SmartPak and Dr. Lydia Gray Answer Questions on Equine Ulcers

Join us in welcoming Dr. Lydia Gray, DVM, and SmartPak to our “Ask the Pros” blog.  Dr. Gray answers your questions on equine health and nutrition….

Q. Dear Dr. Gray,

My 6 year old Paint mare has recently been diagnosed with an ulcer. They recommended 14 days of GastroGuard. I see that most of the studies have been done on 30 days of treatment. Do you usually treat for 14 days or longer in your practice? Also is there a supplement you recommend for horses with ulcers? Thank you.

— Regards, LB

A. You are correct — studies on the effectiveness of omeprazole, the active ingredient in GastroGard, have used approximately one month as the treatment interval. However, these horses’ stomachs were “scoped” on a weekly basis during treatment and it was found that some horses’ ulcers had healed by day 14. It sounds as if, based on this research and your mare’s original diagnosis, your veterinarian feels 14 days will be an adequate treatment time for her. More importantly, the research also showed that once treatment stopped, the ulcers came right back. That means you have to do more than just treat the existing ulcers, you have to create an environment in the stomach that makes it hard for ulcers to form.

There are three ways to do this:

1. Give the preventive dose of omeprazole, either by using less GastroGard or by switching to the company’s non-prescription product, UlcerGard.
2. Select a supplement designed to support a healthy stomach.
3. Change the way you feed and manage your horse.

There are pros and cons to each of these, so talk to your veterinarian about which strategy(s) might work best for you.

Omeprazole works by stopping acid production by the cells of the stomach. Supplements work in a variety of ways depending on the active ingredients.

One of my favorite ingredients to promote long-term stomach health is licorice, one of the most widely used herbs in both Western and Chinese medicine. Other natural ingredients with research supporting their use include pectin and lecithin, the amino acid L-glutamine, polar lipids and beta glucan, and extracts from the plant Aralia elata. Some ulcer supplements simply contain ingredients to buffer stomach acid, like aluminum or magnesium hydroxide.

 Finally, here are some diet and management tips to reduce the risk of ulcers in your horse:

• Provide pasture turnout — this is the best method of preventing ulcers!
• Provide constant access to hay—keeping hay in front of your horse is next best
• Provide hay frequently—if freechoice hay is not an option, feeding it four to six times a day is an acceptable substitute
• Use alfalfa hay—the protein and calcium in hay help reduce stomach acid
• Limit fasting periods—keeping food in the stomach at all times protects it from acid which causes ulcers.
• Limit grain feeding—sweet feeds especially lead to heavy acid production.
• Provide “down time”—heavy exercise is a risk factor for ulcers so include less intense work days and even rest days in your training and showing plan
• Reduce stress—allow social interaction with other horses and keep the feed, turnout, and exercise schedule as regular as possible
• Limit NSAIDS—anti-inflammatories like phenylbutazone have been linked to ulcers, so give the smallest amount necessary for the shortest time possible.