buying a horse with ulcers

That’s for them and their riders to sort out, but for me, it’s the love of the athlete that drives me to do what I do.”, Whether it be sports medicine in general, or specifically the challenge of gastric ulcers in equine athletes, the world of veterinary medicine is shifting toward stewarding a new era of root-cause medicine. “Their job is to quiet that acid production such that the acid cannot insult the mucosa that is trying to heal,” continues Dr. Davis. “We’ll pass through the pyloric sphincter in the pyloric antrum into the small intestine. “For every horse that gets prescribed medication for gastric ulcers without ever taking a look inside their stomach, I always ask myself ‘How do we know if that is a correct treatment? Omeprazole appears to be the most effective. In the pyloric region the acidity level only goes up, ranging from a pH of 1.5 to 4. I don't dampen the feed and she gets a scoop of alfa before she is ridden as well. It is particularly prevalent in racehorses and elite competition horses, although they can be suffered by horses of all ages and types, especially if they have limited access to forage. “I could only give a rough figure and it would generally depend on how long the horse was on medication for. We give UlcerGard when our horses compete to prevent ulcers from forming. “Knowing that we approach our cases from a whole-horse perspective, we’re making sure the hay source is of a good quality, we’re potentially looking at a ration balancer, we’ve prescribed either Platinum Wellness or Platinum GI as a building block and we’re potentially adding Platinum Gastric Support for cases undergoing treatment for EGUS,” outlines Dr. Davis. “Feeding grain or concentrates has consistently shown to increase the incidence of ESGD,” explains Dr. Belgrave. “With time, the accuracy of tests to diagnose ulceration will improve; however, their ability to determine the degree of ulceration will always be limited. This will also happen in a follow up gastroscopy 20 to 35 days following the beginning of treatment.”. “I’m seeing a high number of competitive athletes, so obviously we’re assuming that these horses are encountering stressors such as travel, new environments, intense training, lack of sleep, NSAID use and so on. “We use products like Platinum Gastric Support that are able to offer the horse Saccharomyces c. boulardii and dried Lactobacillus delbrueckii and its vital fermentation products, giving them the support they need in the stomach in particular, as well as with the fermentation component in the hindgut and the cecum specifically.”, A critical component to a whole-horse approach goes well beyond treatment and is seen in its preventive power. When do we stop the medication and what medication would we use?’” Diagnosis is quite literally a guessing game in the absence of gastroscopy. Although Thoroughbred racehorses present with EGUS in significantly higher numbers, there have been no further breeds or ages pinpointed as being at a higher risk. Equine Gastric Ulcer Syndrome, also known as EGUS, is a broad term used in equine veterinary medicine to describe ulcerative and erosive diseases of the stomach. The challenge is unearthing them and piecing them together.”, While the stomach is again the overwhelming focus, it’s important to remember that the small intestine, colon and cecum come into play as well. It was at this point that their goal became to not only reduce the number of gastroscopies but rather to get to the root of the problem that was requiring this diagnostic step in the first place. This is the way horses are meant to eat – they are forage grazers. “You’ve got to take care of the entire GI tract,” says Dr. Davis emphatically. An increased risk has also been demonstrated in non-exercising horses that are stabled and fed grain approximately 1 hour prior to their hay feeding. “Gastroscopy allows for a thorough evaluation of the stomach, grading and localization of the ulcers, as well as assessment of the proximal small intestine (duodenum),” confirms Dr. Belgrave. Abler medications contain the same active ingredients as the ‘big name’ medications but are more affordable because there isn’t a big marketing push behind them. Gastric ulcers can affect any horse at any age. I’m happy to get up every morning, be a part of the team with my clients and see their success in the ring or the arena doing what they and their horses love. When you’re included in that circle, it’s something special, and I don’t take my responsibility to keep them healthy and performing for granted.”, For Dr. Davis, being an athlete himself, he recognizes a familiar drive and love of the game in his equine patients. According to the American Association of Equine Practitioners (AAEP), up to 90 percent of racehorses and 60 percent of performance horses are afflicted with gastric ulcers, with non-performance horses and foals impacted as well. A study looking at feed type on gastric ulcer formation showed an increased risk of gastric ulcers in young growing horses consuming high grain diets as compared to a forage diet. “We documented that Phenylbutazone resulted in an increase in this biomarker of leaky gut, but there was not an increase in either the control group or in horses treated with both Phenylbutazone and a nutritional therapeutic,” outlines Dr. Whitfield. This scenario can cause an overgrowth of bacteria not only in the stomach but throughout the GI tract,” explains Dr. Davis. I don’t win