“If any of these factors points to the potential of low-grade ulcers, that’s where I want to catch them,” says Dr. Davis. A new horse will come into a barn and immediately we’ll put them on Platinum Wellness or Platinum GI, we’ll examine and correct their diet, we’ll become familiar with their stressors and we’ll get a complete picture of their health and risk factors. But they can be painful on your purse too. When do we stop the medication and what medication would we use?’” Diagnosis is quite literally a guessing game in the absence of gastroscopy. All Rights Reserved. I know that these horses want to perform, and it’s my job to give them the best chance to perform at their highest level. Symptoms of Horse Ulcers . Although stomach ulcers in horses may seem like a new trend, they’ve probably been around for much longer than we realise. “I don’t ride the horses. Whenever you observe these clinical signs you should suspect stomach ulcers, and immediately consult or bring your horse to a horse veterinarian. This is laying the groundwork for better and more wide-ranging treatment options, the pursuit of a more personalized approach, a whole-horse view of patient health and a commitment to prevention. I’m happy to get up every morning, be a part of the team with my clients and see their success in the ring or the arena doing what they and their horses love. We have to know our patients.”, One of the greatest advancements in recent years has been a fresh and significantly more thorough understanding of how NSAIDs impact the horse’s GI system and play a role in the formation of equine gastric ulcers. The less time your horse is without forage the better, and a horse with or recovering from ulcers should always have a source of forage available. Horses are natural grazers, evolving on a variety of grasses, barks and mineral-rich forages while grazing up to 18 hours per day. Due to the central role of the equine gastrointestinal system in a horse’s overall health, including their vital immune function, inflammation of the GI tract can have deleterious effects on numerous systems within the body. “I think I can speak for most, if not all, equine veterinarians, in saying that we are extremely fortunate to be able to work on these phenomenal athletes every day,” says Dr. Belgrave, instinctively. “We use products like Platinum Gastric Support that are able to offer the horse Saccharomyces c. boulardii and dried Lactobacillus delbrueckii and its vital fermentation products, giving them the support they need in the stomach in particular, as well as with the fermentation component in the hindgut and the cecum specifically.”, A critical component to a whole-horse approach goes well beyond treatment and is seen in its preventive power. These inevitable losses can take a toll on the equine practitioner. Ulcers can range from mild to severe and require medical attention in order to be properly treated. “It’s 100 percent about the horses. Furthermore, hindgut ulcers are hard (and expensive to diagnose) so treating them, while you treat gastric ulcers makes sense. Of course we all live with a certain level of managed inflammation, both horses and humans alike. Then, there is the glandular mucosa, where acidic pumps are predominantly located and where acid is being produced. “If I have a horse that I know has ulcer issues, I usually treat them aggressively with an Omeprazole-type product for 30 to 60 days, depending on the severity of the case. “What makes me so passionate about this area of research is that equine GI disease is a leading cause of morbidity and mortality in horses, and we now realize that this class of medications actually does quite a bit of harm in both people and animals when not used properly and sparingly.” Together with Dr. Lauren Richardson of Tryon Equine Hospital, Dr. Whitfield documented the effects of NSAIDs on the equine gastrointestinal tract and showed that, in fact, NSAIDs do cause intestinal inflammation and gastric ulcers. “Continued research to better understand EGUS, EGGD in particular, and how to prevent and treat it more effectively is needed,” says Dr. Belgrave, hopefully. We’ll use one of these formulas to provide our patients with that backbone of wellness and performance support, as well as GI-specific nutrients for daily support. If a horse is suspected of having gastric ulcers, gastroscopy will confirm the presence, severity and location of the ulceration. Is it the horse’s diet, environment, training schedule or something else?” By simply treating the horse without uncovering the root cause of its ulcerations, the horse could be destined for recurrence and a cyclical use of medications that may not impact the real issue. How much does it cost to diagnose and treat a horse with gastric ulcers? 