The Management of Gastric Ulcers
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Gastric ulcers are not a problem exclusive to racehorses, and many performance and leisure horses have also been found to suffer from the condition. The Problem Equine Gastric Ulcer Syndrome (EGUS) refers to the ulceration of the stomach lining, which can occur due to a number of factors including feeding, exercise and medication use. It is probable that gastric ulcers have been a problem in horses for many years, yet it has only really come to light more recently due to the development of an endoscope long enough to reach and view the horse’s stomach. This has resulted in a number of epidemiological studies to determine just how many horses are affected. |
What causes ulceration?
To understand why ulcers occur, it is necessary to be familiar with the anatomy of the stomach, which can be divided into two main regions:
To understand why ulcers occur, it is necessary to be familiar with the anatomy of the stomach, which can be divided into two main regions:
- Glandular region: This is the lower region of the stomach and is where hydrochloric acid is secreted continuously for the breakdown of food. There is also a mucus layer providing bicarbonate protection to prevent the acid from damaging the stomach lining.
- Squamous region: This is the upper region of the stomach which acts as a reservoir for food as it makes its way down to the glandular region. There is no mucus or bicarbonate protection in the lining, and instead it relies on an almost continuous supply of fibrous material (forage) trickling into the stomach to defend it against acid attack. The squamous region is therefore at the greatest risk of ulcers occurring, particularly at the margo plicatus in the mid-region.
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A sufficient intake of fibre is of great importance in maintaining gastric health, as it acts as a physical barrier mopping up the acid and literally stopping it from coming into contact with the stomach lining. Additionally, horses only produce saliva when they are chewing and saliva contains bicarbonate which helps to neutralise the acid in the stomach. The increased chewing required for fibrous material results in an increased production of saliva, so eating grass or hay/haylage almost continuously would produce an almost constant supply of neutralising saliva.
It was therefore often thought that a high starch (cereal) and low fibre diet was the primary cause of gastric ulcers. Although this can play an important role in their development, a number of other factors should also be considered. |
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- Exercise: Increased pressure occurring when a horse exercises at high intensity can lead to compression of the stomach, which pushes the acidic contents of the glandular region up into the squamous region (where there is no added protection). The longer the horse trains for, the increased time the squamous region is exposed to the acid, and the greater the potential for ulcers to occur.
- Medication: Ulcers can also occur in the glandular region if the defence mechanism fails to work effectively. Long-term use of non-steroidal anti-inflammatory drugs (NSAIDs), such phenylbutazone (bute), can result in a breakdown of these defence mechanisms, resulting in the formation of ulcers.
Studies have also suggested that a lack of water and periods of fasting can further contribute towards the onset of gastric ulcers, so these should also be considered in the horse’s management.
How would I know if my horse has ulcers?
The only way to make a definitive diagnosis is via an endoscope examination (gastroscopy). The symptoms that would lead you to request an examination include:
Many of these symptoms could be indicative of other problems but if they are all occurring together, ulcers could be the culprit. It should be noted that clinical signs will not always be apparent, so it is important to always provide plenty of forage and contact your vet if you are concerned.
The only way to make a definitive diagnosis is via an endoscope examination (gastroscopy). The symptoms that would lead you to request an examination include:
- Poor appetite
- Weight loss
- Loose droppings
- Mild signs of colic
- Behavioural changes
- Resistance under saddle
- Excessive recumbency
- Dull coat
- Poor performance
Many of these symptoms could be indicative of other problems but if they are all occurring together, ulcers could be the culprit. It should be noted that clinical signs will not always be apparent, so it is important to always provide plenty of forage and contact your vet if you are concerned.
Treatment
Following gastroscope diagnosis, there are a number of medication treatments for gastric ulcers which can be recommended by your vet. A common example is omeprazole, a proton pump inhibitor which suppresses the production of stomach acid. Alongside medical treatment, management and diet are also instrumental for recovery and prevention of recurrence.
Following gastroscope diagnosis, there are a number of medication treatments for gastric ulcers which can be recommended by your vet. A common example is omeprazole, a proton pump inhibitor which suppresses the production of stomach acid. Alongside medical treatment, management and diet are also instrumental for recovery and prevention of recurrence.
