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Treating Ulcers with Products from the Supermarket

Updated: Mar 14

Gastric ulcers are very common in horses, particularly in work.


A study published in the Journal Veterinary Medicine reported the following statistics:

  • Only 37% of untrained Thoroughbreds have ulcers, but that rate increases to 80-100% within 2-3 months of training;

  • About 44% of untrained Standardbred racehorses have ulcers, which increases to 87% during training/racing;

  • Only 48% of endurance horses have ulcers during the off-season; however, 66-93% develop ulcers during the competitive period;

  • Up to 58% of show/sport and pleasure horses have ulcers; and

  • Horses kept at home and that rarely compete only have a prevalence of 11%.

The most common treatment for gastric ulcers in horses is omeprazole, which is a proton pump inhibitor. It blocks stomach acid production. Given how readily available omeprazole is, how much it has decreased in price over recent years, and how relatively easy it is to administer, the problem of gastric ulcers should be solved. Right?


Omeprazole is effective in treating ulcers in the upper third of the stomach (known as squamous ulcers). It is not effective in treating the bottom two thirds of the stomach (known as glandular ulcers). In fact, a study in 2015 found that 36% of horses treated with omeprazole for glandular ulcers got worse.


Blocking acid production can also result in an increase in acid production after treatment, known as Rebound Acid Hypersecretion (RAHS). Owners start treatment again, and it becomes a cycle.


Blocking acid production prevents the horse from producing the enzymes that turn protein into amino acids. It also prevents absorption of important minerals like magnesium and calcium. Calcium is needed not only for bones and teeth but also for muscle contraction, blood clotting, enzymatic functions, and cell membrane functions. Owners are advised administer omeprazole between feeding to increase the digestibility of minerals.


Even with short term omeprazole administration, ample amounts of calcium and magnesium must be supplied by either legume hay, alfalfa pellets/cubes, or a mineral supplement.


Because of this inability to digest calcium and other minerals responsible for bone, omeprazole can also cause bone remodelling:


While research is ongoing, several studies indicate that omeprazole decreased the activation of both the osteoclasts (cells that breakdown bone) and osteoblasts (cells responsible for bone formation).


The racing industry is starting to take a closer look at whether constant use of omeprazole for the 80% to 100% incidence of ulcers in racing horses is responsible for the much higher rates of bone fractures in racehorses.



So what can the horse owner do to help their horse manage ulcers?




First of all, noticing the signs that your horse may have ulcers.


Dull coat

Poor appetite

Grinding teeth or excessive yawning

Girthiness

Preferring hay to hard feed

Kicking with the right hind

Weaving

Crib-biting

Windsucking

Recurring colic

Biting at their stomach



Performance horses are particularly susceptible to ulcers.



There are some management practices that can help reduce ulcers.


Keeping the gut full.


Allowing your horse 24/7 access to pasture or hay means their gut is full, and the stomach acid is busy breaking down forage rather than burning itself. Further, alfafa (lucerne hay) is high in bioavailable calcium which helps to buffer stomach acid.


Feeding your horse lucerne hay while floating, or immediately before riding, or other stressful situations can help to buffer stomach acid.


Reducing stress. Horses in competition are often stressed by factors such as, being away from their herd, being stabled, being in unfamiliar environments. If you are able to limit these stressors, for example by taking a 'friend' to competitions, keeping horses in herds as much as possible, unnecessary transporting, or in other ways limiting stress, this can help to reduce incidence of ulcers in the first place.


Keeping a diary of symptoms, and corresponding feed, work or management can be very helpful in determining the best way to manage your particular horse. For example, a horse may develop ulcers when they are paddocked with another horse that subtly bullies them. They may struggle to rest and relax in that environment. Perhaps it is not the company, but the water source in that paddock is more acid. The cause of the problem may not be obvious at first, but if you can document triggers over time you can see patterns for your particular horse.




There are also many products that you can buy off the shelf in the supermarket, or that you may already have in your home.


Sodium bicarbonate

Baking soda is cheap as chips. It is an alkalising agent which can help to buffer stomach acid. It also helps dissipate lactic acid after hard work, like galloping. A small amount in the feed (no more than a teaspoon) or in the drinking water can have a dramatic effect on many horses. Caution needs to be taken as the ph levels of water from rain or underground sources is usually unknown. It may be worth testing the ph of your water source in case it is already highly alkaline.


Aloe vera juice over the tongue.

Studies have shown that aloe juice is not as effective as omeprazole at quickly resolving ulcers, however, it is safe to use long-term, it is relatively inexpensive and easy to find at your supermarket, and is an excellent preventive treatment after ulcers have healed.


Chia or flax (linseed)

Chia and flax are mucilaginous (they become gooey) and high in omega 3s which reduces inflammation. Both of these seeds are readily available and highly palatable to the horse. You can simply add it to their feed.


Slippery elm bark or marshmallow root

These herbs have been used for thousands of years for stomach inflammation. They are safe for long-term use and can be protective for the intestinal mucosa.



Here at Sound Advice Horse Health we used to make a gut supplement that we called 'Gastro Mix'. It was slippery elm bark, marshmallow root and brewers yeast in a chia seed base. It was highly effective, but it was relatively expensive, and did not have a long shelf-life. We continued researching and found two products that had all of the positive results of our Gastro Mix, but at a much lower inclusion rate, and a better price. We stopped making Gastro Mix and started recommending those two products instead.


Bio Mos is the best gut supplement you've never heard. It is a prebiotic - a live yeast culture, which populates the gut with beneficial gut flora. There is a sister product called Yea Sacc which is a probiotic.


We have had great success treating horses that have chronic scours, malodourous or loose poo. We've also had a great deal of success reducing or eliminating the symptoms of stomach ulcers. We've also found horses on Yea Sacc have improved hoof growth, which is possibly due to high B vitamins.


At 10 grams per day, $35 per kilo, for a completely natural product with no side-effects it is certainly worth trying Bio Mos or Yea Sacc initially or as a preventative measure after a course of omeprazole.








If you have been using omeprazole on your horse to treat ulcers, we very much encourage you to read through the sources listed below (and/or do further research), as there may be long-term side effects that you are not aware of.





Sources:


Sykes, B.W., M. Hewetson, R.J. Hepburn, et al. 2015. European College of Equine Internal Medicine Consensus Statement—Equine gastric ulcer syndrome in adult horses. Journal of Veterinary Internal Medicine. 29:1288-1299.


A comparison of three doses of omeprazole in the treatment of equine gastric ulcer syndrome: A blinded, randomised, dose-response clinical trial

B W Sykes 1, K M Sykes, G D Hallowell Equine Vet Journal 2015 May


A Proton-Pump Inhibitor Modifies the Concentration of Digestion Biomarkers in Healthy Horses


Casner: Studies Show Some Therapeutic Medications Do More Harm Than Good


Equine Research Group. A Proton-Pump Inhibitor Modifies the Concentration of Digestion Biomarkers in Healthy Horses. Journal of Equine Veterinary Science. Nov-Dec 2014.


Effect of sodium bicarbonate on racing Standardbreds

L Lawrence 1, K Kline, P Miller-Graber, A Siegel, E Kurcz, M Fisher, K Bump Journal of Animal Science 1990


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