4. It’s when that inflammation inches above the disease threshold into an unmanaged state that significant clinical issues can arise. “Horses with a history of EGUS should be fed grain and concentrates as sparingly as possible. When treating horses with ulcers, it is important to substitute any sweet feeds, barley or oats where possible for lucerne hay or good quality grass. This could be everything from diet to parasites to alterations in the environment, bacterial overload and inappropriate bacterial growth. A study looking at feed type on gastric ulcer formation showed an increased risk of gastric ulcers in young growing horses consuming high grain diets as compared to a forage diet. These two parts are separated by a barrier called the margo plicatus. “I could only give a rough figure and it would generally depend on how long the horse was on medication for. This inspired them to point their practice down a more functional and integrative path, focusing on whole-horse wellness and preventive medicine by, in part, implementing complementary therapies into their treatment protocols. “The medications we use to treat EGUS try to alter and control the environment in the stomach so that the equine body can heal those ulcerations on its own.” These therapeutics can include both proton pump inhibitors and H2‐receptor antagonists. We know that an athlete devoid of a proper diet, in an unmanaged state of inflammation, can be more prone to injury and disease and less able to perform to his or her potential. That’s predominantly where we’ll see various grades of gastric ulcers. Gastric ulcer syndrome, a very common disease in horses (up to 60-90% of horses in some studies) is an erosion of the stomach mucosa. This seems to work for us. These two linings are separated by a border referred to as the margo plicatus,” explains Rodney Belgrave, DVM, MS, DACVIM, owner of Mid-Atlantic Equine Medical Center in Ringoes, New Jersey. “You’ve got to take care of the entire GI tract,” says Dr. Davis emphatically. “When I see a grade 1 gastric ulcer syndrome, I’ll often see a yellow-green coating over the nonglandular portion of the stomach mucosa and that hyperkeratosis is the body’s biological BAND-AID® trying to heal the insult. Although Thoroughbred racehorses present with EGUS in significantly higher numbers, there have been no further breeds or ages pinpointed as being at a higher risk. Dr. Smith uses a similar approach in his cases at Brazos Valley Equine. Today’s horses are commonly stalled for a portion of their day, if not all of it, and fed meals instead of having continual access to good quality grazing. Although the most common location for ulcers is the upper region of the stomach, ulcers have been known to develop in other areas, including the lower portion and the duodenum. “There is an increased likelihood of ESGD when straw is the only forage provided, though feeding alfalfa hay has been shown to have a protective effect of the gastric squamous mucosa in adult horses.” Dr. Belgrave is a strong advocate for pasture access, and for those times when horses are stalled, he recommends continual and gradual access to good-quality hay while keeping grains and concentrates to a minimum and only feeding them when a sufficient amount of hay is in the stomach to buffer the gastric acid released upon their consumption. Ulcers in horses are periods of inflammation of the lining of the stomach. Dr. Davis is quick to point out that gastroscopy is a necessity when ulcers are suspected to avoid medically treating suspected ulcers when something else entirely could be going on. If the overnight haynets (for those stabled) are empty, you need to provide more. “All portions of the stomach need to be investigated,” asserts Dr. Davis. Most ulcers occur here because the horse’s stomach continuously secretes acid, even when empty. Dr. Whitfield’s most recent research, presented at the ACVS Surgery Summit in 2019, focused on Phenylbutazone- induced gastrointestinal injury. The 15 Best Coat Supplement for Horses 2020 (Reviews & Guide) The 15 Best Horse Feed For Performance Horses 2020 (Reviews & Guide) The … “Everything’s related. Sign in or register below to view your Horse profile. With most grains and concentrates having an inverted ratio of omega-6 to omega-3 fatty acids — meaning they are considerably higher in more pro-inflammatory omega-6 fatty acids — these feeds can exacerbate the condition in horses with confirmed or suspected EGUS. We give UlcerGard when our horses compete to prevent ulcers from forming. Monumental advancements in the role of diet and advanced nutrition is one area of medicine that has moved into mainstream practice as a vital complimentary therapy and preventive tool in recent years. This will also happen in a follow up gastroscopy 20 to 35 days following the beginning of treatment.”