Vet wants horse scoped but I’m on the fence because he wants every horse scoped.
I have a basic knowledge of cause, prevention and treatment. What I do not know are the outward signs that a horse may have a stomach ulcer.
In the past with a horse that showed no outward signs of ulcers but the breed was prone to them, I treated the animal with an antacid and modified their feed to prevent additional stomach acid. This modification included adding alfalfa to the diet, removing sweet feeds and hay varieties that are high in sugars (looking at you orchard grass). If they didn’t improve then I would scope.
I know it’s a pain to scope, but my advice would be to do it. My horse was not girthy, was not unfriendly at all, he just seemed not quite himself. He stopped a couple times for no reason at home, when he hadn’t done that in a good long while. At first I thought he was just being spooky and fresh since the temp dropped 20 degrees.
Well it turns out he had HORRIBLE pyloric ulcers in addition to squamous. And so I recommend scoping, and then if they have them, scoping AGAIN to make sure they’re gone. We treated with GG and sucralfate in addition to giving him time off in a pasture and more alfalfa hay. Yeah that didn’t touch the pyloric ulcers. Three scopes later and a lot of different meds, we finally got rid of them.
Scoping is not that expensive in the grand scheme of things, especially if you’re planning to treat with Gastroguard…If something comes up and your horse is insured, they generally will cover treatment. but they won’t do it without the scope first.
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The outward signs are many, and can vary from horse to horse, however most horses will repeat their specific symptoms if the ulcers come back.
Common signs: leaving grain, not finishing, eating slowly, acting distracted, taking a bite and walking away. May continue to eat hay enthusiastically, or not. May drink more than normal, or dunk hay in water bucket.
May show irritability when grooming, particularly near belly. May be girthy, ear pinning and snapping when saddled or blanketed. May be anxious when tied, pawing, restless when grooming.
Under saddle: unusually spooky, fretting, or worried despite no changes in workload or riding area. May be extra sensitive to leg aids, bolting forward and less responsive to whoa aids. “Sees dead people” in corners, when he used to be laid back and relaxed. Shows less ability to concentrate or focus, less willing to work.
May start cribbing, or crib more than normal. Chews wood, buckets. Twists head, grinding teeth, irritable toward stable neighbors or turnout buddies.
Horses may display one or a dozen of these common symptoms. Some horses are very stoic and may only pin an ear at saddling, or may be just a little anxious under saddle that’s easy to blame on weather, young age, etc. Some horses stop eating and drop weight fast, others never miss an oat.
Know your horse and think carefully when his behavior changes. If your quiet, willing partner starts breathing fire, perhaps his tummy hurts. If he goes from inhaling his dinner to picking at it over 20min, he’s trying to tell you something. If he is hard to get weight on, ribby despite plenty of food, maybe he’s not able to digest it properly due to ulcers.
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My experience with ulcers is that they can have them with no obvious symptoms. It is important to treat them because it can eventually cause colic. I think you should spell you may think your health is in perfect health and it may still have ulcers.
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We just found them in my new horse, and he was never off his feed. We had done a good bit of work to get his body feeling good since he’s a large horse and in his teens - chiro, Adequan, some joint injections (where we saw signs of mild soreness and had our vet check - not just injecting at random!). Despite him feeling really good in his body, we were still getting some fussiness under saddle, a little back soreness, and some resistance/attitude that didn’t make sense because he’s one who generally wants to please. It reminded my trainer of a previous horse she worked with who turned out to have ulcers, and I scoped him on her hunch that maybe there was something going on. She was absolutely correct, and we started treatment a couple of weeks ago. Because I had him scoped, insurance is covering the treatment up to the stated amount in the policy (there is a cap so be sure you familiarize yourself with your coverage!). I’m so glad we did the scope so that we can get him feeling 100%!! We will scope again at the end of each month to check progress and make sure we knock it out. Compared to the treatment cost, the cost of scoping is minimal!!!
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Just finished ulcer treatment (GastroGard) with my mare. I suspected ulcers and the chiropractor said she 100% had ulcers - she was reactive to all of the ulcer points. I opted to not scope because I was anxious to start treatment, it cost about the same if not more than a week or 2 of treatment, and she would have to stay overnight at the clinic, which was just inconvenient for me. I could tell a difference within about a week. We decided to do an additional week of treatment (35 days of full doses) just in case because we didn’t scope and then 2 weeks of half doses to taper her off.
