Hind gut issues - Succeed AND Sucralfate?

[leheath]

Horse is definitely not right. She had ovariectomy surgery in early August that went super well and she seemed to come back better than ever…until ~6 weeks after surgery when things started going downhill. This coincided with coming off the omeprazole treatment (used Nexium, 4 weeks full strength, 2 weeks of tapering) I gave preemptively following surgery since I figured the whole experience was likely to cause them. Now she seems to have classic signs of hind gut ulcers (probably exacerbated by omeprazole, which I didn’t know was a possible side effect) - right flank and belly very sensitive, left girth area sensitive, right canter very uncomfortable, not eating hay as well as expected, and a couple of minor gas colics.

Per vet’s suggestion, did 7-day SandClear treatment and put her on Succeed and things improved, but after 25 days she is still definitely not 100%. Should I just wait longer?

Or would adding Sucralfate seem likely to be helpful? The Abler Sucralfate is 3 sachets, 3x/day for hind gut specifically, but only 3 sachets 2x/day for combined fore and hind gut ulcer treatment. Which protocol have other’s have had success with (I did a search, but most threads didn’t talk much about dosage or frequency or treatment time) - 3x/day will be challenging in the current boarding situations so if 2x/day is an effective alternative, that’d be great. Also length of treatment - Abler suggests 21 days, but that is a cost of nearly $300 (at 3x/day) which is rather outside the budget right now…anyone had success with shorter treatment time?

TIA

[Escapetotjestars]

My mare had the same problems and incidentally is spayed as well. I did 30
days sucrlfate and sand clear as well along with lots of plain rice bran and beet pulp pellets. My mare took 90 days of just letting her be with no riding. She was completely off hay and lost a ton of weight and muscle. My mares issue started after stifle injections I believe the steroids effected her the most. I did have her on Ranitidine and Aloe Vera juice as well.

[leheath]

@Escapetotjestars Thanks. I’m glad my mare isn’t as bad as yours! As a separate question - why did you have your mare spayed and are you happy you did?

What dose and frequency were you giving the sucralfate?

[EmilyM]

Alimend is also a good supplement. it’s a liquid that lines the GI tract. HA based. $300 jug lasts prob 90 days.

[LadyB]

I have had amazing success with Mad Barn Visceral+ for hind gut ulcers. Worth looking into!

[cnd8]

We had a difficult case with my gelding with recurrent colic all summer. After every test they could do, they guessed something hindgut related and told me to give Assure Guard Gold and Relyne GI. The AGG is basically pre and probiotics, digestive enzymes, and psyllium and an acid buffer. The RelyneGI is HA for coating digestive track and stomach. So far…no colic. I’m almost afraid to type that because we’ve had such a rough go of this whole thing, but I am a believer in the AGG especially. I spoke to the head nutritionist at Arenus on the phone for an hour one day where he explained to me why their product is superior. Their psyllium is in flake form and has not been heat processed. Therfore, it doesn’t gum up in the tracts like other psyllium will do. He also called me the following week to check back in on my horse. Plus, they believe in their products and offer 10,000 colic coverage.

Edited to add: vet did say to go 30 days with no hay–just complete Senior feed, but that was impossible given my boarding situation with pastures that have roundbales, so we just added the hindgut supplements. It’s working so far.

[joiedevie99]

Does your vet have experience dealing with hind gut ulcers? My understanding is that it’s not as simple as adding a supplement. My vet does 90 days with no long stem forage - i.e. hay pellets/cubes/complete feed/grass but no hay, along with sucralfate and misoprostol as a start.

[islgrl]

My horse has hind gut ulcers. I treated, then used Succeed for 6 weeks or so then had to treat again. I dropped the Succeed and he now gets a low does of compounded sucralfate daily and is a VERY happy camper.

[IPEsq]

How much Succeed is she getting? I had a rough time with my horse a while back with a lameness that caused stress plus meds plus an ulcer flare and doing GG treatment and then persistent hind gut issues that we couldn’t figure out.

