We’ve got a young horse here who was scoped and diagnosed with severe glandular ulcers a few months ago. He was imported, trucked around the country, no turnout, irregular training - basically lived the sale horse life and got horrendous ulcers as a result. He is on round three of misoprostol and sucralfate. Currently unridable as he is very uncomfortable from the ulcers. He gets better with each treatment, but the moment he ends the treatment, he relapses and is unridable within a week. Wondering if anyone else has experience with these type of ulcers. How long did it take to resolve? How many rounds of treatment? What types of treatments? Is there a systemic complement? Seeking hive mind advice/anecdotes.
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That poor horse! Hate hearing about horses in so much agony. Following as my friend is treating her 17 year old gelding for pretty severe ulcers and is using misoprostol, sulcralfate and Gastroguard. It’s a process just t to medicate him and space it out at our small boarding facility.
I’d like to see what the recommendations are for anything longer term support wise.
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I had a horse on sulcralfate for a couple years with no ill effect. I also had him on U-Guard at the same time. Now he is just on U-Guard and Finish Line U-7 Gastric Aid Liquid Horse Supplement. Maybe try a pre/pro biotic too?
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Going through the same thing with my horse. Just finished four weeks of gastrogard. She was doing better but symptoms came back. The BO just today told me not to suddenly stop treatment, but to slowly wean her off the meds. One week 3/4 dose, next week 1/2, then a week 1/4, then 1/4 every other day, then every three days.
I left a message with my vet about this. We’ll see what she says. We’re probably going to have to do another round of gastrogard anyway. I want to add sulcralfate this time.
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How long is treatment?
Is he scoped at the end of the treatment?
Have you tried adding omeprazole to the mix?
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So far a months worth of meds per treatment. He is scoped at the end of each round, and each time it looks clear, but in a week he is back to grunting, not going forward, and another lesion when rescoped. He was on omeprazole first and it didn’t help so the vet said try miso/sucralfate. I guess we could try the omeprazole along with it. It is so sad, he’s such a lovely creature and so sweet, I can’t fathom the pain he’s been in.
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My thought is that there is something in his gut that is causing this or aggravating it, so I’d consider a pro-biotic. He’s on a puff of grain, barley fodder (barley grass grown in a grow-house) and free choice hay and minerals. He’s turned out from 5pm-7am every day and not in work. Did you have to time his sucralfate when he was getting it daily?
weaning him down is a good idea. I could see how stopping these type of meds suddenly could cause problems.
Omeprazole alone is pretty useless against glandular ulcers. Miso, and especially + sucralfate has proven to be much more effective. But the combo of the 3 is sometimes what it takes. Poor guy 
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How old is he? Do you know (or are you able to find out) his lifestyle pre-import? His turnout sounds sufficient, but if what you’re doing is massively different than what he’s used to, maybe he needs something else (turnout with a buddy, 24/7 turnout, a quieter barn during the day, etc)?
Have you been able to do some lifestyle modifications like unlimited hay, lots of turnout, compatible horse friends, and a really solid lameness exam? Chronic ulcers can also be environmental or unaddressed discomfort.
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Other things I’ve read about and will ask my vet:
Slow feed net so she has food all day. We’re not doing that yet because gastrogard needs to be given on an empty stomach.
Alfalfa supposedly is high in calcium and good for preventing ulcers. https://thehorse.com/1121540/alfalfa-for-ulcer-prevention-in-horses/
Unfortunately, alfalfa causes head shaking syndrome so my horse is on Timothy.
Not going to look it up now, but there’s evidence that alfalfa pellets are better than alfalfa hay for treating ulcers.
Good luck! We all need it.
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After several temporarily successful Omeprazole followed by Esomeprazole (compounded) treatments, the addition of Sucralox which is added to feed and is sucralfate +aluminum phosphate, and lecithin,and adding corn oil and beet pulp as well as a no grain very low starch complete feed, ad lib hay mine is coming good.
I just couldn’t manage the sucralfate dosing time wise,so the feed additive was a life saver, though crazy expensive it is still worth it to me.
I give him a half dose of esomeprazole prior to work, an extra little feed, and give lucerne hay after work. The difference in his comfort has been very noticeable.
Incidentally I found moxidectin wormer made him very unwell and I did read something that said it does exacerbate glandular ulcers. I now give probiotics after worming also.
Although there is no evidence I could find that helicobacter plays a part in EGGD, coconut oil is antibacterial , I havent tried it yet but might if I suspected bacterial overgrowth.
My vet thinks he’s predisposed as he’s very hot and stresses easily so will probably need ongoing treatment.
Good luck with the poor fellow!
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He is on turnout 5pm-7am on grass (and he loves it, he’s getting a bit porky, but I’m loathe to prevent him from eating) next to other horses. He is shod on all four and so is everyone else so we do not do group turnout. I know he had no turnout while he was in the sale program but I don’t know much about his life pre-import. He came from a big fancy barn - which means nothing in terms of proper horse management. He is young, 6 years old. No findings on the lameness exam or in X-rays, his neck was pretty stiff so he’s had chiropractic and that helped.
The alfalfa seems to help so he gets soaked alfalfa cubes.
The Sucralox and lecithin is intriguing. He was on Eguisin the first month he was here (we do it for all horses that come in) and it helped a bit - it has lecithin as an active ingredient. He may have to live on it.
This might be a good thing for him. He can start work again after the 5th day on miso/sucralfate, I definitely subscribe to the idea that horses should have something in their bellies before work, he may need a little something extra.
He came from an extremely well known and established breeding operation outside of the US. He never left the farm till he was sent to the US to be sold as a young 5y/o. He was shipped without any ulcer meds and then lived inside with no turnout and shuttled around the country after the show season ended in Florida. So it is definitely their fault that his gut is a mess. Once he arrived stateside, his training consisted of being crammed together into a second level frame and then having a green change slammed on. He is one of the most confused horses I’ve seen under saddle, but his personality and try means that he is easy to take advantage of. He doesn’t say “no” until it just hurts too much. For the number of “big names” involved in this horse’s management, I’m thoroughly disgusted at the state he is in.
He got his sucralfate twice daily top dressed on his feed (morning and evening), he only gets a tiny bit of grain and a generous amount of alfalfa hay.
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I would make sure he’s on Outlast as well.
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Can it be mixed with everything else he’s on? Some light googling shows that it is a supplement.
Where are you buying the esomeprazole? I looked online and couldn’t find anything.
Thanks!
Not sure why something didn’t come up, but esomeprazole is the drug in Nexium (in the US). There are various generic name products