The only way to 100% diagnose ulcers is a scope…sorry, a chiropractor cannot diagnose by ulcer points alone! Once you’ve scoped and diagnosed where the ulcers are, and how severe they are, then you and your vet can formulate a treatment plan. It. May mean just Gastroguard/ulcergard, or you may have to medicate in combination with something like sulfracate…and maybe, like in my horses case, with misoprostal…then a number of other meds for nearly 2 years! He had severe pyloric ulcers as well as glandular and non glandular ulcers and nearly died (but eventually we got him under control). It was awful and expensive, but if we didn’t keep scoping we would not have known what we were dealing with!
Without a scope, at best you may just throw unnecessary dollars for a very expensive treatment that isn’t needed, at worse it could be the wrong medications! Just get the scope, it really is worth it in the long run!
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Many horses are more sensitive/reactive when they have ulcers (as many have described above), but some also have the opposite response and get balky and behind the leg.
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My mare was drinking an excessive amount of water, not finishing her grain, and was tense under saddle - we would start out fine but as the ride progressed she would become more and more tense and unraveled. Since finishing our GastroGard treatment she’s got a voracious appetite again, not drinking an excessive amount of water, and has been far more relaxed under saddle. She did not have some of the more traditional symptoms such as girthness, dull coat, weight loss, or any sort of attitude. I could just tell she was uncomfortable and while I know the only way to 100% diagnosis is by scoping I felt like in my situation it was best to treat and monitor for improvement.
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I had to quote this… it made me :lol:
@Pocketpony my gelding started attacking his pasture mate so bad that I thought he was going to seriously hurt him. Within 1 week of starting treatment with Nexium he was back to himself… he was also grouchy about being touched on his sides and forget running your hand across his belly without getting kicked and whipped in the face with his tail. Other than that his physical appearance wouldn’t give you a clue. His weight was good, his coat looked healthy and he ate, well… like a horse 
Maybe check out the Esomeprazole thread Simkie started…
https://www.chronofhorse.com/forum/f…-equine-ulcers
Couldn’t agree more - to get my horse scoped was around $250, and now we know exactly what we are dealing with and how to treat it.
I’ve decided to go ahead and scope for ease of mind if nothing else. Internal medicine doctor makes a trip to our area every couple of months but until he comes I’ll work on prevention.
The part I don’t like is fasting a horse… can’t just the act of fasting cause ulcers?
Dr. Ramey DVM wrote an article on ulcers several years ago. Probably available if you google it. It’s long, and I don’t know how to put it on here for you. I found it very helpful. Generic omeprazole costs $200 for a bottle that lasts well through the regular treatment of a month. Scoping here costs $1200 to $1800. If you horse is showing signs of ulcers, most people just go ahead and treat for it with the generic omeprazole, and see if it works (if the symptoms improve). If the symptoms don’t improve, you may have to scope, dig deeper as to the exact source of the gut pain. Very important if you find you are dealing with ulcers is to find the source of the stress that caused them, and eliminate that, if you can. Pain can cause stress, training and riding issues, lifestyle, competition can cause stress. Stress causes ulcers. Stress also contributes to acquiring the cribbing addiction, searching for an endorphin release, the horse searching for something to make them feel better.
Gut pain can come from many different sources, not just ulcers. The symptoms are the same. Many ulcers are non symptomatic, it may not be the ulcer that is causing the pain. I have two mares who both showed classic ulcer symptoms, though both lead very relaxed and undemanding lifestyles. One of them is a cribber. Using the generic omeprazole was helpful to one of them, but not the other. Turned out it was a sensitivity to protein in their diet. High protein levels in alfalfa and commercial bagged feed. The advice to feed alfalfa for the apparent ulcer situation proved to be counter productive. Problems solved by feed change to grass hay and low protein feed. Both TB horses. Good luck with yours.
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Thank you for your very informative reply. My horse has zero indication of gut pain but is the “breed” that can get ulcers being a WB/Anglo Arab. He lives outside with buddies and is fed 6 meals a day of hay and hay cubes soaked with minerals. Chiropractor and massage therapist don’t see any ulcer issues but have recommended adding aloe vera juice & tums just in case.
My horse was shipped from TX to NC, and was very irritable and nervous. He didn’t like being touched or groomed. He broke out of cross ties. The well known local dressage trainer i worked with suggested he had ulcers. I immediately had him scoped because the price of scoping was less than many of the treatments. It cost me $320 for a traveling vet endoscopist. It costs about $500 to trailer to our state vet school and have a horse scoped. I can’t imagine why Nancy M’s vets cost this much. We expected bloody ulcers because of his behavior but actually, only very mild ulcers were found on retreat of the endoscope but missed on initial entry. i treated him because he is insured.
In my experience, endoscopy tells you what you are dealing with. Generic, compounded omeprazole is not the same as what is on the market.
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