Kallie not quite right - video, advice please re. ulcers?

[kit279]

My black ex-racehorse has been slightly off these past few days - he has started to crib which he has never done before, he is slightly girthy (not new but he is worse now) and he objects to the leg which again is a new thing. Kallie is an extremely nice-natured horse and has never been naughty or bucked with me before so I know there's something not right and my top differential right now is ulcers. He is otherwise completely sound, not lame, just not quite right.

I've got a little slow motion video of him here, including when he objects to the leg:-

http://www.youtube.com/watch?v=CAOYIauuE4c

With the benefit of hindsight, Kal has probably always had ulcer-type symptoms. He came out of racing in March and was been very difficult to get weight on, getting distressed if brushed around the tummy. However, the cribbing and the bucking is new and I want to get on top of it ASAP.

He is fed ad lib haylage (I know some people say haylage gives them ulcers but he will not eat hay and he has been on haylage for the last year prior to the onset of this new cribbing etc) and he was until recently being fed Baileys Conditioning Cubes, with some supplement. He looks very well in himself, he is a good weight and nice and shiny, he is passing nice looking droppings, nothing splatty. The only thing I have changed since he came home to me from Phoebe's yard is that he doesn't have his Guinness every day!! Perhaps that's where I've gone wrong!

As of yesterday, I've changed him over to unmolassed sugar beet, Alfa-A Oil and limestone flour (calcium carbonate, ought to neutralise his stomach acid in the short term). The plan is to get him back on his Guinness (!) and add in a bit of brewer's yeast and linseed. A quick chat with the 'family vet' and he said not to bother scoping but to start him on omeprazole (the stuff in Gastrogard) so that's ordered but might take a wee while to arrive. I've ordered some Coligone as a short term bridging measure.

People with experience of ulcers - am I doing all the right things? Any advice? I'm sure Kal will let me know when he feels better but I just want to try and cover everything here.

 

[SpottedCat]

Personally I think your vet has given you the wrong advice re scoping.

Apologies in advance if this is teaching you to suck eggs!
There are two types of ulcer, splash and glandular. Splash ulcers affect the lining of the stomach above the normal acid levels, and are generally caused by a combination of the type of grass we feed and the normal movements of the stomach caused by the contraction of the abdominal muscles during exercise. Essentially, these days most of the grass we graze on is rye grass which was grown to feed cows. It is mostly leaf and very little stalk. The horse's stomach is designed in such a way that it 'layers' fibre during digestion, with the leaf at the bottom as a sort of grassy soup and the long stalky fibres at the top, and a graduation in between. The long fibres at the top buffer the walls of the stomach from the acid splash during exercise. However as rye grass is mostly leaf and no stalk, this buffer layer does not exist and so splash ulcers occur.

The second type of ulcer is glandular, and these are found in the lower part of the stomach which is normally covered in acid - the wall is usually protected by mucus and the ulcers only develop when there is some kind of problem either with the amount or type of mucus being produced. In humans (who as you know only produce stomach acid as a direct response to an eating stimulus), stomach ulcers are often caused by bacterial infection, and it has been hypothesised that some equine glandular stomach ulcers are caused by the same bacteria (no-one has ever been able to isolate the bacteria and culture it, but treatment with the same antibiotic used on humans does the trick in curing these cases, hence the hypothesis).

Therefore you need to scope to see what you are dealing with. As you know, something like 97% of racehorses have stomach ulcers, so that he may have them is no real surprise, what you need to know is what type they are, and how they respond to treatment, which you can't know if you just use gastrogard. Because some glandular ones don't respond to GG alone, and need antibiotics as well, you could treat with GG, see no clinical improvement and then start heading off down all kinds of blind alleys to find out what is wrong....when the answer was always ulcers, it was the treatment which was wrong.

Feed/supplement-wise, I now feed Pure Feed Company Pure Easy/working and use settlex from feedmark - but there is no supplement on the market which will cure ulcers (despite any claims they may make!), they simply reduce the symptoms - but the underlying problem is still there, and can lead to other issues such as colic if left untreated. I've been through most of the supplements and feeds on the market getting to know what is in them, and why they will/won't work very well - FB me and I'll give you my phone number if you want to chat about it sometime?

ETA: My horse is on haylage, it really isn't a huge problem when it comes to managing ulcer-horses.

 

[hkryan]

One of my schooling liveries had gastric ulcers and the nutritionist at Falcon Feeds advised a low starch diet; oat & barley free, omega rice to keep condition on, U-gard to help treat ulcers and a probiotic that he made up himself. Said to add hi-fi lite to bulk up feed if necessary. Always good to ring a qualified nutritionist. Any feed manufacturer should give you advice over phone.

 

[TarrSteps]

Personally I think your vet has given you the wrong advice re scoping.

Therefore you need to scope to see what you are dealing with. As you know, something like 97% of racehorses have stomach ulcers, so that he may have them is no real surprise, what you need to know is what type they are, and how they respond to treatment, which you can't know if you just use gastrogard. Because some glandular ones don't respond to GG alone, and need antibiotics as well, you could treat with GG, see no clinical improvement and then start heading off down all kinds of blind alleys to find out what is wrong....when the answer was always ulcers, it was the treatment which was wrong.

