Veterinary research has shown that 60-90% of adult horses have ulcers. If you’re amazed by these high numbers you’re not alone, but since definitively diagnosing ulcers takes a sedative, a long endoscope and a vet, many horses may be suffering from ulcers without their owners or handlers knowing about the problem. While horses will exhibit some symptoms of discomfort that can lead to a diagnosis of Equine Gastric Ulcer Syndrome (EGUS), symptoms are often mild and may not be noticed right away. Your vet may say that there’s no need for an endoscope if your horse has some of these signs:

 

 

 

The bad news is that even an ulcer-free horse can get ulcers in one to two days, if the conditions are “right”. The good news is that curing ulcers is entirely possible, and good preventive strategies can keep them from recurring. But how do horses get ulcers in the first place?

 

While human ulcers have been found to be largely caused by a bacterium called Helicobacter pylori, this bacterium hasn’t been found in horses. Ulcers in horses tend to be directly related to the way the digestion functions and the way feeding and lifestyle impacts the digestion. While ulcers can develop in the intestines, mouth or esophagus, they most commonly develop in the stomach. Ulcers are more common in the top (squamous) portion of the horse’s stomach, but they also occur in the bottom (glandular) portion of the stomach.

 

Foals may develop ulcers because of other medical problems such as gastric blockages that result in stomach acids failing to move correctly through the body. In situations such as these, where feeding hasn’t created the problem (as in young foals), it’s important to get the veterinarian on board to find the cause of the blockage. Foals with ulcers may grind their teeth in pain, avoid or interrupt their nursing, and drool.

 

The fact that so many horses, particularly show and race horses, get ulcers has much to do with the lives they lead. The horse’s digestive system was made for an animal that grazes all day long on fresh grass. The equine stomach, rather than operating in a meal-time mode, runs constantly, emitting hydrochloric acid. The horse’s saliva contains sodium bicarbonate, which, along with the calcium phosphate present in alfalfa grass or hay, helps neutralize some of the stomach acid while the feed absorbs and is broken down by the rest. In nature, the system is perfect. But when horses aren’t grazing, especially if they’re being fed meals at particular times without free access to hay or grass in between, the stomach continues to churn out acid and the liver contributes bile. Grains and pelleted feeds also increase the production of the hormone gastrin, which also stimulates acid production. The lining of the stomach, receiving more than its natural share of acid, rapidly develops wounds, or ulcers.

 

Research has shown that horses deprived of food for 12 hours at a time can develop ulcers in less than a week, and often in just a day or two. High performance horses such as race and show horses are at an added disadvantage because intense training results in increased blood flow to the stomach and decreased gastric motility. In these cases, the stomach is working overtime, but the gastric juices produced aren’t moving out of the system as quickly, causing increasing irritation to the stomach lining. Add to that the effects of stress from trailering and travel, and you have the perfect situation for creating ulcers in even the healthiest animals.

 

 

Some veterinarians suggest that ulcers can be cured by moving the horse to pasture and allowing free grazing, but most are careful to suggest drug therapy. Ulcers, once they have grown deep enough, can kill a horse, so consult your vet before deciding on the best treatment for your animal.

 

The hands-down preferred treatment for ulcers in horses is a drug called Omeprazole (brand name Gastrogard: in humans, this drug is sold under the name of Prilosec). Omeprazole reduces the production of hydrochloric acid in the “acid pump” cells of the stomach and helps ulcers heal. It isn’t an antacid, which works on stomach acid that’s already been released: it stops the release of acid in the first place. Omeprazole is expensive, with the standard 28 day treatment costing around $1,500 for a warmblood-sized animal, but it works so well that nobody’s complaining.

 

Other drugs, called histamine (H₂) receptor antagonists, reduce acid production as well. Known as Cimetidine (Tagamet, for human use) and Ranatidine (Zantac, for humans), these drugs are effective as treatments and in prevention. Cimetidine and Ranatidine cost about half that of Gastrogard, but must be administered every six to eight hours, and research has shown that horses are often underdosed on these drugs. However, for the owner who’s serious about ridding his or her horse of ulcers, it only takes a commitment to faithfully follow the dosing instructions.

 

Antacids are often used to reduce stomach acid, but because they don’t prevent its production, they aren’t as effective as H₂ receptor antagonists or Omeprazole.

 

Sucralfate, instead of preventing acid production, meets the hydrochloric acid in the stomach and creates a paste that binds to the ulcers themselves. The paste acts as a barrier, protecting the ulcer from additional damage from stomach acids. It can be used with antacids or Cimetidine, but must be administered at least half hour before the other drugs: it protects ulcers for up to six hours. Sucralfate is often used in foals.

 

 

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