What Causes Equine Gastric Ulcers
The stomach is divided into two parts separated by a band called the Margo Plicatus. The bottom two-thirds are the glandular region that secretes acid continually as part of the digestive process. In the glandular region, there is secretion of bicarbonate-rich mucous which protects the stomach lining. The top part, the non-glandular region, has a lining of squamous epithelium and lacks the bicarbonate-rich mucous which protects against the stomach acid. This means that the majority of ulcers occur in the non-glandular squamous region.
Gastric Ulceration occurs when the stomach becomes hyperacidic and/or contacts and damages the squamous mucosa that lines the stomach, but is not used to being in contact with the acid.
Due to the anatomical and physiological differences between the glandular and nonglandular regions of the stomach, EGGD and EGSD can have different causes. The causes of EGGD are not well understood, but is thought to involve breakdown of the normal defence mechanisms of the stomach lining.
Feed Multiple Small Meals
For some horses that are exercised rigorously or are particularly hard-keepers, some type of grain or processed feed is necessary. If your horse needs grain to meet nutritional or energy requirements, its better to feed in multiple small meals throughout the day rather than two large ones. We generally recommend that you give your horse no more than 5 pounds of processed feed in one meal. Heres how this can help:
- smaller amounts of feed going through the system at a time helps to ensure that starches in grain are digested and absorbed in the small intestine before reaching the hindgut
- feeding more forage and less grain keeps undigested starch out of the hindgut where it can disrupt the delicate balance of microflora
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How Are Gastric Ulcers Treated
There is currently only one pharmaceutical treatment omeprazole approved by the U.S. Food and Drug Administration for gastric ulcers in horses. Omeprazole is available as a paste formulation and has been very effective in preventing and treating gastric ulceration in all types of horses. Although the commercial paste is expensive, it is very effective and requires administration once a day. Due to the cost of this product, some compounding pharmacies prepare and sell paste or liquid omeprazole at cheaper prices. However, several studies have shown that the amount of active omeprazole in those products is lower than the label. In addition, the ability of those products to inhibit gastric acid production and their ability to resolve gastric ulcers has been variable. Horse owners should be wary of claims for products that are not controlled or regulated by the FDA or evaluated in scientific studies. While those products may be less expensive to purchase, they may be more costly in the end due to inefficacy.
A preventative dose of omeprazole is commercially available for use around transport or stressful events. Horses with a history of gastric ulceration may benefit from proactive treatment to decrease the chances of ulcer recurrence. At this dosage, the omeprazole is less costly and may serve as a good investment.
Diet Is Important For Successful Ulcer Treatment
Diet tips for your ulcer prone horse
If your horse needs extra energy, look for feeds that have restricted starch and sugar levels and added oil rather than cereals. For a good balance if starch intake is reduced add fat supplements.
Copra is naturally low in sugars and starches but has a high digestible energy content. Copra may support horses with metabolic disorders including tying up, laminitis or excitable behaviour.
Soaked beet pulp has the same caloric value as oats. However, it is fermented in the hindgut.
Lupins are high in fiber and protein and low in fat and starch
Oils Omega-6 fatty acids have been shown to stimulate production of protective prostaglandins and increase pH. Therefore use corn oil, sunflower seeds, or stabilized rice bran as a fat supplement.
Chaffs & Hays. Lucerne is effective in reducing the severity of ulcers by providing superior buffering capacity compared to grass forages. However, high levels of lucerne hay or chaff may not be desirable for some horses due to its high calorie, protein, and calcium levels. Ideally, lucerne/alfalfa should be included in hard feeds but should not form the basis of ad-lib forage access. Ideal forage for 24/7 access is low sugar grass forages
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Naf Five Star Optimum Concentrated Feed Balancer
Sizes: 3.7kg, 9kg | RRP: £29.99 for 3.7kg | Daily feeding rate: 100g | Cost per day: £0.81 |
This concentrated formula is described as suitable for all from the family pony to performance horse. It contains key ingredients to optimise gut function, combined with optimum nutritional supplement specification that balances a high-fibre, low-concentrate, or performance diet.
