7 point checklist for management and prevention –
If you’re anything like me, you don’t have time to read every interesting thing you see on the internet… so here’s a quick summary of the main points!
1) – Feed the steed at the tie up rail – Exercise on an empty stomach is an excellent way to produce ulcers! Lucerne hay is particularly good directly before work, it has a natural ability to buffer acid and the long stems form a ‘mat’ in the stomach, covering the acid from the bottom half of the stomach and stopping it from splashing around.
2) – Food 24/7 – A horses stomach secretes acid continuously regardless of contents, this means that horses must eat constantly to buffer this acid!
4) – Go saliva – The constant slow trickle of roughage is also important to maintain chewing which in turn promotes saliva release – saliva buffers acid. A slow feeder is useful here as it will increase the saliva to roughage ratio. Limit concentrates, as they don’t require as much chewing and saliva production. For excellent slow feeder nets checkout Gutzbusta HERE.
5) – Go Water – Make sure the horse is drinking regularly; water will also dilute stomach acid.
6) – Decrease stress – by keeping your horse in a biologically appropriate, natural, horse centred environment – AKA a herd environment with 24/7 turnout.
7) – Avoid long term NSAID’s – (bute), they can damage the protective lining of the stomach.
And just to confuse you a bit before we go into detail… According to the research, it is fairly clear that if:
- Your horse is showing ‘ulcer symptoms’ – This doesn’t mean he has ulcers!
- Your horse isn’t showing ‘ulcer symptoms’ – There is still a good chance that he has ulcers!
Ok, that was the summary… now for the details:
Prevalence and Diagnosis
It is fairly well established that the prevalence of gastric ulcers in horses goes up with the intensity of training and competition. For example, the prevalence of ulcers in racehorses is thought to be between 87-100% and for non race horses in light to full work, its around the 58-89% mark. There is however, many studies where the prevalence varies widely.
Diagnosis is based on history, clinical signs, gastroscopy, and response to treatment.
Typical complaints/clinical signs include failure to finish grain meals, preference for roughage (hay and pasture) over concentrates, progressive weight loss and underperformance.
In reality however, ulcers are blamed for a myriad of symptoms from girthiness, behaviour problems, colic to hoof and coat dullness and even diarrhea. Many of the claimed symptoms of ulcers lack scientific validity.
A recent study in Polish pleasure horses included over 100 horses in light non-competition work. They split the horses into two groups, one group was displaying typical ulcer symptoms, the other had no symptoms. The interesting thing about this study is that it clearly demonstrated that the observation of symptoms is not a reliable factor in determining whether or not a horse is likely to have ulcers. This was demonstrated by the fact that 21% of the symptomatic horses did not have ulcers and 63% of non-symptomatic horses actually did have ulcers. The study also demonstrated that the only way to definitively diagnose ulcers is via a complete gastroscopic examination.
The research is clear… The observation of symptoms is not a reliable factor in determining whether or not a horse is likely to have ulcers.
Why do horses get Ulcers?
The stomach of most mammals is lined with glandular mucosa, in contrast, the top half of the equine stomach is lined with a non-glandular or squamous lining structured similarly to that lining the oesophagus which does not produce stomach acid or digestive enzymes. This seems to be where the majority of Ulcers form in horses.
The lower portion of the stomach has a glandular lining and secretes acid continuously regardless of the stomach contents.
The acidity of the horses stomach varies depending on the site and is determined largely by the roughage component and ‘fullness’. The lower density/larger particle size content remains at the top and is less exposed to the stomach acid, that is secreted in the lower half of the stomach, and maximally exposed to the incoming buffering action of saliva.
Horses produce a massive amount of saliva per day, with an average pH of 7.4, it has quite a buffering effect against stomach acid. The upper portion of the stomach has a pH of around 5-7 whereas the lower more distal portion of the stomach, where the acid is secreted, is consistently within the 2-3 range.
When forage (or water) is restricted and the stomach contents are reduced, the pH can drop quickly below 4 in the upper squamous part of the stomach. This is a problem for this part of the stomach as the integrity of the squamous mucosa (the protective lining) lacks the protective mechanisms that allow the glandular mucosa (the lower stomach) to remain intact under much more acidic conditions.
Transit time in the Stomach is as little as 2 hours and depends on several factors including particle size, starch vs fibre, exercise and fluid content. This means the horse needs a constant trickle of food into the stomach to avoid it being empty!
Feeding free choice forage in a slow feeder net is advisable. This has two advantages – it will slow the horse down, encouraging a constant trickle of roughage into the stomach. And secondly because the horse has to work to get each mouthful, this provokes more salivary secretion which, in turn, results in more buffering of the gastric contents covering the squamous mucosa.
It’s also been clearly demonstrated that exercise in itself can lead to a higher ulcer risk. Exercise causes an increase in intra- abdominal pressure that can push the more fluid, acidic contents in the lower glandular portion of the stomach and ‘splash’ it up to the more sensitive squamous upper region. This effect increases at the canter, gallop and when jumping. At the end of each stride or on landing after a fence, the horse’s intestinal contents (or guts!) literally slam forward into the stomach, squashing the stomach into the diaphragm, turning the stomach into a washing machine of acid! It is thought that this is the reason that horses in intensive training often have a much higher incidence of squamous ulcer lesions.
Several studies have also demonstrated that alfalfa/lucerne hay decreases the prevalence of ulcers, possibly due to its calcium and protein content as buffers.
Non-steroidal anti-inflammatory drugs (NSAID’s) such as phenylbutazone are known to disrupt the protective mechanism of the stomach. Overuse of these drugs can cause ulcers.
The balance between Omega-3 and Omega-6 fatty acids is important in inflammatory diseases of the gastrointestinal tract because of their anti-inflammatory properties. Make sure you chose feedstuffs with healthy omega 3 : 6 ratio’s – See link HERE for more info.
It should be fairly obvious from the above points that treatment revolves around good management practices and prevention.
A gastroscopy for many horse owners will be out of the question so often it’s advisable to treat ulcer symptoms regardless and hope for an improvement. Just be aware however, that long term suppression of stomach acid, also suppresses protein utilisation – since the first step in the protein digestion is achieved by stomach acid hydrolyzing the bonds between amino acid chains.
Omeprazole drug treatment is the gold standard in the initial stages of treatment but unfortunately its also VERY expensive! Best to get Veterinary advise regarding drug therapy.
In my clinical experience, there are several herbs that can be very effective in soothing and healing ulcers. We formulate a herbal blend designed by Dr Ann Nyland specifically for Ulcers and are continually getting great feedback on it. Ulcer Fx is available HERE.
Support the horse nutritionally by feeding an appropriately balanced, quality mineral mix like Missy’s Bucket.