Gastric Ulcers- desperate!

[vespa]

We have a very talented gelding who has been scoped again this morning for his ulcers ( the sixth time this has been done)

To go back -he was treated for grade 3 ulcers in November & again in December 2012 - usual meds of Gastro Gaurd Antepsin & Norodine Granules scoped again and they were significantly better - put him on to Protexin ulcer guard & gut balancer, 24hr a day turn out, ad lib hay -fed twice daily on Alpha A oil - calm & condition - Healthy Tummy .

All good back in work - competing & winning . In June he had two leg injurys was given bute & box rest for 6 weeks - at NO time did he look stressed he had ad lib hay ( not haylage -too much sugar) fed twice daily & had ready grass feed twice a day - he was also in a large airy American barn ,quiet & calm with lots of company.

Once he came back into work he started having serious behaviour problems , he was scoped again & found to have grade several 5 Ulcers at the top of his stomach . This time I am out of insurance and the usual meds & vets fees have cost me £1000 +
After a month of him being on them he is still displaying behavioural issues (planting himself/ spinning around) out hacking
But a saint days before in a dressage lesson!
So today scoped again (more money) and the ulcers are still there possibly grade 2 ish . Vet recommends another course of Gastro Guard & turned away for the winter,
My worry is that after the winter will they be back again once he comes back into work & starts competing? My daughter & I love him so much and would do anything to help him but his behaviour worries her and I'm not sure she trusts him anymore as he has scared her and she is not a novice rider- I am truly at my wits end - help please.

 

[YasandCrystal]

OP I can sympathise. Are you sure that his ulcers are not symptomatic of another underlying problem? My WB displayed the sort of behaviour you are talking about but to a much greater degree and he was scoped for ulcers and grade 2 found. He had chronic sacro illiac dysfunction. have you thought of trying a cheaper diagnostic tool like iridology? This picked up a r/h upper hind injury on my WB before Sue Dyson diagnosed him and was cheap at around £45. I think if you believe your management is good then you have to look outside the box and expect the unexpected. Low grade pain can cause all sorts of behaviours and my WB was alright ridden unbelievably until a very long time in. Oftn the ridden side can be the last to go.

 

[AmyMay]

You should still have another two months of insurance left on the claim, if the first treatment was November last yer.

Have you had bloods run??

 

[Slinkyunicorn]

Have PM'd you

 

[philamena]

OP I can sympathise. Are you sure that his ulcers are not symptomatic of another underlying problem? My WB displayed the sort of behaviour you are talking about but to a much greater degree and he was scoped for ulcers and grade 2 found. He had chronic sacro illiac dysfunction. have you thought of trying a cheaper diagnostic tool like iridology? This picked up a r/h upper hind injury on my WB before Sue Dyson diagnosed him and was cheap at around £45. I think if you believe your management is good then you have to look outside the box and expect the unexpected. Low grade pain can cause all sorts of behaviours and my WB was alright ridden unbelievably until a very long time in. Oftn the ridden side can be the last to go.

This ^^^. The ulcers my mare came to me with were very much integral to back and poll pain, which got into a cycle of the one making the other worse. I knew they were both problems but hadn't at that point twigged how interrelated they were. If a horse can't run way from pain (as in the case of stomach pain) it braces its muscles against it, causing hypertonicity and pain in the muscles. And I don't think it's always easy to spot, even though I had around half a dozen different physios, chiros and osteos see her initially, until the last one they really didn't get to the bottom of sorting it. We eventually managed to get both sorted and she was great for a while. Then she hurt herself in a fall, was quite sore, and had a week of bute... I was in hospital at the time but next time I saw her I knew instantly that they were back. Her management is spot on ulcer friendly, but she just can't cope with being in pain. She'd had bute before since being clear of the ulcers and it didn't kick them off, but I can only conclude that the combination of the bute and the stress of being sore set them straight back off again. It wasn't much bute at all, the vet specifically gave as little as possible because of her history, but she was quite sore for a couple of weeks, so I think it was probably more the pain and trauma of the fall than the NSAIDs.


I'd seriously consider having a really really good osteopath look at the horse at the same time as you treat these ulcers. The muscle patterns that the bracing can set up can be very deep, and even the chiro I'd used admitted her work wouldn't have been able to get to it. It needed deep work from an osteopath over several sessions, including around ehr pectorals and girth area, not just her neck and back. Good luck, it's just awful when they come back. :-(

 

[samlf]

Best thing I have found for ulcers is a 15ml scoop of bicarbonate of soda twice daily. Worked wonders when other treatments only improved symptoms slightly, this cleared them completely. Dirt cheap too - try hyperdrug.

The other thing about ulcers is that if a horse keeps getting them it is likely they are due to management. In your case it appears you are managing him as well as possible, so the other thing to consider is long term pain.

My treatment plan would be carry on as you are with the ad lib hay, alfalfa feeds etc. Plus 2x daily doses of bicarb and a thorough investigation for pain.

