning.
Again I highly suggest getting a scope to get a proper diagnosis before and after treatment as it is the only way of knowing for sure that the treatment has worked.
These more natural options can aid in the comfort of your horse during the time they are experiencing ulcers. Will there is some evidence in studies to suggest Lecithin does have high chances in healing ulcers I am yet to see more research and evidence to prove this.
Even though we highly recommend vet medications to heal ulcers we also recommend using some natural supplements to reduce the pain and discomfort in your horse. Lecithin is ideal for this as it coats the stomach lining protecting it from the acid that burns the ulcers. We see great results in reduction of symptoms and discomfort while horse is on Lecithin.
Combining this with a good probiotic such as Yea-Sacc and a good prebiotic such as Bio-Mos will really aid in the protection and health the stomach during this process.
When to start feeding Lecithin?
We highly recommend to add Lecithin into your horses diet at the first signs of ulcers, while this may improve the symptoms of ulcers it does not fix the problem. Still organise a scope by the vet to confirm the diagnosis.
Lecithin should be continued during treatment of vet prescribed medications and then up to 6 months post ulcer healing.
With horses that are highly anxious or stressed we recommend keeping the horse on a smaller maintenance dose to aid in the prevention of forming ulcers.
✦ PREVENTION ✦
As with everything it’s best to prevent them from happening then treating them. There are several steps you can take to make sure you are reducing your horse’s risk of getting ulcers.
Never exercise on an empty stomach, feed half to a full biscuit of hay (Lucerne/alfalfa hay being best) prior to exercise.
Provide constant roughage/forage, if locked up due to overweight then supply constant low sugar hay in slow feeder nets. Starving fat ponies/horses does not work and will result in ulcers, they need constant roughage.
Reduce grain based feeds
Feed a low sugar and low starch diet
Multiple smaller feeds daily instead of one big one
Use hay nets or slow feeders to increase chewing and slower intake of feed/hay
Keep stress levels to a minimum which can be aided with supplements such as mag oxide.
Also during times of medication make sure to help the stomach with a great probiotic such as Yea-Sacc and a prebiotic such as Bio-Mos. If it is hindgut ulcers you are dealing with then Equishure can also benefit
As a preventative and to greatly help with the symptoms of Ulcers I highly recommend the Ulcer Aid pack which includes Lecithin and Yea-Sacc. Along with a great prebiotic Bio-Mos
You can read up on the supps at this digestive supplements article
These supplements are highly beneficial in managing your horses stomach health, behaviour, pain and discomfort through the process of dealing with ulcers
● Yea-Sacc (probiotic)
● Bio-Mos (prebiotic)
● Lecithin (protects the stomach lining)
● Equishure (Hindgut supplement)
These are all available in our store and in various packs for most cost effective options
Please feel free to discuss and share your experiences or ask questions regarding gastric ulcers. I hope sharing my experience can help you in reducing the risk of your horse getting ulcers or to help you make the right decision in treatment.