Long Term Hind Gut Success Stories?

I’ve posted on the forums too many times regarding my problem child (13 YO OTTB).

Quick Recap - Prior to three years ago I had no trouble keeping weight on this horse though he always had tummy troubles in the winter - he’d usually show colic signs and we’d treat with omperzole and be on our way - but starting two winters ago (Following barn change - barn a) had issues with him losing weight - was ulcers (verified by scope) treated with succeed and omperazole (for several months). Since then I haven’t been able to get this horse back to a good weight - its gotten better but not great.

Horse seemed to have issues again second winter at barn A and hay quality wasn’t ideal - very stemmy - they offered alfalfa but he didn’t seem to want to eat it. Also had issues getting him to finish grain consistently. At this point I tried a lot of ‘hind gut’ specific remedies (equisure, oil, safflower oil, succeed, corn and molasses free grain, alfalfa pellets). My conclusion is that the horse doesn’t winter well and I live in the midwest. I can’t change availability of grass pasture in the winter but I could get him out of a stall 15 hours a day in the winter months.

I moved the horse this summer so he’s now out 24/7 with one friend on an acre pasture with shelter and an attached grass pasture. Horse gets - 4lbs of senior + 1lb RB + empower boost twice daily and all the 2nd/3rd cut, soft (not stemmy) grass hay he can get + daily pasture in the summer. Horse started gaining weight post move. Horse was eating all of his grain and seemed in good spirits.

Around the move I also tested horse for cushings (becauase I’d had trouble keep weight on him thought it might be something more). Test did come back positive and hes now on 1/2 tab of prascend (low dose due to not super high test results). I was hoping the prascend may help with weight gain/topline but doesnt seem to have made a huge difference.

Since this summer horse has become pickier (not always finishing grain) and weight gain seems to have stalled and maybe even gone the opposite direction. I’m really thinking now its obvious this horse doesnt do well on hay (vs grass) and has hind gut issues.

So what do I do - Over the months/years I’ve tried succeed - equipsure - safflower oil - ulcer eraser - regular oil - outlast - alfalfa pellets - abler’s Sucralfate - ompreazole - molasses and corn free grain. I couldn’t get him to eat the equisure - but tempted to try agan this year? He is still eating better than he did at Barn A. Im curious to try succeed again but have never seen great results in the past. Safflower oil was suggested by a vet but again no real results in the past.

The only time I tried ablers Sucralfate was during the most recent move over the summer and that is when he gained the most weight so I’m curious to try that again.

Also curious to try adding Chaste berry supplement to see if that helps?

How have people managed hind gut problem horses successfully long term? I was really hoping if i moved this guy and got him better quality hay and outside 24/7 some of his issues would resolve and while he does seem to be doing better I’m panicking its not getter better/faster. I know i could feed more grain but I also am not sure that is the smartest option with this horse- I have fed him up to 12 lbs of purina and he still didn’t put on that much weight.

Is Succeed really just oat flour as others have said? I haven’t tried that…

If Equisure is really the answer I could set up syringes and the barn would give but would that need to go on for months? Daily? Twice daily?

Overfeeding grain and also treating for stomach ulcers can disrupt the hind gut microbes. I understand Prascend can dull the appetite.

How do you know the horse has hind gut issues? Does he have diarrhea? If so, I’ve found Herbs for Horses Probios and if necessary Yeassacc as well to eventually clear that up.

Does he have hind gut impaction colic? If so I’ve found getting more water into them is really important.

Anyhow what are the symptoms that make you say hindgut problems?

Right - agree about grain. I have been tempted to pull it as you hear these stories about horses gaining weight after grain is pulled but I’m too scared to try so far…

Yes - He was on pracsend for a few months before any of the decrease wanting to eat.

I think hind gut because while he doesnt have loose stool he does get liquid before/after which gets in his tail/down his legs. He has tested positive for the succeed hind gut ulcer test - which I think is just blood in the stool? And difficult keeping weight on and picky eater only in winter months when hes off grass/only on hay.

I’ve had him on probiotics before with no major difference.

While this horse has shown colic symptoms of laying down/getting up repeatedly and not wanting to eat - these usually go away with banamine and/or omperazole and he usually continues to have bowel movements so not sings of impaction colic.

If not hind gut what do you think? I’ve given him everything I can think of to get enough calories in him that he should gain weight but he doesnt and if he does its incredibly slow. I worked with a purina rep to score some free bags of ultium and even she was shocked.

The fecal water and the bouts of low level colic may be unrelated. I think the major hind gut colic is impaction and that’s obviously not an issue if his manure is wet. So he could be having gas colic in the small intestine, for instance.