the ribbons. “What makes me so passionate about this area of research is that equine GI disease is a leading cause of morbidity and mortality in horses, and we now realize that this class of medications actually does quite a bit of harm in both people and animals when not used properly and sparingly.” Together with Dr. Lauren Richardson of Tryon Equine Hospital, Dr. Whitfield documented the effects of NSAIDs on the equine gastrointestinal tract and showed that, in fact, NSAIDs do cause intestinal inflammation and gastric ulcers. A steady supply of forage – all the time, all day, and all night – will put the acid to its proper work and protect your horse’s stomach. I could be seeing a bacterial overgrowth, and now it’s clear that I’m dealing with gastric ulcers because of these contributing factors. Why Horses Get Stomach Ulcers and How To Treat Gastric Equine Ulcers Naturally! A primary factor to keep in mind is that the horse’s stomach is a naturally-acidic environment with a pH that can range from an acidic 1.5 to a more neutral 7, depending on each horse’s unique chemistry. However, if the ulcer symptoms are from the glandular portion of the stomach, GastroGard will be ineffective. Ulcers are, unfortunately, a common part of horse ownership. Horses that compete frequently may be getting UlcerGard for several weeks in a row. “EGUS is most often a reflection of what we ask of these horses,” says Chad Davis, DVM of Davis Equine Sports Medicine in The Plains, Virginia. Gastric ulcers, also called equine gastric ulcer syndrome (EGUS), are thought to be present in a large proportion of horses, with an estimated 80-90% of racehorses, 60% of competition horses and 40-50% of leisure horses suffering from this condition. My horse who has suffered with ulcers is fed Alfa oil and saracen shape up. Most ulcers occur here because the horse’s stomach continuously secretes acid, even when empty. As a result, a stall side test will likely never fully replace the benefits of a thorough gastroscopic examination.” Other diagnostic methods that are used stand-alone or in conjunction with a gastroscopy can include veterinarians pulling blood and running a full CBC and chemistry panel as well as serum amyloid A (SAA) to understand potential infections and the inflammatory component, respectively. While not accommodating the level of detail that the gastroscopy can offer, ultrasound can provide valuable imagery, particularly if the veterinarian is looking to confirm or rule out a specific concern. Our recommendations are designed to nourish and manage gastrointestinal health, and in an animal that relies predominantly on fermentation as his primary source of calories, you had best get that fermentation and that bacterial flora right. They may get up and slowly finish their meal, sometimes eating their grain at a slower rate than their hay due to the influx of acid that it causes. This root-cause approach to patient care has veterinarians no longer treating conditions and injuries as stand-alone ailments, but rather, seeing the horse as an interconnected and synergistically-operating collection of systems. While gastroscopy gives the veterinarian a window into the horse’s stomach and gastrointestinal tract, properly diagnosing then grading ulcers is still a challenge, especially given their location. Ulcers can range from mild to severe and require medical attention in order to be properly treated. “I think the best way to look at inflammation as it relates to the gastrointestinal tract is to see it from a preventive standpoint. “Primary ESGD occurs in the absence of other gastrointestinal abnormalities, while the secondary form occurs in relation to existing gastrointestinal abnormalities such as duodenal and pyloric strictures.”, While a clear grading system exists as a diagnostic tool for squamous ulcers, glandular ulcers have no clear-cut grading system. Symptoms of Ulcers in Horses. In horses, the acid burns holes into the lining of the stomach, small or large bowel. “I don’t want to be months down the road looking at grade 4 ulcers thinking that I should have paid more attention to the details sooner. Today’s horses are commonly stalled for a portion of their day, if not all of it, and fed meals instead of having continual access to good quality grazing. Many misconceptions exist about ulcers and horses. 4. As Dr. Whitfield mentioned in his findings, inflammation can be a significant contributing factor to equine gastrointestinal disease, including gastric ulcers and Leaky Gut Syndrome. Dr. Whitfield’s research demonstrates that advanced nutrition can play a role in supporting a normal, healthy gut environment in horses undergoing NSAID therapy. Breaching of the intestinal barrier can lead to systemic inflammation and eventually contribute to many disease processes. Most of the horse feed products on the market today have wheat, barley, rye and/or oats in them. While there is a long list of behavioral and performance indicators that can point toward the presence of ulcers, equine veterinary medicine relies on a strong set of diagnostic tools, led by gastroscopy, to definitively confirm, then grade ulcers. “One of the interesting things about our early research is that we showed that both classes of NSAIDs cause gastric ulcers, and they both cause not only glandular ulcers but can actually cause squamous ulcers as well, which was a surprising finding given the biology of the stomach.”