The horse’s gastrointestinal system is a beautiful one when allowed to function as intended—in an environment where horses are almost constantly eating. Because their stomach is expecting that food, it is constantly secreting acid. Instead of access to a free-choice buffet, most horses today are fed a couple of times a day, leading to a buildup of acid that can lead to gastric ulcers. Helping horse owners understand gastric issues is key to developing a plan that supports a healthy gastrointestinal system.
This article is brought to you by ADM Animal Nutrition.
“Much of it boils down to the fact that many horse owners are really unaware that gastric ulcers could even be a big issue,” said equine nutritionist Katie Young, PhD. “There are so many situations where gastric ulcers may not be the first thing that pops into a horse owner’s head until they realize that ulcers can cause symptoms like a poor attitude, poor hair coat or crankiness when the girth is tightened.”
Equine nutritionist Clair Thunes, PhD, agreed that when ulcers are questioned as the cause of “problems,” the diagnostic step of endoscopy is often skipped in favor of going directly to treatment. Little regard tends to be given to what triggered the flare-up.
But unless the likely cause is identified, the chances for recurring issues are higher.
Treating ulcers isn’t cheap, with one round of medication costing close to $1,000. Thunes recently had a client treat a horse for ulcers for the second time this year. The client’s expenses were at nearly $2,000, yet the horse was never scoped, so there was no definitive diagnosis. The horse did scope clean after treatment, but the owner was uncertain the horse had ulcers in the first place. Additionally, the underlying issue hasn’t yet been identified, so if it was ulcers, chances are they could return.
“The preventative part is really important,” Thunes said. “If a horse is being treated, you’ve bought yourself a month, maybe two, to try and figure out what things have to change to reduce the risk of a recurrence.”
Sometimes the cause will be obvious. For example, if someone buys a horse, ships it across the country and finds the horse didn’t handle the travel well, Thunes said the gastric issues are likely caused by the stress of travel and the new environment and hopefully will respond to treatment.
However, if a horse has lived in the same barn and experienced the same routine for extended periods of time and has gastric issues, it is time for the veterinarian to have a conversation with the owner and to dig a little to try and find the cause.
In mid-August, Equine Veterinary & Dental Services, Pty. Ltd. (EVDS) in Australia posted on Facebook: “For the second time in a fortnight this week, our gastroscopy service at EVDS has proved that not every horse with symptoms of gastric ulcers should simply be treated without evidence through scoping.”
Young distinctly remembers the post because she hears many cases where the decision is made to skip the scope and instantly treat for ulcers. Turns out the EVDS patient had a gastric impaction, which they dissolved with 4.75 liters of diet coke given over three tubings and four hours.
“If they had just gone ahead and treated for gastric ulcers, they would not have addressed the real issue,” Young said.
Last summer, Thunes also had a client with a horse exhibiting classic ulcer symptoms. Instead of starting in with medication, she explained that $300 to scope the horse and confirm the issue was prudent for budgetary and treatment reasons. Turns out the horse had delayed gastric emptying. Even though ulcers were the most obvious issue believed to be causing the problem, confirming the diagnosis meant the horse got a better treatment and saved the client money.
“Educating the client on why they are spending money for the scope and explaining the importance of knowing what you’re dealing with leads to better, often more cost-effective outcomes,” Thunes said. “When I’ve had that conversation, most clients understand why they need it.”
The Unexpected Ulcer Case
Clients who recognize the risk for gastric issues are taught to expect them in horses that are nervous or anxious. Communicating to customers that even the most easy-going, laid-back horses can experience ulcers is important for keeping horses comfortable.
As an example, Young cites her riding student’s Haflinger pony. Although Haflingers are not known as a nervous breed, he was diagnosed with gastric ulcers after several mild colic episodes.
This easy keeper’s diet is primarily hay with a ration balancer. Pasture is not a good option, as the pony is extremely prone to obesity. While limiting his intake, she uses a hay net with the smallest openings available so his meal lasts longer to limit the amount of time with no feedstuffs in his gut. He also receives a supplement that buffers stomach acid.
