Ideas for senior with ulcers

[alterblue]

I’ll start by saying my horse recently turned 30, and I have no qualms with euthanasia if that’s the right choice for him, but we’re not quite there yet, and I’d like to at least give this guy a chance as he is my heart horse and deserves everything.

He started having colicky episodes last year in August and has since had 3 inidents, increasing in severity and always resolving with a dose of banamine. They seem to be painful and the last one was honestly awful to watch.

Obviously we are not going to scope a 30 year old, the stress of taking him to the hospital alone is not worth it, but my vet strongly suspects ulcers - he has been on Equioxx for 5+ years now (EOD) and we recently increased his dose to 1/day and within 6 weeks he had a second incident (previous episodes were 6 months apart).

We are treating with omeprazole and sucralfate currently and I’m considering putting him on Uckele GUT afterwards. We also decreased his Equioxx dose back to every other day and he seems to be doing OK on this dosage for now. Unfortunately because of his arthritis we can’t take him off completely, and his vet felt this was the best compromise.

Anything else you would recommend for him? He has a low-stress retired life, we think the ulcers are just related to the meds. He lives out 24/7 and only comes in if inclement weather He gets hay 3x a day which he picks at and alfalfa pellets soaked 2x a day along with Triple Crown Senior. He could use some more weight, hoping the ulcer treatment will help. More forage is tricky because he had all his incisors removed due to EOTRH, so he can’t really chew long stem super well.

Thanks in advance!

[walkinthewalk]

I wouldn’t be so sure it’s ulcers. It might be strangulating lipomas. They are common in older geldings.

My beloved Duke was around 25 when he first colicked and had NINE colics that year before a new vet at the facility suggested putting him on Succeed. I did, and I kept Duke on it until the end. The colics stopped for 2-1/2 years. Then there was one last big colic that was the nightmare that took him.

He had been with me since he was barely three years old, so I knew he had never colicked. The owner of the clinic did not run tests but had enough experience to say my horse in all likelihood had strangulating lipomas. They are generally benign as far as being cancerous, their method of attack is entwining themselves around the intestines.

You could try the Succeed and see if it helps.

Hugs to you and your senior gentleman, and for keeping him to his end time, whenever that is:)

[cayuse]

I second the adding the Succeed and also the lipoma thing having lost a elderly mare to that. Have you tried Adequan for the arthritis? I don’t know if it would be an option for a horse his age but if it is it might get him off the equioxx, or help enough so that the equioxx doesn’t need to be increased again. Good luck with your fella, I have an old timer too who is good buddy.

[JB]

You can add Outlast to his meals, up to 6 servings a day, to help raise stomach pH for about 4 hours with each full dose.

At his age, I wouldn’t be concerned about the long-term nutritional issues with long-term PPIs, so you could toss a few Nexium into his feed once a day - way cheaper the UG/GG. You can bump up his TC Sr if you want to mitigate some of that issue. I’ve been adding soaked beet pulp to my 33yo’s meals, which behaves like long-stem fiber and has actually significantly improved the quality and quantity of his manure, even at just a couple pounds total per day. That higher level of calcium may also help with the reduction in absorption with long-term PPIs.

Soaked alfalfa cubes can also help both issues (ulcers, fiber intake)

[alterblue]

Thanks for the ideas so far! Addressing a few thoughts/questions below:

Re: strangulating lipomas - could be, but unfortunately no way of knowing. My vet has seen this guy for much of his life and I trust her opinion and she is pretty certain it’s ulcers, so we are going to try that route first.

Adequan - unfortunately as his arthritis is pretty advanced his vet didn’t think Adequan would help him enough to be worth the $$

Succeed is pretty pricey, unfortunately I don’t think I can swing it right now but will definitely keep it in mind if that changes, I know it’s a great product.

My vet also suggested Outlast so I’m going to look into that more, seems to be fairly reasonably priced. He only could get it 2x a day but would be better than nothing.

Thanks all! These old guys are so tough, and I’ve had this guy since he was 3 so to say he is dear to me is an understatement.

[JB]

If you do some digging around for “homemade Equishure” or something like that, you might be able to find how some have made their own by mixing baking soda with oil, so that the fat encapsulates the baking soda so it can get past the stomach to help buffer the hind gut.

Triple Crown Senior Gold is another great option if you can get it. It has about 250 more cal/lb than regular Sr, and has the added gastric support similar to Outlast, as well as additional electrolytes, and generally only a couple $ more than the regular, so that might be cheaper than just adding Outlast to the regular Sr.