. Veterinary medicine is witnessing significant leaps in areas including the impact of NSAIDS, the critical role of diet, the influence of advanced nutrition and the tie between equine gastric ulcers and the horse’s gut microbiome. How much does it cost to diagnose and treat a horse with gastric ulcers? “Pasture turnout is considered to reduce the risk of EGUS as does free access to fibrous feed or frequent forage feeding,” notes Dr. Belgrave. All Rights Reserved. The volatile fatty acids produced when greater than 1 to 2 kg of grain is fed per meal, can exert damage on the squamous mucosa, thus leading to ulceration. Two drugs of choice, omeprazole and ranitidine. “The key is recognizing the stressors for each individual horse and what exactly is causing this issue. Length of treatment is important. “If any of these factors points to the potential of low-grade ulcers, that’s where I want to catch them,” says Dr. Davis. “If we’re not looking at the horse as a whole, with a nose-to-tail perspective, then it’s easy to forget the impact of altering the macro- and microbiome in an effort to deal with X, Y, Z disease. I know that these horses want to perform, and it’s my job to give them the best chance to perform at their highest level. “There is an increased likelihood of ESGD when straw is the only forage provided, though feeding alfalfa hay has been shown to have a protective effect of the gastric squamous mucosa in adult horses.” Dr. Belgrave is a strong advocate for pasture access, and for those times when horses are stalled, he recommends continual and gradual access to good-quality hay while keeping grains and concentrates to a minimum and only feeding them when a sufficient amount of hay is in the stomach to buffer the gastric acid released upon their consumption. “If you have the pH wrong, you’re going to get improper fermentation,” says Dr. Davis. My part is to make sure that I listen and act on behalf of that horse. Copyright © 2020 Platinum Performance. These drugs reduce/stop gastric acid production and create an environment in the stomach where healing can take place. They’re not performing to their abilities because of that gastric pain.”, Clayton Smith, DVM,Brazos Valley Equine Hospital in Navasota, Texas, Rodney Belgrave, DVM, MS, DACVIM,Mid-Atlantic Equine Medical Center in Ringoes, New Jersey, Chad Davis, DVM,Davis Equine Sports Medicine in The Plains, Virginia, Canaan Whitfield, DVM, PhD, DACVS, DACVSMR,Texas A&M University in College Station, Texas. A healthy glandular mucosa in a pylorus has a sheen to it thanks to that protective waxy barrier. “For us, those preventive steps encompass several things, with diet being of paramount importance.”, Beyond the typical stressors that are commonly attributed to EGUS, diet and the manner in which horses are fed have been identified as critical factors in both the prevention and treatment of ulcers. These two parts are separated by a barrier called the margo plicatus. They may only suspect the presence of ulcers because of small noticeable changes in their horse’s condition. Is a horse simply being irritable or “girthy,” or could there be ulcerations revealing themselves through these behaviors? Foals are also subject to ulcers and it is well known they can cause morbitity and mortality (Becht and Beyers). The most common medication for gastric ulcers is Omeprazole. They can diagnose it definitively using an endoscope (a device that can see the inside of the horse stomach) … “In the case of gastric ulcers when stomach acid becomes too acidic in nature, the question becomes not just how do we treat it, but why is this happening in the first place,” says Dr. Davis of his root-cause approach. Gastric ulcer syndrome, a very common disease in horses (up to 60-90% of horses in some studies) is an erosion of the stomach mucosa. “If it’s getting insulted by things that are ingested, then that immune system is going to have to combat whatever it’s being insulted by. “Inflammation of the mucosal lining of the stomach is the first stage in the development of gastric ulceration. When treating horses with ulcers, it is important to substitute any sweet feeds, barley or oats where possible for lucerne hay or good quality grass. Due to the central role of the equine gastrointestinal system in a horse’s overall health, including their vital immune function, inflammation of the GI tract can have deleterious effects on numerous systems within the body. “We showed this also occurs in horses, although the clinical significance is still unknown,” says Dr. Whitfield of their findings. If ulcers in an individual horse are suspected to be causing these then clinical improvement should occur as the ulcers heal, and so a critical appraisal of the value of treatment at repeat gastroscopy is essential. When you break it down, you have that nonglandular stratified squamous mucosa. Predisposing factors are wide-ranging and vary from environmental influences, travel, stalling practices, NSAID exposure, diet and competition, to name just a few. “Chronic use of NSAIDs can easily lead to gastric ulceration and a disrupted equine gut microbiome, which then trickles down to a host of other secondary concerns. A certain level of managed inflammation, buying a horse with ulcers horses and the margo plicatus meet portion of the stomach that should. All of those things can trigger inflammation in the GI tract, ” says Dr. Davis the. Fed only once to twice daily at the most clinical issues can arise the advantage. 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