ulcers | Horse Racing Free Tips

Promising OTC Ulcer Treatment Identified

Omeprazole is the drug of choice for ulcer treatment in horses. It is particularly helpful in the treatment of ulcers in the squamous regions of the stomach.

Short-term omeprazole use typically doesn't cause any long-lasting issues, particularly if horses are weaned from it carefully to avoid a rebound acid effect. Using omeprazole for longer than four weeks can cause complications though, particularly the complete elimination of stomach acid, which is crucial for protein digestion.

Lack of protein can cause muscle loss, a depressed immune system, hormonal imbalances, and poor digestion in horses. Omeprazole also inhibits the absorption of magnesium and calcium, which can potentially damage bone health.

Veterinarians are beginning to look at lecithin, used in conjunction with apple pectin, as a potential new treatment for ulcers. It has recently been used on racehorses and on horses that have had their forage restricted. This combination can also be used after a traditional course of omeprazole has been administered for additional healing effects.

Lecithin occurs naturally and is commonly derived from soybeans and other plants. When lecithin is combined with pectin, a water-soluble fiber, a hydrophobic barrier is created, which can protect the stomach's mucosal membranes against stomach acid.

Lecithin granules and apple pectin can be bought at most health food stores and are helpful for horses that are on NSAIDs or firocoxib, as well as for horses that are travelling, on stall rest or are stressed for other reasons.

Study: Omeprazole And Bute Not Necessarily A Good Combination

Omeprazole is often prescribed to horses that are receiving phenylbutazone in an effort to reduce the chances of a horse developing equine gastric ulcer syndrome (EGUS), though it isn't clear how safe or effective this treatment is.

Drs. Megan Ricord, Frank Andrews, Francisco Yñiguez, Michael Keowen, Frank Garza Jr., Linda Paul, Ann Chapman and Heidi Banse created a study to evaluate the effect of omeprazole on adult horses with EGUS caused by phenylbutazone.

The research team used 22 horses that had equine glandular gastric disease (EGGD) and equine squamous gastric disease (ESGD), each horse had a score of a 2 or higher when tested for the disease. The horses were divided into three groups: one group (eight horses) received 4.4 mg/kg of oral phenylbutazone every 12 hours; the second group (eight horses) received the same phenylbutazone dose plus 4 mg/kg of oral omeprazole every 24 hours. The control group (six horses) received neither phenylbutazone or omeprazole.

The horses were treated for 14 days and had their stomachs scoped at days seven and 14. Blood tests were done at the beginning and end of the study period. Five of the horses did not complete the study because of intestinal issues (two in the phenylbutazone-only group and three in the phenylbutazone/omeprazole group).

The scientists found that the EGGD score increased in the study group that received the phenylbutazone only when compared to the horses that also received omeprazole. They found no difference in the ESGD scores between the two groups. Strikingly, six of the eight horses in the phenylbutazone/omeprazole group developed intestinal complications—two of which were fatal. Only two of the horses in the phenylbutazone-only group had intestinal complications, and neither of them died.

The team concluded that using omeprazole reduced the severity of EGGD, but that caution should be exercized when using the two concurrently, especially when this takes place at the same time as a management change.

Read the study here.

Thoroughbred Aftercare Summit: What We Know About Ulcers And OTTBs

Gastric ulcers are startlingly common among performance horses of all kinds, and horses coming off the racetrack are no exception. In a recent virtual education session as part of the Retired Racehorse Project's Thoroughbred Aftercare Summit, three experts gathered to share their thoughts on dealing with this issue in off-track Thoroughbreds.

Drs. Frank Andrews, director of Equine Health Studies at the Louisiana State University's School of Veterinary Medicine, Dr. Rana Bozorgmanesh, associate veterinarian at Hagyard Equine Medical Institute, and Dr. Bill Vandergrift of International Equine Consulting agreed ulcers can be a challenging problem, but there are a few management changes that can help.

A few takeaways:

There is more than one type of “gastric ulcer” in horses – the stomach may have either squamous or glandular ulcers, depending upon their location. Ulcers are really a type of wound caused by acidic secretions into the tender tissue lining the stomach. Glandular ulcers are those that appear in the first third of the stomach, which in horses is really like an extension of the esophagus; it was previously thought the glandular part of the stomach was resistant to ulcers, but research now indicates that may not be the case. Squamous ulcers occur in the latter two-thirds of the stomach and are considered the most common type. Ulcers may also occur in the esophagus as a result of acid reflux.Ulcers can also occur in the start of the small intestine. While an endoscopy may pick up on glandular or squamous ulcers in the stomach, it likely won't be able to show ulcers that far along in the gastrointestinal tract.

