Although stomach ulcers in horses may seem like a new trend, they’ve probably been around for much longer than we realise. “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.”. This inspired them to point their practice down a more functional and integrative path, focusing on whole-horse wellness and preventive medicine by, in part, implementing complementary therapies into their treatment protocols. In horses, the acid burns holes into the lining of the stomach, small or large bowel. When you break it down, you have that nonglandular stratified squamous mucosa. “If I have a horse that I know has ulcer issues, I usually treat them aggressively with an Omeprazole-type product for 30 to 60 days, depending on the severity of the case. Some of the ‘big name’ … Copyright © 2020 Platinum Performance. See also: What Effect Does Magnesium Have on Horse Growth? Foals are also subject to ulcers and it is well known they can cause morbitity and mortality (Becht and Beyers). Equine Gastric Ulcer Syndrome (EGUS) frequently referred to as gastric ulcers in horses is a common problem among domesticated horses. The first of which was a biomarker of the permeability of the intestinal mucosa, or ‘leaky gut,’ ” explains Dr. Whitfield. Wheat, barley and rye have gluten in them which most humans and animals cannot break down to digest in the small intestine. “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. Dr. Whitfield’s research demonstrates that advanced nutrition can play a role in supporting a normal, healthy gut environment in horses undergoing NSAID therapy. At birth, the equine gastric epithelium is thin and lowly keratinized (Murray and Mahaffey). Developments in technology have meant that vets can now endoscope horses and see the ulcers in the stomach, adding to our understanding of the condition. You can treat horse ulcers with medication available online with no prescription required. Grain meals should also be limited and fed only once to twice daily at the most. “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. 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. Ulcers are, unfortunately, a common part of horse ownership. A lot of times they’ll eat a part of their feed and then lie down, mirroring the symptoms of a mild colic. Then, for the final seven days of the study, the normal ration was resumed. “I think the best way to look at inflammation as it relates to the gastrointestinal tract is to see it from a preventive standpoint. “Probably the biggest diagnostic challenge is the inability to accurately diagnose and determine the severity of ulceration without a gastroscopic examination,” says Dr. Belgrave. There’s always a trail of bread crumbs. “Two forms of ESGD exist,” explains Dr. Belgrave further. “When we have a horse with EGUS, we add Platinum Gastric Support to the Platinum GI that we likely already had the horse on,” says Dr. Davis of his protocol. There is also a population of horses that appear normal, but whom benefit from diagnosis and treatment of ulceration. It seems like an obvious thing, but taking care of diet, nutrition, proper conditioning and stress management, it’s all so important in everything we do as veterinarians, and we’ll continue to see greater results as we forge this new way of thinking and practicing.”. If a horse has gastric ulcers, they must be medically treated. “These ulcers are often recalcitrant to treatments available in today’s market and have the greatest negative impact on performance in equine athletes.”, As equine veterinary medicine shifts its focus, resources, research and attention on a more predictive, preventive and personalized approach, horses at risk and suffering from diagnosed gastric ulcers will benefit. (See figure 1.) We know that; however, we need to further consider the implications of what we’re doing and how it’s affecting all aspects of the horse.”, For most equine veterinarians, their passion for tackling challenging conditions, such as EGUS, stems from a genuine love of the horse and appreciation for the athletes whose goals depend on a healthy and well-performing equine partner. We give UlcerGard when our horses compete to prevent ulcers from forming. But they can be painful on your purse too. “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. “The mucosal lining of the stomach consists of two regions, the squamous mucosa, which is the nonfunctional lining of the stomach, as well as the glandular mucosa, which secretes gastric acids (hydrochloric acid), pepsinogen, histamine and bicarbonate. Many misconceptions exist about ulcers and horses. By Dr. Richard Shakalis ( co-founder and researcher for SBS Equine Products ) Most people do not know for sure if their horses have gastric ulcers. “Continued research to better understand EGUS, EGGD in particular, and how to prevent and treat it more effectively is needed,” says Dr. Belgrave, hopefully. “You’ve got to take care of the entire GI tract,” says Dr. Davis emphatically. Horses that compete frequently may be getting UlcerGard for several weeks in a row. Whenever you observe these clinical signs you should suspect stomach ulcers, and immediately consult or bring your horse to a horse veterinarian. 