More info at naf-equine.eu
Finding The Right Feed For Your Ulcer Prone Horse Or Pony
We work closely with other experts in nutrition, research, and veterinary science so that we can continue to strive to provide our clients not just with research-proven products to help manage and support horses with EGUS, but to also understand and communicate important management strategies that can make a real difference to not just these horses but in general.
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Changing Gastric Care Through Horse Feeds
The Nutrena® brand changed the feed industry over 15 years ago with the debut of the original SafeChoice® Horse Feed, the first-ever controlled starch horse feed to hit the market. By controlling the starch and sugar content of the feed, the Nutrena® brand is a leader in promoting a healthy digestive tract from front to back. Through the multiple feeds now available in the SafeChoice® product line, the synergistic use of prebiotics, probiotics and organic trace minerals was also pioneered. All of these innovations come together to ensure the entire digestive tract is working at peak efficiency to support digestion, immunity, and overall health.
Feeding And Managing Horse With Gastric Ulcers
Small adjustments to the management and feeding regime can help reduce the risk of gastric ulcers.
Split forage intake across the day:When eating forage horses will produce twice the amount of saliva than they would eating the same amount of concentrate feed. Ideally horses prone to EGUS should have ad-lib supply of hay or haylage. If your horse is prone to weight gain then you can replace part of their forage with oat or wheat straw. There is an association between EGUS and crib-biting and research has shown that limited forage intake increased the risk of crib-biting. You should however, pay close attention to the pH of the forage fed.
Contact us for advice on how to get the best from your horse
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Determine Your Horses Nutritional Needs
To create an optimal feeding program, you should evaluate your horses current diet, health status and nutritional needs.
All horses need to engage in species-appropriate foraging behaviours, which means they need to be eating for at least 12 hours a day.
In addition to this, they need to meet their nutritional requirements for energy, protein, fat, minerals and vitamins.
Factors that alter your horses nutritional requirements include:
- Body condition
- Reproductive status
From there, tailor your feeding program to your individual horse, to their housing situation and to which feeds are available in your geographic region.
Analyzing the macro- and micro-nutrients that your horses diet currently provides will help you fill in any potential gaps.
This is best achieved with a . Closely examining the feed tags for any complete feeds or ration balancers you provide is also important to assess whether they are the right option for your horse.
At Mad Barn, we design thousands of feeding programs for horses every year and all of our diet plans start with these principles in mind.
If you need help with analyzing your horses current diet, and our nutritionists can provide you with a complementary review.
Ensure Adequate Water Intake
Horse owners often overlook hydration when it comes to ulcer prevention. Horses at risk of ulcers will benefit from having fresh, clean water available at all times.
Water dilutes gastric fluids and reduces stomach acidity. Water can also improve the transit of food through the gastrointestinal tract.
Research shows that horses without constant access to water are 2.5 times more likely to develop ulcers.
To encourage hydration, feed 1-2 tablespoons of plain salt per day and offer free-choice loose salt. A salt lick can encourage water consumption, but may not provide enough salt and may cause sores on the tongue.
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Symptoms Of Gastric Ulcers In Horses
Symptoms are not always very easy to distinguish from other issues or diseases but some common ones include weight loss, dull coat, biting when being girthed and intermittent colic. However, it is important to consider that good doers and those that look healthy on the outside can have ulcers too. It is also apparent that there is no link between the severity of ulcers and the symptoms some horses are clearly very stoic and can have grade 4 ulcers with no obvious clinical signs.