SC is obviously the voice of authority and experience, so while bowing to her superior knowledge, I will say it's not at all uncommon for vets to advise simply going with a course of Gastroguard off the top, rather than scoping first, especially if there is good reason to suspect the horse has had ulcers and/or scoping is not an easy option. It's not so much ultimate proof as a likely guess, so if it doesn't work it doesn't necessarily rule ulcers out, but if it does, it's pretty conclusive. It's really up to you and your vet to decide the best course (Gastroguard is not particularly cheap but then neither is scoping!) for your situation. I presume insurance status also comes into it in some cases.

On whether or not he seems a likely candidate, I'd say definitely from your description. Many trainers seem to have accepted the fact that the vast majority of horses in training have ulcers and have added Gastroguard to their regular routines. (Which may raise an ethical question but leaving that aside . . .)

 

[SpottedCat]

Scoping's pretty cheap really I think, in the grand scheme of horses and vet bills anyway. Last time I had it done was £159 ish for the scope and £30 ish for the sedative. Gastrogard here is over £200 for a seven day course for a horse of Kallie's size - it's much cheaper in the USA (and possibly all North America - I have no experience of Canada) because Merial sell the same stuff rebranded as UlcerGard for 'ongoing maintenance' of horses which have been treated with gastrogard. It's also not always POM over there - you seem to be able to buy it online - though whether that differs from state to state I have no idea.

Also, there is a good deal of evidence to suggest that it the ulcers are low grade (1/2) but still providing clinical signs, then you can give a quarter tube of GG and get the same effect as a full tube, which at £30 odd a syringe is worth knowing!

TS is right - it's a decision to take with your vet, but for me personally it's a no-brainer because if it isn't ulcers then that is a hell of a lot of money you have flushed down the drain, bearing in mind most vets say 2-4 weeks of one syringe of GG/day to see if it helps, and if it is, scoping vs the cost of GG is negligible and at least you can see if there is an improvement or not.

PS: I may have an unwelcome amount of experience, but I certainly wouldn't bill myself as any kind of authority....

 

[Chloe_GHE]

Before you go down the expensive route I would try this - http://www.protexin.com/products/acid-ease/9

this is a product made by my sponsor Protexin, I have had all my tbs on it 'just incase' as they were all poor and had been in racing when i got them, they all bloomed and chilled out and I think this helped. I've now weaned mine onto the gut balancer product and they now have that.

My mother's horse has been v grumpy, girthy, fat bellied, bucky, and a general mizzog for quite a while but the past few week she has also put him on acid ease and he's a totally different horse, chilled, happy, and much nicer. It might be coincidence but it might also save you some very ££££ vets bills. If you wanted to talk about it further in more depth give Jonathan a call at protexin and he will go over all your questions he's really helpful, might be the answer?...

good luck, hope kallie is better soon I love him he's a poppet

 

[ArcticFox]

Scoping's pretty cheap really I think, in the grand scheme of horses and vet bills anyway. Last time I had it done was £159 ish for the scope and £30 ish for the sedative. Gastrogard here is over £200 for a seven day course for a horse of Kallie's size

Also, there is a good deal of evidence to suggest that it the ulcers are low grade (1/2) but still providing clinical signs, then you can give a quarter tube of GG and get the same effect as a full tube, which at £30 odd a syringe is worth knowing!

TS is right - it's a decision to take with your vet, but for me personally it's a no-brainer because if it isn't ulcers then that is a hell of a lot of money you have flushed down the drain, bearing in mind most vets say 2-4 weeks of one syringe of GG/day to see if it helps, and if it is, scoping vs the cost of GG is negligible and at least you can see if there is an improvement or not.

PS: I may have an unwelcome amount of experience, but I certainly wouldn't bill myself as any kind of authority....

I agree with this, however as someone who used to work for this company and having seen the responses to the product, you should usually see a good response within 2 weeks, but as you say, it is better to try for at least a month.

I would still have my horse scoped though as its only the cost of one weeks treatment with the product.

The quarter of a syringe is not a treatment though, it is a preventative dose to reduce the amount of acid to reduce the chance of ulcers coming back. If an ulcer is present it will heal at this dose, but it take much longer so is not really the best idea and you would end paying the same in the long run. It is much better to treat at full dose, then when the ulcer is gone, either try the horse without the treatment, or use at the lower dose rate.

The problem with ulcers is that the degree of clinical signs the horses show does not reflect on how bad the ulcer is, some horses have grade 4 and show no symptoms at all. So scoping is recommended before and after treatment.

Also, this product is the only product that will treat the ulcers. Horses produce 2litres of acid per hour, the other products on the market are only antacid type products, so will only neutralise the acid that is in the horses stomach at that time but an hour later the acidity will be back. The Omeprazole will inhibit the proton pump that causes acid secretion so reducing the amount of acid produced - this has no effect on digestion.

hope this helps