 

[philamena]

Have PM'd you.

 

[LizScott]

I would agree re getting him checked out for pain elsewhere as this is what is going on with my boy at the moment. Like you, I have ultra ulcer-friendly management, did a course of gastro guard and all seemed fine but they are now back and making him almost unrideable

My vet advised that scoping in itself is enough to cause ulcers so I would consider not scoping again but judge how he looks and feels instead. Also horses are very good at hiding stress, just because he didn't look stressed in his stable, doesn't mean he wasn't suffering. Add to that the bute which will aggravate the ulcers, I'm not surprised that they have come back.

I would do as the vet advises personally and also investigate a possible pain issue. Good luck!

 

[skint1]

This is a really interesting thread for me to read today of all days as we're kind of in the midst of this with our boy.

Our TB gelding's behaviour has been deteriorating in various ways for a while now. He'd had his hocks medicated 2 years ago,had that redone and some heartbar shoes to address some issues in his feet, but he was still not right. Vet suggested a chiro, so she came out, found various things wrong including sacroiliac area, treated and recommended he have a few weeks off ridden work but with lunging and hand walking then get his saddle re-fitted.

Monday vet came, took bloods, slightly low protein but no other cause for concern. He is still very sore across his back, vet is doing ex rays next week but has also given us Succeed for his hindgut. Anyway, one of the things vet said was that very often back pain and ulcers are connected, even where the horse has very "ulcer friendly" lifestyle, something I'd never come across before. I really do not want this horse being scoped though my vet did much to try to allay my concerns should it come to that but I still feel it's something I'd like to avoid so am hoping the Succeed and the ex rays and subsequent treatment will help.

It would seem that some people at my yard think I am wasting money and inventing problems, I am not sure why I would be doing this but there you go. His back is definitely sore, I just want him to go back to being our happy boy again.

 

[Frozen Hoof Boots]

The only thing that fixed my boy was RiteTrac by Kerx. Buy from saracen direct. Amazing results. Get bigger tub and use it for 4 weeks and then reduce over following two weeks to nothing and review. It could be you horse has something SI or something else causing the ulcers which nothing will resolve unless root cause tackled.
However ulcers will be helped by RiteTrac and mine was amazing in 48hours. Lots of Gastrogard won't help hind gut acidosis.

 

[paddy555]

Best thing I have found for ulcers is a 15ml scoop of bicarbonate of soda twice daily. Worked wonders when other treatments only improved symptoms slightly, this cleared them completely. Dirt cheap too - try hyperdrug.

The other thing about ulcers is that if a horse keeps getting them it is likely they are due to management. In your case it appears you are managing him as well as possible, so the other thing to consider is long term pain.

My treatment plan would be carry on as you are with the ad lib hay, alfalfa feeds etc. Plus 2x daily doses of bicarb and a thorough investigation for pain.

this plus in addition feeding copra which really seems to soothe the gut. Also in addition to giving bicarb in feed also offer bicarb dissolved in water, about 2 good x 15ml scoops per gallon of warm water. I do this morning and night.When my horse is bad he knows he has to drink and willing takes up to 4 or 5 doses like this. When he is OK he may come over for a mouthful but that is it. The problem seems to come and go and when it gets bad I just keep offering the bicarb water to blitz it. Takes around 4/5 days.
Also found that leaving him continuous hay overnight however much he wants to eat so there is plenty left in the morning and not letting him get cold in winter but keeping him well rugged. Also feeding magox and limestone flour.

 

[jessieblue]

My horse was treated for ulcers this year too. My vet suggested keeping him on a low dose of gg indefinitely. Do you keep him on a maintenance dose? When you take the ingredient of gg which is omeprazole, which they also give to humans, it can cause an increase in acid production when it is stopped! Like any medication, its never that simple to cure things and often can make matters for sensitive individuals. Usually a month course is given with a 2 week weaning off period. Unfortunately some horses do need to be kept on a small dose daily to keep them at bay. My horse was on them for 7 months and eventually we stopped, due to the livery yard having not been giving him the gg at all last 3 weeks!!! GG wont address hind gut ulcers and my vet who had worked for 8 years at newmarket with racehorses said on autopsy most horses who had gastric ulcers also had some hind gut ulcers, so this may also be a concern. However I was told by another vet that hind gut ulcers also known as colitis causes watery diahrreoh! You could tru a hind gut ulcer supplement such as succeed. My horse also had this for 4 months. I would also suggest looking really closely at the diet. So many feeds are high in starch and sugar without stating it and this causes hind gut acidosis and will aggrevate the ph balance in the stomach and gut. I think if you were to approach as if your horse were laminitic you may find this helps manage ulcers. Soaked hay as low sugar starch as possoble limit grass with a muzzle when it is flushing like now. Box rest stresses horses even if they dont look stressed and bute is a definite no no for a horse known to have an ulcer problem. Ask vet for metacam if pain relief is needed, it is a bit more pricey but is gentler on the stomach, easy to administer and only once a day. If your horse has splash ulcers (ulcers on the top half of the stomach) you could try feeding a handful of alfalfa or lucerne half hour before working, so acids dont splash up and burn the stomach lining. I see you had a course of antibiotics, which is interesting as antibiotics are not often offered for treatment of ulcers. It is generally not thought that horses ulcers are caused by a bacteria h pylori as human ulcers are, but I have heard that some treat with a month long course of doxycycline alongside gg and this has had good results for persistant ulcers. Have not heard of norodine being used but interesting to hear. One other thing, I heard yesterday is that actually haylace tends to be lower sugar than hay if properly produced. There should be analysis available for exact readings. I always thought hay was better than haylage for ulcer prone horses due to acidity, but this may not be the case.

