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Ask the Veterinarian: Gastric Ulcers


By Dr. Ellen Yungmeyer
Do you have questions about your horse’s health? The veterinarians at Full Circle Equine Services – Drs. Kakki Wright, Sarah Cates, and Ellen Yungmeyer – answer your questions. Submit your questions to their Facebook page, Full Circle Equine Services. Those that aren’t selected for publication in this feature column will be answered on Facebook.
I have been told my horse might have gastric ulcers. What are the signs of ulcers in horses, and how do I know if he does have them?

Horses develop gastric ulcers, or erosions in the lining of the stomach, very easily compared to most species. They are grazers by nature, and their digestive tracts are designed to be continuously taking in grass. Their stomachs secrete a continuous flow of acid to break down the forage they eat. By keeping them in stalls and providing the majority of their calories from grain, they spend long periods of time without eating. Without food to digest, the gastric acid damages the lining of the stomach and can eventually create a painful, bleeding ulcer. Horses that are under stress from traveling and competing are even more at risk. In fact, a study conducted on Thoroughbred racehorses in training in 1996 estimated a 90% prevalence of gastric ulcers (Murray, et al).

Some of the classic clinical signs of gastric ulcers are trouble keeping weight on, preference for hay or grass over grain, taking all day to finish a meal, mild recurrent colic episodes, stretching or lying down after meals, and performance or behavior problems.

Veterinarians will sometimes recommend treatment for ulcers based on clinical signs, but the only sure way to diagnose gastric ulcers is via gastroscopy. Gastroscopy is a minimally invasive procedure in which a video camera on the end of a long slender tube is passed up the nostril, into the esophagus, and down into the stomach.

The treatment of choice for gastric ulcers is the FDA approved form of omeprazole, Gastrogard. Other medications available to treat ulcers are less effective, and must be given every 8 hours, which is difficult for some owners to comply with. However, these other medications can be a good option if treatment funds are limited. Most horses require at least a month of treatment, at which time they should have a repeat gastroscopy to ensure their ulcers are completely healed. There are also multiple antacid supplements available over the counter that may buffer the stomach enough to keep ulcers from forming again after a horse has been treated.

Another important aspect of managing a horse with ulcers (or with a history of previous ulcers) is making changes in their feeding and turnout routine. Ulcer prone horses should be turned out on a pasture with good grass as much as possible, and have unlimited access to hay while they are stalled. Certain feeds can also help buffer the acid in a horse’s stomach and reduce the formation of ulcers. Alfalfa hay is high in calcium, which buffers acid. Because alfalfa is also high in protein and calories, it is an especially good option for a competition horse with ulcers to take the place of some or all of their concentrates.  If concentrates must be fed to maintain good body condition, complete feeds or senior feeds, which contain ground up forage, are best. Sweet feed should be avoided because the high sugar content causes a surge of gastric acid secretion at meal times. If you do switch a horse to a mostly forage diet, remember to add a vitamin/mineral supplement or a ration balancer to ensure your horse isn’t becoming deficient in any nutrients.

If you are concerned that your horse may have gastric ulcers, contact your veterinarian today to set up a gastroscopy.

Murray, M.J., Schusser, G.R., Pipers, F.S., and Gross, S.J. 1996. “Factors associated with gastric lesions in Thoroughbred racehorses.” Equine Veterinary Journal. 28: 5, pp. 368-374.

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