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Friday, 20 March 2020

Equine Gastric Ulcers: One Year On

A little over a year ago, Louie almost overnight changed behaviourally. I knew something was wrong, but I didn't know what. A quick phone call to our vet, and I was booked in for a gastric scope. It was hard to believe that he would present with ulcers as he had no other common symptoms, but I went to omit them from any potential issues. I'm so glad I did, as a brief overnight stay and scoping the following morning revealed grade 2 & 3 ulcers. If you didn't already know that, I've got a blog post from last February sharing our story of diagnosing gastric ulcers.

So, here we are one year later and I've decided to revisit our story to share that the big dark cloud that seems to hang over equine gastric ulcers really needn't exist.

My first piece of advice to every horse owner now would be that if your horse has any signs relating to the typical symptoms associated with ulcers, just book a scoping in with your regular vets.

Signs and symptoms of gastric ulcers in horses

This list is not exhaustive, and you definitely do not need to present on all to potentially be positive. Equally, it does not mean that your horse has gastric ulcers if they present on these. I would urge anyone with suspicion to have a scope to rule it out.
  • Muscle, weight or condition loss
  • Dull coat
  • Discomfort in the flank areas
  • Intermittent colic symptoms
  • Poorer or loss of appetite
  • Lack of energy
  • Unusual or lame movement in hind limbs
  • Reluctance to lateral bend, extension or collection
  • Tail swishing
  • Kicking stomach with hind legs
  • Change in attitude
  • Aggressive behaviour
For Louie, the symptoms I saw last February were aggressive behaviour & discomfort in the flank area (mildly). Looking back, his coat didn't look as good as it usually did. I had zero signs under saddle - everything was in the stable prior to being ridden, not after.

Understanding, treating & preventing ulcers

Firstly, Louie's ulcers based on location and time of year when they seemed to cause him discomfort would indicate that they are caused from having less food in the stomach. This doesn't mean he has been starved or left for periods without food, in fact something much simpler that I'd never considered... 

It's February. The grass is minimum and most mornings are spent with a light frost on the ground, or at least they were last year. Louie is out in the field 7am until about 3/4pm. All that time, taking little nibbles on short grass with low nutritional content, not because of poor grazing but just the time of year (in case my yard owner reads this! 😜)

This means that his tummy is less full for most of the day, so as he wanders around and plays about in the field, the upper part of his stomach is being splashed with the acid forming in place of stomach content. Cue ulcerations.

For Louie, our vet opted for the injections, mostly due to how sensitive he is with his mouth. We injected once per week for four weeks, reviewed the stomach to find the front stomach ulcers gone, but the back stomach ones were still slightly visible. We decided to repeat for another four weeks to ensure that we did fully treat all of them. After the second four week period, a clear scoping showed that all the efforts had worked.

I'd been feeding a gastric specific supplement alongside, but this was to promote a healthy gut against typical ulcer symptoms and not a treatment for ulcers. I continued to feed that supplement for a couple of months after, but haven't added it back to Louie's diet since.

At no point did Louie show any symptoms of his ulcers under saddle, so his workload carried on - he wasn't taken out of work at all. And, with such evidence pointing to his ulcers being caused due to the level of contents of his stomach, there was no need to make any adjustments to his routine, workload, competition plans or anything other than putting as much food on his stomach as possible when he would typically feel an emptier one.

So that takes us up to May 2019, but what's happened since then?

I'm confident that Louie's stomach has been in tip-top condition this winter, and I've not had a single day really where I've thought that he's a bit uncomfortable. When Louie was first suspected of having ulcers, there was instantly a dark cloud that seemed to hang over the word 'gastric ulcers'. A few people almost seemed to believe that Louie was doomed and done for... And to be fair, I'd only ever heard negative stories of horses with them.

But I soon realised how easy it was to diagnose (or omit as a cause), and how easy it was to treat to cure. A year later, I'm now also very comfortable to say that they are also fairly straightforward to prevent returning or getting worse. OK, so I was quite fortunate - Louie's weren't really caused by stress.

So here's what I've done to help limit the chances of them returning.

Neutralising acid in the stomach

I've not bought a single "fancy" ulcer-orientated product. Instead, I've continued to avoid high starch-based feeds, avoid any kind of molassed feed or treats, aims for high fibre, and seek non-conditioning feeds (Louie's a good doer!).

Louie's base feed is Allen & Page's Fast Fibre - between 1/2 a cup and a full cup (dry) depending on the time of the winter season. He's on just 1/2 right now due to his spring diet! Then, mixed with Alfa A Oil...and here's where you can get smart with ulcers. 

Yes, it is a conditioning feed, BUT it is also slightly alkaline, so can help reduce any acid that is already in the stomach. Therefore, he has a few big handfuls when he comes in from the field between December and March (until the spring grass). Why? Basically, not only to neutralise some of the acid, but to put content onto his stomach when it's going to be typically low due to less grass in the field. It's that simple. 

He then also has anywhere between 1/2 and a full stubbs scoop of Alfa A Oil in his morning and evening feeds, with the Fast Fibre, along with a cup of Top Spec's Joint Balancer in each. Actually, over the last few weeks, I removed the balancer... Firstly, I ran out (bad mother!), but secondly, it's quite conditioning too, so it's helping his diet. I need to now decide whether to get the lite balancer and add joint supplement in, or just to stay as I was.

Hay is known to be better than haylage, but I've chosen to keep Louie on the haylage throughout the last year. Our yard has great quality haylage and only offers low-cal hay, so during the winter months, I don't want to feed a low-cal feed.

Why is hay better? Simply for the ph levels of haylage being more acidic.

Another tip is to bed your horse on shavings (or similar), but Louie can be quite dirty in his stable, so I've stuck with straw. I've picked up some tips on how to stop him from eating any lovely new fresh bedding along the way - good spray with Jeyes fluid and putting the new bedding under the already used bedding. Particularly if you deep litter on straw, don't just pile the new straw on top, but scrape back to the bulk of the bed, put your new straw in and then pull the top of the bed back down.

Why shouldn't you bed your horse on straw when they are suffering or prone to gastric ulcers? This is due to the usual reasons but also due to starch volumes being high in straw. You need to avoid starch as much as possible.

Prevention is better than cure

I believe this 100%.

I've now gone a full winter after being confident Louie is suffering from ulcers. I've bent over backwards to make sure that he has a comfortable tummy. I'm sure those around me think I'm bonkers and to some degree neurotic, but it's all worth it if Louie isn't in so much pain that he doesn't even want me in the stable...

In summary these are the steps I've taken to minimise the risk of those pesky ulcers coming back:
  • Ad lib haylage & grass - never allowing him a period of time without any grazing or forage
  • Stubbs scoop of Alfa A Oil when he comes in from the field
  • Preventing him eating his bed by putting dirty/reusable straw on the top of any fresh bedding
  • Feeding a high fibre and low starch diet - no mixes, cereals or molassed feeds
I'm going to repeat myself...if your horse's behaviour changes reasonably quickly and sits in line with the list above, I would suggest that you have him or her scoped. If nothing else, to eliminate gastric ulcers. We all know how sore an ulcer can be on our own bodies, imagine that in your horse's stomach... 

The big black cloud over the diagnosis of ulcers doesn't exist anymore! Honestly. A simple scoping, treatment and a commitment from you to stick to the routine needed no matter how inconvenient, and you'll be able to stay on top of things. 

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