 

[Hedwards]

My gelding took a couple of attempts with GG to sort him out, he is kept out 24/7 on good grazing, regularly sees the osteo and is kept warm (I'm totally against over rugging, but he's rugged far more then any horse I've ever had before). However the one thing I really highly rate is Alltech Lifeforce, I see a noticeable difference in him if he doesn't get it... I stupidly tried something else recently and was in years about how different he was. After 1 week back on the lifeforce... Back to being perfect again. I'm not one to go one about something normally, but it has genuinely made a difference, and means I can enjoy my horse.

 

[Jackie JA Taylor]

Pain/stress issues definitely need to be ruled out, but unfortunately some horses do relapse several times after treatment for gastric ulcers, and may need dramatic changes in diet, management, and even some kind of maintenance product in some cases. I recommend a herbal approach to soothe and heal the entire gut, because sometimes strong antacids (both medication and in-feed) can produce a rebound effect. It is a tough issue to crack and I think a lot of horses suffer in silence to be honest.

 

[amandap]

Pain/stress issues definitely need to be ruled out, but unfortunately some horses do relapse several times after treatment for gastric ulcers, and may need dramatic changes in diet, management, and even some kind of maintenance product in some cases. I recommend a herbal approach to soothe and heal the entire gut, because sometimes strong antacids (both medication and in-feed) can produce a rebound effect. It is a tough issue to crack and I think a lot of horses suffer in silence to be honest.

I so agree with the last sentence.

Out of interest what herbal remedies would you suggest? Slippery elm?

 

[Jackie JA Taylor]

Yes, I developed my own blend in the end which includes slippery elm. Make sure it is pink and fluffy - there is some fake brown material around. Aloe vera is very helpful too, you can buy that in juice form at health food shops, but make sure it is marked as certified by the Aloe Science Council.

 

[squeery]

Wow, really interesting thread. I have an OTT racehorse who has ulcer issues, however, after further investigation there is a possibility of it being right dorsal colitis (rdc) but the downside is the vets do not really know enough about this.
Strangely, the addition (as mentioned) of bicarb of soda in her daily feed has made a 60% progress so far (sorry, mathematical mind going on here). I have now put her on pure aloe vera juice and am waiting an arrival of micronised linseed too.
Not sure if we should have been riding her again so soon but walk is okay and first few strides of trot then back go the ears and the ceasing up bit. However, walk under saddle is fine with her so we have gone back to that for now.
She appears to be much happier rugging up and grooming now, alhtough when pressure is applied to her right side (where leg goes) her ears flick back even untacked and from the ground.

I will not have her scoped and sadly the vet does not inspire confidence in me as I feel they are experimenting (dont hound me for this pls!). Have done masses of research and found american/canadian websites very helpful.

My conclusion so far is - ex racers seem to suffer a lot of digestive disorders that sometimes go undetected (our leg pressure is not theirs - as our lower legs are lower on the body). Not sure all are as serious as the vets make out and a change of management - out 24/7, plenty of forage, more natural diet and lack of stress - seem to ease this. Having said this, there are a lot of riding horses that suffer the same issues and most are put down to napping and behaviour issues. Most of this I believe are dietary and management - just like us.

Dont get me wrong, I do not have an 'issue' with vets as such but have only been in the north of england for 4 years and have not found a vet as switched on as my guy down south. So guess I need to adapt a bit more. I just don't want my little mare to be a guinea pig for them.

From many years of stable management of competiton horses I have realised that the more natural approach is always the best for the horse, despite our human need to see then tucked up snuggly in a stable!

 

[amandap]

I will not have her scoped and sadly the vet does not inspire confidence in me as I feel they are experimenting (dont hound me for this pls!). Have done masses of research and found american/canadian websites very helpful.

I can understand why you made this decision.

I do think stress is a very underestimated cause of digestive upset in many horses. I don't just mean stressful situations but feeding and management regimes as well ie. overall stress on the body.
Add to that cattle grazing, high sugar hays and starchy, sugary feeds and it's almost guaranteed to cause gastric ulcers and hind gut upset.

 

[squeery]

Thks will try that too!