. As Dr. Whitfield mentioned in his findings, inflammation can be a significant contributing factor to equine gastrointestinal disease, including gastric ulcers and Leaky Gut Syndrome. Veterinary medicine has propelled forward in its approach to not only treating disease, such as EGUS, but in preventing disease. “We showed this also occurs in horses, although the clinical significance is still unknown,” says Dr. Whitfield of their findings. It was at this point that their goal became to not only reduce the number of gastroscopies but rather to get to the root of the problem that was requiring this diagnostic step in the first place. If we don’t keep the gastrointestinal tract intact, we’re going to have to fight longer and harder with our medications than if we had thoroughly thought through the preventive steps,” says Dr. Davis as an example of his approach. “In the case of gastric ulcers when stomach acid becomes too acidic in nature, the question becomes not just how do we treat it, but why is this happening in the first place,” says Dr. Davis of his root-cause approach. “For every horse that gets prescribed medication for gastric ulcers without ever taking a look inside their stomach, I always ask myself ‘How do we know if that is a correct treatment? Gastric ulcers can affect any horse at any age. To spot ulcer symptoms in a horse, keep an eye out for behavioral changes, like increased irritability, nervousness, or fatigue, which can be a sign that a horse has gastric ulcers. Our practice pays keen attention to that process.”, Equine Gastric Ulcer Syndrome is a daily challenge for veterinarians, with a horse’s performance and overall health being challenged by ulcers and their secondary effects. Affiliate Disclosure, Guide on Choosing the Proper Treatment for Ulcers in Horses, What Are the Symptoms and Risk Factors of Stomach Ulcer in Horses, Med-vet Pharmaceuticals Gastro-plex Paste, Gooseberry Ulcer Guard for Stomach Balance, Our final thoughts on treating ulcers in horses, Best Equine Probiotic: Top 15 for 2020 (Reviews & Guide), The 15 Best Treatment for Rain Rot 2020 (Reviews & Guide), The 15 Best Horse Treats 2020 (Reviews & Guide), The 15 Best Horse Wormer for Fall 2020 (Reviews & Guide), The 13 Best Wound Cream for Horses 2020 (Reviews & Buying Guide), 12 Best Hoof Supplements for Barefoot Horses 2020: Reviews & Guide, The 11 Best Horse Feed for Weight Gain 2020: Reviews & Guide, The 15 Best Stall mats for Horses 2020 (Reviews & Guide), The 15 Best Cordless Horse Clippers 2020 (Reviews & Guide), The 15 Best Horse Riding Helmet 2020 (Reviews & Guide), The 12 Best Joint Supplement For Horses 2020: Reviews & Guide, The Best Horse First Aid Kit 2020 (Reviews & Guide), Best Natural Fly Spray For Horses: Top 15 in 2020 (Reviews & Guide), Prolonged use of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs). Performance horses are very susceptible to stomach ulcers because of their high levels of physical activity. Also, monitor how much food your horse is eating since horses with gastric ulcers can be reluctant to eat. Equine Gastric Ulcer Syndrome (EGUS) frequently referred to as gastric ulcers in horses is a common problem among domesticated horses. “Chronic use of NSAIDs can easily lead to gastric ulceration and a disrupted equine gut microbiome, which then trickles down to a host of other secondary concerns. Prevention is key because once the horse is in a disease state it becomes a battle,” says Dr. Davis. That’s for them and their riders to sort out, but for me, it’s the love of the athlete that drives me to do what I do.”, Whether it be sports medicine in general, or specifically the challenge of gastric ulcers in equine athletes, the world of veterinary medicine is shifting toward stewarding a new era of root-cause medicine. When shopping for supplements, you should buy the best ulcer supplement for horses you can find. Part 1: Natural Ulcer Relief for Horses. Ulcers Found In More Than 60% of Horses. In this post, we’ll be discussing some of the things you need to know to take proper care of your horse if it develops stomach ulcers. There is also a population of horses that appear normal, but whom benefit from diagnosis and treatment of ulceration. While there is a long list of behavioral and performance indicators that can point toward the presence of ulcers, equine veterinary medicine relies on a strong set of diagnostic tools, led by gastroscopy, to definitively confirm, then grade ulcers. Veterinary medicine is witnessing significant leaps in areas including the impact of NSAIDS, the critical role of diet, the influence of advanced nutrition and the tie between equine gastric ulcers and the horse’s gut microbiome. Ulcers develop from the build-up of hydrochloric acid within the stomach. Length of treatment is important. Ulcers touch an overwhelming percentage of the horse population, making them one of the more prolific struggles faced by both riders and equine veterinarians. According to the American Association of Equine Practitioners (AAEP), up to 90 percent of racehorses and 60 percent of performance horses are afflicted with gastric ulcers, with non-performance horses and foals impacted as well. Be sure to check out the other articles in the series for an overview of equine ulcers , gastric ulcers , colonic ulcers , diagnosing , and treating equine ulcers . Is a horse simply being irritable or “girthy,” or could there be ulcerations revealing themselves through these behaviors? In the case of