Supplements
A growing variety of supplements are available with some now also being included in feeds as well. These may help support a treatment and management regime and aid in the prevention or recurrence of ulcers. Key ingredients include:
- Beta-glucans: Soluble fibre which can act as a coating for the stomach and intestinal lining, as well as improving the digestion of starch and sugar within the foregut
- Antacids: Support the buffering of gastric acid, helping to neutralise stomach pH
- Pre- and pro- biotics: Support the population of beneficial bacteria within the hindgut, helping to promote the digestion of fibre
Many Baileys products contain our own Digest Plus Prebiotic, which provides a feed source for the beneficial gut bacteria and helps to maintain the population balance, promoting a healthy gut.
A growing variety of supplements are available with some now also being included in feeds as well. These may help support a treatment and management regime and aid in the prevention or recurrence of ulcers. Key ingredients include:
- Beta-glucans: Soluble fibre which can act as a coating for the stomach and intestinal lining, as well as improving the digestion of starch and sugar within the foregut
- Antacids: Support the buffering of gastric acid, helping to neutralise stomach pH
- Pre- and pro- biotics: Support the population of beneficial bacteria within the hindgut, helping to promote the digestion of fibre
Many Baileys products contain our own Digest Plus Prebiotic, which provides a feed source for the beneficial gut bacteria and helps to maintain the population balance, promoting a healthy gut.
Feeding Recommendations
Forage/Fibre
Concentrates
Lower Calorie Requirements
Moderate Calorie Requirements
Higher Calorie Requirements
Forage/Fibre
- Feeding management should include the provision of ad lib forage, ensuring continuous chewing and saliva production to buffer the stomach acid. Fibre also acts as a physical barrier in the protection of the stomach and retains water.
- Being turned out as much as possible will benefit from a fibre consumption point of view as well as reducing mental stress.
- Stabled horses who are poor forage eaters, even when given ad lib hay or haylage, should be offered alternatives, such as Alfalfa Blend, Alfalfa Plus Oil, Fibre-Beet or Speedi-Beet, in separate buckets from the hard feed, to encourage natural foraging behaviour and increase fibre intake.
Concentrates
- Concentrate feed should be kept as low in starch as possible to help keep acidity levels in the digestive tract under control, and meals should be kept small and more frequent. The horse should not be exercised on an empty stomach, so it is wise to ensure that some forage has been consumed. A small feed containing alfalfa (known to have natural acid-buffering properties) could also be given before exercise to form a “raft” over the stomach contents and help protect against acid splash.
Lower Calorie Requirements
- A balancer will provide your horse with their full complement of vitamins, minerals and quality protein with minimal starch and sugar levels. Lo-Cal balancer is ideal for horses at rest or in light levels of work, while Performance Balancer is formulated for horses working up to the highest levels.
Moderate Calorie Requirements
- Keep Calm has a starch content of just 7% and is a fully balanced soaked feed which contains Speedi-Beet alongside essential nutrients. It is ideal for maintaining condition for horses in up to moderate work and is a complete feed, so should be fed at full recommended quantities to meet nutrient requirements.
- Alternatively, a balancer can be fed to provide essential nutrients, then additional sources of calories added to meet requirements. These can include highly digestible fibre sources like, Speedi-Beet (12 MJ/kg), Fibre-Beet (11 MJ/kg), Alfalfa Blend (9 MJ/kg) or Alfalfa Plus Oil (12.5 MJ/kg) which will need to be fed in reasonable volumes to make a significant calorie contribution. Outshine high oil supplement (24 MJ/kg) is a useful addition when further slow release calories are required in a small volume
Higher Calorie Requirements
- Ease & Excel (13 MJ/kg) is a fully balanced feed which, when fed at recommended levels, will promote condition and support performance for horses working up to the highest levels. Its recipe is also concentrated so that it can be fed in smaller volumes than our other performance mixes and cubes, which helps when feeding fussy or stressy horses with limited appetites.