What Are The Clinical Signs Of Gastric Ulcers
The majority of horses with gastric ulcers do not show outward clinical signs and can appear completely healthy. Subtle signs may include:
- Poor appetite
- Low grade colic
More serious cases will show abdominal pain and/or grinding of the teeth. Some horses are found on their backs since this position seems to provide some relief from severe gastric ulceration. Others will walk away from food if they experience discomfort when the food first reaches the stomach.
Clinical signs of ulcers in foals include intermittent colic , frequent recumbency, reduced nursing, diarrhea, poor appetite, a pot-bellied appearance, grinding of teeth, and excess salivation. When a foal exhibits clinical signs, the ulcers are likely to be severe and should be diagnosed and treated immediately.
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Feed Fibre Before Exercise
One of the age-old golden rules of feeding horses is not to exercise on a full stomach, however, this only applies to concentrate feeds and it is actually highly recommended to allow your horse some hay or chaff immediately before exercise. Having fibre present in the stomach will help to prevent the gastric acid splashing up into the non-glandular portion of the stomach, where ulcers are most common.
Ulcer Treatment For Horses
Now that the condition of horses is known, what does ulcer treatment for horses look like? The acid pump in the horse’s stomach producing gastric juices needs to be suppressed.
Pasture and free access to hay is the most natural and least ulcerogenic environment. Forage consumption not only slows speed of feeding, but also stimulates saliva that acts as a protective buffering agent. This dietary ulcer treatment can be great for your horse.
Racehorses and performance horses generally heal faster if removed from training and competition.
Horses with documented gastric ulcers have responded to histamine H2-receptor antagonists, such as cimetidine and ranitidine, commonly known as H2 blockers. Although H2 blockers may provide limited, symptomatic relief, they block only one of several sites that stimulate acid production and may not heal the underlying gastric lesion.
Antacids need to be given every two to four hours in a volume of 200g at each treatment to be effective.
A newer approach to the treatment of gastric ulcers is the introduction of the proton-pump inhibitors, also referred to as the acid-pump inhibitors. This is the “gold standard” for ulcer treatment in humans and promises to be a cure for ulcers in horses. The major advantage is this treatment has the same active ingredient, omeprazole, as in human ulcer medication.
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Why Does Alfalfa Contain More Calcium Than Grass Forages
Alfalfa has really deep roots about 3 to 4 metres and the calcium at this depth in the soil is more available for absorption. This means that alfalfa plants can take up more calcium than grass chopped alfalfa contains between 30 and 50% more calcium than grass forages. Early studies suggest that omeprazole is reducing calcium absorption in the horse as is seen in humans and in Swanhall et als study, they recommend using bio-available calcium sources in the diet to help counteract this effect. Plant based sources of calcium such as alfalfa are much easier for the horse to absorb than inorganic sources such as limestone flour.
Why Do Horses Get Gastric Ulcers
Wild horses are not prone to gastric ulceration, so why do domesticated horses have such high rates of this condition?
Gastric ulcers are unfortunately an artifact of modern equine management practices. This is why as horse owners we have a responsibility to manage our horses in a way that minimizes ulcer risk.
The horses stomach continuously produces acids, such as hydrochloric acid, whether or not there is food to digest. This creates a highly acidic environment in the stomach that is a major risk factor for ulcer development.
A typical 500 kg horse can produce up to 60 litres of gastric acids per day!
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Clinical Signs Ulcer Treatment Is Needed
Clinical signs are vague and are not unique to gastric ulcers but fit many of the common complaints veterinarians hear from owners and trainers. These include: Adult Horses Poor appetite, Colic, Decreased performance, Attitude change, Poor body condition and Weight loss Foals Intermittent nursing, Poor appetite, Intermittent colic, Poor body condition, Diarrhoea, Teeth grinding, Salivation, Pot belly and rough hair/coat.
However, owners and trainers should inquire about ulcer treatment for horses if any or all of the signs are observed or reported in the horse.
Medications For Ulcer Treatment
Drug therapies are commonly used to treat equine ulcers. Available drugs include omeprazole, ranitidine, and cimetidine.