glandular ulcers, Dr. Belgrave explains that, “The ulceration is described according to the anatomical location of the glandular mucosa in which they occur.”, Equine Gastric Ulcer Syndrome can cause mild to extreme discomfort, which will inevitably impact a horse’s ability to perform.PHOTO BY CAROLYN SIMANCIK, Perhaps one of the most challenging aspects of equine gastric ulcers is that, much like colic, there is no clear-cut, singular cause. Learn more about feeding your performance horse. “I’m seeing a high number of competitive athletes, so obviously we’re assuming that these horses are encountering stressors such as travel, new environments, intense training, lack of sleep, NSAID use and so on. Why Horses Get Stomach Ulcers and How To Treat Gastric Equine Ulcers Naturally! “For us, those preventive steps encompass several things, with diet being of paramount importance.”, Beyond the typical stressors that are commonly attributed to EGUS, diet and the manner in which horses are fed have been identified as critical factors in both the prevention and treatment of ulcers. “We know that NSAIDs cause gastric ulceration, so we looked at that as well and while Phenylbutazone did induce gastric ulcers, there were significantly fewer ulcers in the control group and the group treated with both Phenylbutazone and a nutritional therapeutic.” Lastly, Dr. Whitfield and his team looked at the dysbiois (microbial imbalance) caused by NSAIDs. “In that study, we looked at a number of things. Whether it’s diagnosing ulcers and treating a horse successfully to allow it to fulfill its potential, or successfully treating a horse with a dire medical condition that returns to be victorious on the racetrack or the show ring, I relish any victory that I’m fortunate to be associated with.”, Dr. Belgrave’s sentiment is shared by Dr. Smith, a lifelong horseman in his own right. All roads lead to stress. “Therefore, the horse’s nutrition is going to fall off. The acids may burn a crater deeply enough to cause bleeding or even burn through and penetrate the gut. This is because 65% of ulcer suffering horses have both gastric & hindgut ulcers. “In the future, we will ideally head toward personalized medicine and a whole-horse approach in order to prevent and then, as needed, treat disease,” says Dr. Whitfield. A steady supply of forage – all the time, all day, and all night – will put the acid to its proper work and protect your horse’s stomach. This is particularly important when considering a horse’s unique hindgut fermentation process that plays a pivotal role in nutrient absorption and greatly impacts the horse’s overall health and condition. A lot of times they’ll eat a part of their feed and then lie down, mirroring the symptoms of a mild colic. When gastroscopy isn’t an option due to cost, a client’s unease at the prospect of fasting their horse or other factors, the diagnostic process turns to other options. While grains and concentrates can have a detrimental effect in some cases, forage choices and grazing behavior can both positively and negatively impact a horse’s propensity for ulcers as well. “We’re sport horse veterinarians, but we approach our patients from a functional and integrative medicine perspective,” says Dr. Davis. “The mucosal lining of the stomach consists of two regions, the squamous mucosa, which is the nonfunctional lining of the stomach, as well as the glandular mucosa, which secretes gastric acids (hydrochloric acid), pepsinogen, histamine and bicarbonate. Two drugs of choice, omeprazole and ranitidine. This approach offers a few benefits, one being a cost savings to the client and the other being, in my opinion, a greater efficacy in the long run.”, When Dr. Davis and his wife and business partner Dr. Stephanie Davis first started in practice, they were performing hundreds of gastroscopies per year. My part is to make sure that I listen and act on behalf of that horse. They may get up and slowly finish their meal, sometimes eating their grain at a slower rate than their hay due to the influx of acid that it causes. This root-cause approach to patient care has veterinarians no longer treating conditions and injuries as stand-alone ailments, but rather, seeing the horse as an interconnected and synergistically-operating collection of systems. A diagram of the inside … “What can happen with this approach is that you take a horse that naturally tends to be normally more acidic and repeatedly push it into a more neutral or basic realm for extended periods of time. Dr. Whitfield’s research demonstrates that advanced nutrition can play a role in supporting a normal, healthy gut environment in horses undergoing NSAID therapy. “Primary ESGD occurs in the absence of other gastrointestinal abnormalities, while the secondary form occurs in relation to existing gastrointestinal abnormalities such as duodenal and pyloric strictures.”, While a clear grading system exists as a diagnostic tool for squamous ulcers, glandular ulcers have no clear-cut grading system. However, if the ulcer symptoms