A case of ulcers doesn't look the same in all horses. Those with ulcers in the intestine may experience intermittent diarrhea, which loses protein and dehydrates the horse, inducing further stress. Of course, stress is one of the potential causes of ulcers.Vandergrift told the story of one owner who noticed a horse was losing weight, so began offering the horse more and more grain until it was taking in nearly 25 pounds per day and still losing weight – likely because of ulcers which were worsened by the addition of more high starch concentrate.
Infrequent, large meals of high starch grain are believed to increase stomach acid production, which can cause ulcers or make a case of ulcers more painful. All three experts agreed that small, frequent meals of concentrate along with lots of forage are better for an ulcer-prone horse. Vandergrift also recommends hay pellets instead of long-stemmed forage in cases of horses experiencing diarrhea.
Long-term use of NSAIDs can be a cause of ulcers, but not all risk factors are drug-related. The withdrawal of food prior to competition, the stress of travel and athletic work, and dehydration can all result in increased acid production. Often, owners or managers may struggle to recognize when a horse is stressed by the living environment, daily routine, training load, etc. Assessing behavior can be just as valuable a tool to combat ulcers as diet changes.
Management changes like an adjustment in feeding schedule are only effective after a horse has completed treatment, including pharmacological intervention, for ulcers. Omeprazole is the obvious candidate for resolving ulcers and is considered safe to use over a period of weeks, depending upon the horse's needs. Bozorgmanesh said she also adds misoprostal in cases of horses battling diarrhea, though that isn't safe to use in pregnant mares.
If you're going to use supplements or other feed additives to address ulcers, the same logic applies – those are really best for prevention, not cure of existing ulcers.“Some of these nutraceuticals can reduce the incidence or severity, but if you've actually got a horse that is presenting with ulcers, has had a history of ulcers, then I think you've got to get people involved and work with some pharmacological agents and actually treat those ulcers. Yes, there are nutraceuticals that can help but if you're trying to treat ulcers, then treat them.
Owners should seek out research data and published research that backs up the claims of a supplement designed to reduce ulcer risk. Products that don't have this information readily available should be avoided. Also make sure you know what's in them. Many people are fond of using aloe vera as a feed additive to reduce acid; Andrews cautioned that many of those products may be diluted – if you're going to try this, make sure the variety you purchase is at least full strength.

Ulcers can be the primary cause of symptoms in a horse, or they may be secondary to some other issue.“I look at the stomach as the window to the rest of the GI tract,” said Andrews. “And if there's stress farther down the GI tract, that may manifest itself in ulcers.

Vandergrift said he's skeptical of the use of probiotics as a solution for ulcers.“I think too much emphasis is placed on probiotics or the actual bacteria themselves,” he said. “Many times I think everyone out there forgets that the vast majority of the innate bacterial, whether it's in the large intestine or the small intestine, are anaerobic. Being anaerobic, you can't make a probiotic out of them. They can't live outside the horse. So, the question remains – how do you establish a healthy microbiome?”
Vandergrift prefers the use of prebiotics, which are a type of saccharide that stimulate the growth of good bacteria, making it easier for them to thrive.

The post Thoroughbred Aftercare Summit: What We Know About Ulcers And OTTBs appeared first on Horse Racing News | Paulick Report.

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Concrete Results Found Between Transportation And Equine Ulcers

It has long been known that there is a relationship between transportation and gastric stress in horses. Researchers in Italy and Australia now have some definitive answers—and some surprising results–between transportation, gastric pH and gastric ulcers in horses, reports The Horse.

Drs. Babara Padalino, Sharanne Raidal and Georgina Davis carried out a two-part study to find out if transportation would lead to an ulceration of the squamous cell mucosa in a horse's stomach and if it would be more severe in horses that were fasted beforehand.

In the first part of the study, the team fasted 12 confined horses overnight and placed nasogastric tubes to aspirate gastric fluid every two hours. They also collected blood before and after the horses were confined and completed a gastroscopy directly after confinement and again 60 hours after confinement.

The second part of the study evaluated the effects of transportation on 26 horses that were shipped 546 miles. The scientists collected blood and performed the same gastroscopy routine as with the horses that were confined.

The scientists found:

Average gastric fluid pH was much higher during transport than during confinement
Squamous ulcers were more prevalent in horses that were transported (and some of those horses had severe ulceration)
Severity of squamous cell ulceration was inversely related to the amount of feed retained in the stomach during transport; the less feed in the stomach, the more severe ulcers the horses had
The researchers were surprised that the pH of the stomach became higher during transport and that after 12 hours of fasting that some horses still had feed in their stomach