These drug therapies can be effective for treating ulcers, although they are not without side effects.
Drug therapies act to inhibit the secretion of gastric acids. Reducing acid secretion can increase stomach pH and allows the ulcers to heal.
However, ulcer rebound after treatment with drug therapies is common in horses. Once treatment stops, the stomach responds with an over-production of acid.
This phenomenon is known as rebound acid hypersecretion and it results in an unnaturally low pH. This highly acidic environment can cause new ulcers to form.
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Topspec Lite Feed Balancer
Sizes: 15kg | RRP: £22.75 | Daily feeding rate: 500g | Cost per day: £0.76 |
Designed for good-doers, this balancer is a non-heating, cereal-grain-free formula, with low levels of starch and sugar, and a considered level of protein to help maintain muscle function but avoid promoting body condition. It contains all the micronutrients required to balance the diet of horses in light to medium work in a small amount of exceptionally low-calorie feed. It is suitable for horses and ponies that have recovered from laminitis providing they are not obese.
More info at topspec.com
Science Supplements Wellhorse Veteran
Sizes: 1.6kg | RRP: £34.99 | Daily feeding rate: 54g | Cost per day: £1.18 |
Formulated to meet the demands of the older horse, it contains every important nutrient your veteran requires and meets the NRC and BASF recommendations for vitamins, microminerals and macrominerals. It also supports joint, hoof and gut health as well as the immune system.
More info at sciencesupplements.co.uk
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Treatment For Equine Ulcers
The only FDA-approved drug for treating equine ulcers is omeprazole. It is sold under the tradenames GastroGard and UlcerGard.
is a proton-pump inhibitor that raises stomach pH and allows ulcers to heal.
Other available treatment options that are not FDA-approved include Ranitidine or Cimetidine, which have antihistamine properties. Additionally, coating or binding agents, synthetic hormones, prokinetic agents, antibiotics, or a combination of several therapies may be used.
Treating equine ulcers can be a long and costly commitment, and horses often experience high rates of recurrence. This makes it even more important to mitigate ulcer risk through feeding practices and management changes.
If you believe your horse may be affected by ulcers, contact your veterinarian for a full diagnosis. Your veterinarian can help you better understand available treatment options, including omeprazole, and how to minimize the risk of ulcer rebound.
Looking for help with feeding your ulcer-prone horse? Our nutritionist can help you for free.
Maintain A Regular Feeding Schedule
Keep regularly scheduled meal times, especially for grains and concentrates to minimize digestive upset.
Like humans, horses have an internal clock that signals when to eat. Hormonal signals stimulate hunger and foraging behaviours.
Sporadic feeding schedules can cause stress and result in cribbing, wood chewing, soil licking and other unwanted behaviours.
Horse owners using a complete feed may find it more convenient to give their horse their daily ration all at once. However, research shows that this can increase ulcer risk.
Split any concentrates over multiple small meals -two at a minimum.
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How To Feed An Ulcer
Nutrition and feeding play an integral role in the prevention of equine ulcers. Ulcer-prone horses can benefit greatly from a feeding program that supports gut health and supports the horses natural defences against ulcers.
Equine ulcers are painful sores or lesions that develop along the digestive tract lining. They can cause poor performance, aggression, and girthiness in your horse.
Forage type, meal size, meal composition, and feeding frequency can all impact ulcer risk. These factors are so critical that poor feed management can significantly increase your horses likelihood of developing ulcers.
A well-structured feeding program that accommodates species-appropriate foraging behaviours will limit the time your horse spends with an empty stomach. This will help to buffer against gastric acids that can cause ulcers to form.
Reducing the amount of grain and concentrates in your horses diet, ensuring access to water, and feeding certain gut-healthy foods can also defend against ulcers.
Looking for assistance with designing a diet for your horse to reduce their risk of ulcers or promote ulcer recovery? and our nutritionists can help!