are from the glandular portion of the stomach, GastroGard will be ineffective. It’s surprising just how many parallels run between equine athletes and their human counterparts. Provide Plenty of Water. That’s not my part. This discomfort impacts their performance, and we see these horses often kicking out when their rider puts a leg over them or becoming uncharacteristically temperamental when they’re in the ring. Gastric ulcers are obviously painful for the horse which is the number one consideration. A simple fecal test can be an important component to the overall diagnostic picture as well. Because ulcers can be so uncomfortable for horses, the temptation for their owners is to reach for the product that will offer the quickest relief, usually in the form of conventional drugs. Beneath the surface, however, it quickly becomes clear that ulcers remain a bit of an enigma, with near endless causes, high recurrence rates and an approach that requires a multifaceted and individualized plan to accomplish a successful outcome. I don’t take home the big checks. “The take-home message in terms of gastric ulcers is that they are most likely more prevalent than we think, especially in sport horses,” says Dr. Whitfield, confidently. In some cases, it’s those performance-related changes in a horse that often indicate a potential ulcer issue and cause veterinarians to investigate further. A unique aspect of the glandular mucosa is its protective waxy coating that, when broken down, allows for glandular mucosal ulcers and also ulcers in the pyloric region,” explains Dr. Davis. I did read somewhere (though I can't remember where - possibly Kentucky research) that dry feed was better than damp, and we have found it has helped our mare. That’s the top portion of the stomach, which also contains a cardiac sphincter where the scope enters the stomach,” he explains. There are two sections of the horse’s stomach; the glandular portion, which secretes acid and enzymes to break down food, and the stratified squamous portion. We then pay close attention to how that horse responds to the program, ensuring that our client and trainer are fully supportive. It may just need a singular component, and that’s where the horse’s history is so important to know, as well as the horse’s diet, workload and how it’s being managed.”. Predisposing factors are wide-ranging and vary from environmental influences, travel, stalling practices, NSAID exposure, diet and competition, to name just a few. As a result, a stall side test will likely never fully replace the benefits of a thorough gastroscopic examination.” Other diagnostic methods that are used stand-alone or in conjunction with a gastroscopy can include veterinarians pulling blood and running a full CBC and chemistry panel as well as serum amyloid A (SAA) to understand potential infections and the inflammatory component, respectively. When you break it down, you have that nonglandular stratified squamous mucosa. That inflammation works against veterinarians in several ways, including hindering a horse’s ability to properly absorb both nutrients and medications. The inflammation subsequently gives rise to erosion, and eventual ulceration of the mucosa,” explains Dr. Belgrave. “The entire horse plays a role in most conditions that we’re addressing, and this demands that we look at the horse from nose to tail and everything in between.”, In the case of EGUS and the stable of pharmaceutical drugs that veterinarians commonly rely on, Dr. Davis sees the benefit of these therapies and uses them frequently while always falling back on a functional and integrative whole-horse approach. Gastric ulcers, also called equine gastric ulcer syndrome (EGUS), are thought to be present in a large proportion of horses, with an estimated 80-90% of racehorses, 60% of competition horses and 40-50% of leisure horses suffering from this condition. “EGUS is most often a reflection of what we ask of these horses,” says Chad Davis, DVM of Davis Equine Sports Medicine in The Plains, Virginia. Our recommendations are designed to nourish and manage gastrointestinal health, and in an animal that relies predominantly on fermentation as his primary source of calories, you had best get that fermentation and that bacterial flora right. We know now that the gut is vital to the horse’s overall health, and we’re learning how serious the implications can be when NSAIDs are over-prescribed or used for elongated periods of time coupled with stress, competition, travel and so many other contributing factors.”, One of the foremost experts on the effects of NSAIDs on the equine gut environment is Canaan Whitfield, DVM, PhD, DACVS, DACVSMR, of Texas A&M University. It’s not uncommon that horses will be on different feeds and various products, but with Platinum, I know I have that strong base, and I know I’ve looked at their diet and given them the best chance for success. Stomach need to become “ gluten ” free from grains Effect Does Magnesium on! 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