Dear SmartPak: My horse’s ulcer is giving me an ulcer

June 25, 2012Leslie WylieUncategorized#HEALTH, #SMARTPAKLeave a comment

When your horse has been diagnosed with a stomach ulcer, getting rid of it is half the battle. The other half is keeping it from coming back. SmartPak vet Lydia Gray explains how.

From the SmartPak Blog:

My 6 year old mare has recently been diagnosed with an ulcer. They recommended 14 days of GastroGuard. I see that most of the studies have been done on 30 days of treatment. Do you usually treat for 14 days or longer in your practice? Also is there a supplement you recommend for horses with ulcers? Thank you. Regards, Laurie B.

Dear L.B.,

You are correct—studies on the effectiveness of omeprazole, the active ingredient in GastroGard, have used approximately one month as the treatment interval. However, the horses’ stomachs were “scoped” on a weekly basis during treatment and it was found that some horses’ ulcers had healed by day 14. More importantly, it was also found that once treatment stopped, the ulcers came right back. That means you have to do more than just treat the existing ulcers, you have to create an environment in the stomach that makes it hard for ulcers to form.

There are three ways to do this: 1) give the preventive dose of omeprazole, either by using less GastroGard or by switching to the company’s non-prescription product, UlcerGard, 2) select a supplement designed to support a healthy stomach and 3) change the way you feed and manage your horse. There are pros and cons to each of these, so talk to your veterinarian about which strategy(s) might work best for you.

Omeprazole works by completely stopping acid production by the cells of the stomach. Supplements work in a variety of ways depending on the active ingredients. One of my favorite ingredients to promote long-term stomach health is deglycyrrhized licorice, a widely used herb in both Western and Chinese medicine. Other natural ingredients with research supporting their use include Seabuckthorn, Aloe Vera, pectin and lecithin, and the amino acid L-glutamine. Some ulcer supplements simply contain ingredients to buffer or neutralize stomach acid, like calcium or magnesium.

Finally, here are some diet and management tips to reduce the risk of ulcers in your horse:

• Provide pasture turnout—this is the best method of preventing ulcers!
• Provide constant access to hay—keeping hay in front of your horse is next best
• Provide hay frequently—if free-choice hay is not an option, feeding it four to six times a day is an acceptable substitute (hint: try a small hole hay net)
• Use alfalfa hay—the protein and calcium in hay help reduce stomach acid
• Limit fasting periods—keeping food in the stomach at all times protects it from acid which causes ulcers
• Limit grain feeding—sweet feeds especially lead to heavy acid production
• Provide “down time”—heavy exercise is a risk factor for ulcers so include less intense work days and even rest days in your training and showing plan
• Reduce stress—allow social interaction with other horses and keep the feed, turnout, and exercise schedule as regular as possible
• Limit NSAIDS—anti-inflammatories like phenylbutazone have been linked to ulcers, so give the smallest amount necessary for the shortest time possible.

Have a conversation with your veterinarian about the different strategies to first treat the ulcers in your mare then prevent their recurrence. You’ll probably settle on some combination of omeprazole, supplements and a few of the diet/management tips above.