4. Prevalence of ulcers in horses Studies indicate the prevalence of gastric ulcers is high: 93% of Race horses 63% of Performance horses 37% of Leisure horses (that’s a 1 in 3 chance of developing gastric ulcers!) We know now that the gut is vital to the horse’s overall health, and we’re learning how serious the implications can be when NSAIDs are over-prescribed or used for elongated periods of time coupled with stress, competition, travel and so many other contributing factors.”, One of the foremost experts on the effects of NSAIDs on the equine gut environment is Canaan Whitfield, DVM, PhD, DACVS, DACVSMR, of Texas A&M University. 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. It may just need a singular component, and that’s where the horse’s history is so important to know, as well as the horse’s diet, workload and how it’s being managed.”. The progress happening in the understanding, treatment and — perhaps, more importantly — the prevention of equine gastric ulcers is incredible. No matter how big, no matter what the success story is. Foals are particularly susceptible because they secrete gastric acid as early as 2 days of age and the acidity of the gastric fluid is high. All of those things can trigger inflammation in the GI tract,” he explains. “The take-home message in terms of gastric ulcers is that they are most likely more prevalent than we think, especially in sport horses,” says Dr. Whitfield, confidently. “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. In this post, we’ll be discussing some of the things you need to know to take proper care of your horse if it develops stomach ulcers. “In the future, we will ideally head toward personalized medicine and a whole-horse approach in order to prevent and then, as needed, treat disease,” says Dr. Whitfield. This is the way horses are meant to eat – they are forage grazers. It’s surprising just how many parallels run between equine athletes and their human counterparts. 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. They can diagnose it definitively using an endoscope (a device that can see the inside of the horse stomach) … The less time your horse is without forage the better, and a horse with or recovering from ulcers should always have a source of forage available. The horse’s ulcers are a combination of this hydrochloric acid, as well as volatile fatty acids and bile acids. This scenario can cause an overgrowth of bacteria not only in the stomach but throughout the GI tract,” explains Dr. Davis. “The medications we use to treat EGUS try to alter and control the environment in the stomach so that the equine body can heal those ulcerations on its own.” These therapeutics can include both proton pump inhibitors and H2‐receptor antagonists. Many horse owners automatically think of omeprazole when gastric ulcers occur, and they aren’t wrong to do so. “Continued research to better understand EGUS, EGGD in particular, and how to prevent and treat it more effectively is needed,” says Dr. Belgrave, hopefully. Sign in or register below to view your Horse profile. “We’ll pass through the pyloric sphincter in the pyloric antrum into the small intestine. Often we see signs of an ulcer in our horses and we start the GastroGard without question. “If any of these factors points to the potential of low-grade ulcers, that’s where I want to catch them,” says Dr. Davis. 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. It is important to take care of not only the stomach but the entire GI tract. That’s not my part. “I could only give a rough figure and it would generally depend on how long the horse was on medication for. 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. These two parts are separated by a barrier called the margo plicatus. Some of the most widely held beliefs are that they only affect the horse’s stomach (gastric ulcers), and they only plague high performance horses, horses that travel frequently, or horses that are nervous or stressed. We’ll use one of these formulas to provide our patients with that backbone of wellness and performance support, as well as GI-specific nutrients for daily support. Length of treatment is important. Most of the horse feed products on the market today have wheat, barley, rye and/or oats in them. This barrier can be damaged by things such as antibiotics and NSAIDs. Next, their focus landed on the impact of NSAIDs on the gut microbiota since this class of medications is well-known in human medicine to cause dysbiosis or alter the delicate balance of bacteria within the gut. Learn more about feeding your performance horse. Once the clinical presentation is improving, I’ll then maintain them on Platinum Gastric Support longterm. “We know that NSAIDs cause gastric ulceration, so we looked at that as well and while Phenylbutazone did induce gastric ulcers, there were significantly fewer ulcers in the control group and the group treated with both Phenylbutazone and a nutritional therapeutic.” Lastly, Dr. Whitfield and his team looked at the dysbiois (microbial imbalance) caused by NSAIDs. 