Another alternative is recommending that clients use a tool such as the IFEED Naturally system, according to Thunes. The electronic feeder is programmed to drop predetermined amounts of pelleted or textured feed at specific times.
“Then the client is not dependent on having to hire a barn manager or someone go and put out additional feed or hay,” Thunes said. “It can feed the horse a lot more often while controlling the quantity fed.”
Anything that keeps horses eating longer is a plus.
Thinking about the nutrients within each meal is another approach to supporting horses with gastric issues. Thunes said that starch can ferment in the stomach and the volatile fatty acid bioproducts of that process are acidic.
“That’s why high-starch diets tend to lead to ulcers,” Thunes said. “Moving to a fat- and fiber-based diet, especially for horses that need more calories, helps buffer acid.”
Alfalfa is high in calcium and protein, both of which buffer the stomach. Thunes recommends limiting alfalfa to 25-30% of the overall diet to control protein intake and maintain a good calcium- to-phosphorus ratio in the ration. Alfalfa is also higher in calories than most grass hays, so intake might need to be controlled in easy keepers.
Finding a supplement for buffering acid is also helpful. Some buffers, such as those with calcium and magnesium, are designed to raise the pH of the stomach so it is less acidic. With a less-acidic environment, the gut wall won’t corrode.
Another approach is using a coating agent containing aluminum, such as Maalox, to coat the lining of the stomach and protect against corrosion. Other supplements such as Seabuckthorn berry pulp can help, she said.
Acidity is especially problematic when working horses on an empty stomach.
“It’s important to educate clients about not exercising horses with an empty stomach, which results in acid splashing around,” Thunes said. “Having some amount of fiber in the stomach before horses are worked is good idea, as it creates a barrier. It can be as simple as offering a half-scoop alfalfa pellets, a flake of hay or a handful of buffering supplement while grooming.”
Young added that veterinarians should also consider talking to clients about ulcers in a horse that is a “hard keeper” or one that has unexplained weight loss without other symptoms, because it might have ulcers.
“That’s when you may want to check with a nutritionist,” Young said. “If you evaluate a horse’s feeding program and the diet is providing more than enough calories to support body weight and performance, the teeth have been checked, fecal count reveals no significant parasite load, but the horse is still losing weight, the poor condition may be due to ulcers.”
Getting beyond nutrition to look at management practices to reduce stress in a horse’s life is also important in avoiding gastric issues. Vets might suggest keeping horses on a consistent turnout and exercise schedule and using omeprazole before and during a horse show when they think it is appropriate for a specific horse, according to Young.
Minimizing stress at a horse show isn’t easy. Encouraging clients to provide “normality” away from home can help, said Young. For example, feeding the horse at the same time and stabling near other horses it is familiar with might help reduce off-property stressors.
The Perfect Storm
The horse’s gastrointestinal system relies on a delicate balance that works well in nature, but it can be dramatically impacted by domestic management practices. Because the horse’s stomach continuously produces hydrochloric acid, it relies on food as a buffer.
“Veterinarians know that when a horse is grazing, there is grass and forage in the stomach pretty much all the time, which helps buffer the acid,” Young said. “Today horses don’t usually have that luxury. During extended periods of fasting between meals, the pH of the stomach becomes highly acidic, and that increases the risk of gastric ulcers.” That needs to be explained to owners.
Looking beyond the diet and daily management practices can also give clues to whether a horse is suffering from gastric ulcers. Thunes emphasized the importance of veterinarians asking whether the horse’s work has changed, whether the horse has exhibited any lameness or maybe is even suffering from saddle fit issues.
Looking to the horse’s environment is critical, and veterinarians can assist in this process. Does a horse feel threatened by its neighbor? Are horses competing for hay, water or space?
“I’ve have had to move horses because they keep picking at each other all day long,” Thunes said. “I’ve worked with owners who don’t necessarily see it because they think it is normal, and they don’t realize it’s a source of stress. Finding what makes that horse feel comfortable is important.”
A Word From Sponsor ADM Animal Nutrition
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