I tried a lot of things but what finally helped at the end of the day on top of being careful with his diet overall was doing Succeed 2x a day for much longer than the instructions say…I think it was a full month at least, and I’ll also do that for any other high stress times or if I have to give Nexium/GG. If you’ve seen some improvement already with Succeed, maybe try a bigger amount?

The only issue I’ve had is that he is doing so well on Succeed, I can’t seem to take him completely off of it. Tried a couple of times but after about a week or so, started feeling not 100%. It’s stupidly expensive but at this point…

[leheath]

@IPEsq I did 2X Succeed for the first 10 days and single dose since then (15 days). I am doing the money-back guarantee trial so I can’t change the dosage until we finish the 60 days. I could definitely consider a higher dose then if I think progress is made but not 100% if others have seen success with a higher dose.

@islgrl Did you treat with sucralfate before switching to the Succeed? What dosage and how many doses per day?What was the cause of your horse’s hind gut ulcers and what were the symptoms?

@joiedevie99 I don’t know how much hind gut specific experience he has but he literally just returned from a vet conference/symposium specifically about equine digestion and associated issues, so I would at least say he is up to date on relevant information. Our vet choices are somewhat limited in my area! Yes, in serious cases, no long stem forage might be appropriate, but that is extremely difficult in most boarding situations (including mine) and I don’t think my horse’s situation is sufficiently dire for that approach (yet…and hopefully never!).

@LadyB The Visceral supplement looks interesting, but it specifically says it is for gastric ulcers and makes no mention of hind gut issues. What kind of hind gut issues what your horse experiencing (cause and/or symptoms) that it helped with?

@cnd8 Thank you for the supplement recommendations - I hadn’t come across the Assure Guard Gold before. I will keep my fingers crossed you didn’t jinx your colic free time! However, the Assure product is extremely expensive (nearly $5/day at maintenance and more for loading!) and I would need a lot more research to believe it is worth that expense. What did you try before the Assure product that was ineffective?

Thanks everyone for your suggestions/comments - keep’em coming!

[Outyougo]

Sucrarate worked better than omeprozile did. On my OTTB. After two months of 10 pills 2x day. Down to 5 a day. No more mr cranky face

[islgrl]

[QUOTE=

@islgrl Did you treat with sucralfate before switching to the Succeed? What dosage and how many doses per day?What was the cause of your horse’s hind gut ulcers and what were the symptoms?

[/QUOTE]

I treated with sucralfate for a month before switching to succeed but couldn’t keep him happy until I dropped the succeed and went to daily sucralfate. He was dosed 2x daily at 12kmg (if I remember correctly). Maintenance he gets less. I don’t know why he has hindgut ulcers, he just does. Symptoms are very clear with him. He gets VERY grumpy and becomes truly unpleasant to ride, he is spooky, nappy, ears pinned, doesn’t want to be groomed. All around unpleasant. On sucralfate he is a joy. He was diagnosed with an ultrasound.

[cnd8]

@leheath In July, he started the random colic episodes that seemed to have no rhyme or reason. I started him on MVP Gastroplex. No change. We adjusted his grain to a low starch and I gave him 2 weeks of Abgard (generic omeprazole from Abler). He didn’t have another episode in those two weeks, so I thought it worked. One week later, colic continued. We kept him off of grain completely for 2.5 weeks, no change. Had vet out for scoping. He didnt see any ulcers, but the stomach was thickened from former ulcers (or just a stressy horse in general), so he gave 28 days Gastrogard. Colic continued. At end of that treatment, I took him to an equine hospital. Scoped again. No ulcers still. Did abdominal ultrasound–no thickening of colon. Did bloodwork–all normal. Did rectal–felt normal. Did radiographs–teeny tiny amount of sand and no enteroliths. They boiled it down to something hindgut related that will not be detected without exploratory surgery. They put him on Senior feed, and told me to do the Assure Guard Gold and Relyne GI. The AGG is expensive, but it has a 95% success rate. I’m doing it. It is worth it. So far so good.

[leheath]

Thanks for the additional information. Very helpful! My mare continues to improve a little at a time, but I think a bit more “help” may be needed. I think I will order some sucralfate and see if I can convince my boarding facility to feed them 2x/day as that seems to have been successful for others.