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. While a high-quality, forage- based diet is essential, the type of hay fed can also factor into a horse’s risk of developing ulcers. This discomfort impacts their performance, and we see these horses often kicking out when their rider puts a leg over them or becoming uncharacteristically temperamental when they’re in the ring. “Everything’s related. “All portions of the stomach need to be investigated,” asserts Dr. Davis. At first glance, equine ulcers seem well understood with an established diagnostic process and tried treatment modalities. If a horse is suspected of having gastric ulcers, gastroscopy will confirm the presence, severity and location of the ulceration. With that, we celebrate the wins. Veterinarians and physicians have gleaned vast knowledge from translational research that has shown positive effects in human athletes and is thus adopted for equine competitors and vice versa. “In our practice, we consider Platinum Balance — or Platinum GI, which combines the foundational wellness of Platinum Performance Equine with the prebiotics, probiotics and glutamine of Platinum Balance — as a great place to start in order to support the microbiome. A healthy glandular mucosa in a pylorus has a sheen to it thanks to that protective waxy barrier. 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. That’s predominantly where we’ll see various grades of gastric ulcers. I did read somewhere (though I can't remember where - possibly Kentucky research) that dry feed was better than damp, and we have found it has helped our mare. 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. “Often what we’ll see, especially in these performance horses, is after they eat, they’ll get painful. The inflammation subsequently gives rise to erosion, and eventual ulceration of the mucosa,” explains Dr. Belgrave. However, if the ulcer symptoms are from the glandular portion of the stomach, GastroGard will be ineffective. EGUS can be broken down into two distinct classifications, Equine Squamous Gastric Disease (ESGD) and Equine Glandular Gastric Disease (EGGD), with these classifications being based on the affected region of the stomach. “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. In some cases, it’s those performance-related changes in a horse that often indicate a potential ulcer issue and cause veterinarians to investigate further. “Inflammation of the mucosal lining of the stomach is the first stage in the development of gastric ulceration. How do we know exactly what condition is going on? 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. However, I do agree that horses with ulcers are just like people and need to become “gluten” free from grains. A diagram of the inside … While Platinum GI provides a crucial balance between foundational wellness and GI-specific pre- and probiotics, there is a second step in the playbook for horses diagnosed with any level of EGUS. 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. They first studied both classes of NSAIDs — COX-2 selective NSAIDs such as Equioxx® and nonselective NSAIDs such as Phenylbutazone (Bute) and Banamine® — and showed that both classes caused gastric ulcers and intestinal inflammation, albeit at different levels of severity. 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. Gastric ulcers can affect any horse at any age. Gastric ulcers are obviously painful for the horse which is the number one consideration. There are two sections of the horse’s stomach; the glandular portion, which secretes acid and enzymes to break down food, and the stratified squamous portion. “A lot of these case presentations can mimic the symptoms of mild to severe colic,” says Clayton Smith, DVM of Brazos Valley Equine Hospital in Navasota, Texas. Platinum Performance® Equine: Wellness & Performance, Platinum Performance® CJ: Wellness & Performance + Complete Joint, Platinum Performance® GI: Wellness & Performance + Digestive Care, Barn Pricing Guide for Foundation Formulas, Platinum Colic Coverage™ Qualifying Formulas, Online Form - Request Platinum Magazine - Magento. Prevalence of ulcers in horses Studies indicate the prevalence of gastric ulcers is high: 93% of Race horses 63% of Performance horses 37% of Leisure horses (that’s a 1 in 3 chance of developing gastric ulcers!) 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. Ulcers develop from the build-up of hydrochloric acid within the stomach. They may only suspect the presence of ulcers because of small noticeable changes in their horse’s condition. “If you have the pH wrong, you’re going to get improper fermentation,” says Dr. Davis. We have also learned that whether we’re talking about equine or human competitors, when we ignore the critical role of the gut in overall health and performance, we’re often faced with negative results. “We don’t actually have to do gastroscopy as often in a lot of our barns today because of the daily management changes we recommend. Dr. Davis is quick to point out that gastroscopy is a necessity when ulcers are suspected to avoid medically treating suspected ulcers when something else entirely could be going on. “Horses with a history of EGUS should be fed grain and concentrates as sparingly as possible. “I try to incorporate pre- and probiotics often,” says Dr. Smith. 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. “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. We know that an athlete devoid of a proper diet, in an unmanaged state of inflammation, can be more prone to injury and disease and less able to perform to his or her potential. But throughout the 24 hours after administration trail of bread crumbs factors have in common behalf of that horse to! Only in the environment, bacterial overload and inappropriate bacterial Growth bacteria not only treating disease such! Incidence of ESGD, ” or could there be ulcerations revealing themselves through behaviors! 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