[cayuse]

Check out Manna Pro’s Benegest Pro, it is similar to Succeed I think, and cheaper. I have my minis on it (if anyone thinks minis don’t get ulcers, yes…yes they do ) and it’s helpful. I’m also using U-Gard pellets, it’s a stomach support supplement (not to be confused with ulcergard) and this has also been a help with them and it’s not too pricey.

[bingbingbing]

Sounds like you are on the right path. I would consider feeding him three times a day since he picks at the hay because of his teeth.
I have a 31 one year old who started to lose weight, luckily no colics. I cut out the hay pellets (they were timothy and she will not eat alfalfa ones) for mine and increased the amount and frequency of the triple crown senior gold.

[joiedevie99]

If it is related to the meds, you may have to keep him on ulcer treatment going forward. I’d be worried about that in a younger horse, but I wouldn’t care at all about that at his age. It’s possible you can maintain him on Outlast instead after treatment, but the only way to find out is to try (and risk having to do another treatment round if it doesn’t work).

Chronic pain can also cause ulcers, so keep in mind that it’s possible that the cause of the ulcers is the pain meds not doing enough.

[Pico_Banana]

Great replies here. I also have a senior – 29 y.o. QH mare. She also has arthritis, but it sounds like it’s not as bad as your guy’s arthritis.

My girl also picks at hay these days. So I try to get her on grass as much as possible, as she happily eats that. I also give her soaked timothy/alfalfa cubes two or three times a day, which she really enjoys. Note she much prefers the timothy/alfalfa mix to straight alfalfa cubes, so worth some experimenting.

For the arthritis, have you tried taking a break from the Equioxx? My girl was on it for quite a while and then I dropped her down to a half and then to nothing – fully ready to bump her back up if it seemed necessary for her comfort. She’s doing great in the warm weather without any. YMMV but something to consider.

Also agree with the suggestion for a daily low dose of Nexium if it is ulcers. For my younger mare, while we were still boarding, I had her on a single Nexium for quite a while and one was enough to keep her stomach happy.

There’s also this product, which you might want to have on hand. I’ve personally have never tried it but I have it available:

Amazon.com: EQUI-SPAZ Horse Digestion Supplement to Prevent and relieves Gas...

[quietann]

Picking at hay may mean he just can’t chew it very well anymore. At that point, you may need to switch to a senior complete feed and/or soaked hay cubes or pellets. If he will eat soaked feed, that will be easier. He might need more than 2 feedings a day, though. If he’s not at risk for choke, leaving him some soft hay to nibble at just to keep himself occupied is good. There is also bagged chopped forage that some older horses do well on, but it’s a bit expensive.

The repeated colicky signs are, in my limited experience, often a sign of a strangulating lipoma. If you treat him and he recovers well, you can keep doing that, but keep in mind that at some point, they will strangulate painfully and he will need to be put down. But think … he’s 30, and that’s just amazing.

I am a huge fan of Outlast – my elderly mare has been getting it since 2020 after her ulcers were treated. It’s relatively inexpensive; you’d be feeding roughly a pound per day and it comes in 40 pound bags, which I’m currently paying $43 for. So a bit more than a dollar a day. And yes – there are less expensive alternatives to GG/UG. There is a whole thread on Nexium here, and Abler omeprazole and sucralfate are also much less expensive.

[alterblue]

I just wanted to thank everyone who took the time to share ideas and suggestions.

After much thought and careful observation of my boy, I have made the difficult decision to lay him to rest peacefully next week. The possibility of losing him to a painful colic frankly terrifies me, and if it is ulcers, he isn’t able to tolerate the amount of Equioxx he needs to stay comfortable. It’s an incredibly painful admission as I’ve owned him since age 3, but he deserves a dignified end and I’m determined to give that to him.

[quietann]

You’re taking on his pain to help him out. You deserve praise for doing right by him for so many years.

/hugs

[alterblue]

Thank you. It was incredibly difficult, but I know it was the right decision. He had a great last day and passed so peacefully. It was exactly what I wanted for him and that he deserved. Miss him terribly, but there is peace in knowing he is free from any pain.

[RhythmNCruise]

Hugs to you and godspeed to your old friend. I’m glad his last day was a good one and he left this world for the next peacefully. You will miss him, but at least you don’t have to worry about something bad happening to him. He’s free from all of that now.