I am a big believer in pulling everything but hay and water and a salt block when a horse shows signs of diarrhea.

Probiotics will help if there is a problem with the gut microbes. I think that if they have diarrhea too long, they can lose the ability to repopulate the gut microbes and it can become chronic. However, probiotics won’t work if there are problems with just physically tolerating fiber.

I’m not familiar vwith the various seniors complete feeds that replace hay as they aren’t sold in my market. You could try hay pellets or soaked hay cubes maybe?

You’ve tried so many things without success. I’d want real answers at this point. Scope for stomach ulcers, ultrasound the colon for hind gut ulcers, and do a fecal occult blood test. From there, you and your vet can take an educated guess as to whether you have ulcers, and where. If the conclusion is that you don’t, you can consider other related conditions like hind gut acidosis, delayed gastric emptying, etc.

If you do have hind gut ulcers, you might need the serious route - misoprostol and sucralfate for 90 days, and no long stem forage for 90 days to let the hind gut rest. Then you gradually cut back on your subtitutes (hay pellets/cubes/complete feed) and reintroduce.

My ottb mare also starts to leave some grain in the winter. Last year I did suceed which atleast got her finishing her meals. I did some research and on the succeed and it says on the website it is the beta glucan in the bran of the oat that makes their “oat flour” special. Long story short I started adding 1/4 cup of oat bran to my mare’s grain and she has been finishing her meals ever since. Not sure if it does much other than getting her to eat, but thats enough for me!

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Mine sounds really similar to yours. I did GG and she scoped clean in her stomach but she still gets just off in the winter. If I’m not proactive by January she looks terrible.

I’ve had luck with adding really high quality alfalfa. If you can get nice alfalfa are you sure he won’t eat it? I’d be very surprised if that’s the case. Some older horses just can’t eat the stems but that’s ok. You can still feed it and as long as they pick through the yummy leafy parts you’ll still get the benefits. Then you can donate the stemmy stuff to a less picky neighbor horse/ goat.

For supplements I have mine on Forco and probios. The probios I can’t say one way or the other if it helps but I don’t think it hurts. The research is pretty inconclusive about adding probiotics too but IMO it’s in the “can’t hurt might help category”. Plus when she was hospitalized for a bad colic they along with my regular vet wanted her on some so I feed it but TBH I don’t notice anything that different.

Forco however, I like a lot. It’s a prebiotic so the idea is it feeds the bacteria she already has in her hindgut. She’s been on it since last spring and she hasn’t had any colic or ulcery stumptoms since which could also be a coincidence but I’d really like to think it’s helping. Also we’re a few months into winter and she still looks just as great as she does in the summer. She might even be a little pudgy which is crazy because this time last year she was already skinny and ulcery. It’s also way more affordable than some other hind gut support supplements so I’m a fan of that aspect as well.

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Thanks for the suggestions! I’ve never heard of Forco but reading it bit it seems to make sense - I’m up for trying anything for a few months!

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I second doing the diagnostics. At least start with ultra sounding the right dorsal colon–that will give you a lot of information. I have dealt (successfully) with right dorsal colitis, but it was pretty involved and I wouldn’t have been willing to try the majority of the treatments without a diagnosis. I’ve posted on here before about my experiences, if you’d like I can try to pull up my past response.

Sucralfate with no other drug, particularly not omeprazole was what fixed my horse. I went through exactly the same, “but I don’t want to eat” whining with mine during what I like to call The Great Omeprazole Waste of Time. Sucralfate alone made the biggest difference.

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Thanks guys - I will definitely ask my vet about ultra sounding the colon. I’ve used several vets and I think they are all behind the times… They all seem to think there is no medication for hind gut ulcers (never mentioned sucraflate) - no mention of colon ultra sound when we’ve previously suspected hind gut ulcers - they push succeed and one had read studies on safflower oil being able to get to the hind gut. I’ve also asked about injectable omperazole in the past and got weird looks like it didnt exsit.

If you give sucraflate is it a tube? do you purchase from vet? My only experience is with abler’s packets of pop rocks which Id be happy to try again but I know their products aren’t FDA approved, etc.

I think we went into this winter thinking/hoping because it was a new barn, new/better hay, new routine (out 24/7) and cushings diagnosis hopefully we wouldnt see the same issues we had in the past. I even asked my vet if I should put him on succeed or something but she thought not - that we should treat as symptoms occur. What we are seeing so far is very mild so vet isn’t concerned but Id like to think I know my horse the best and I’m worried we are on the tip of another downward spiral.

I ordered forco - I’m thinking I’ll probably order a month of sucralfate as well and definitely consider a colon ultra sound if things dont improve. I really dont want to scope because at this horses absolute worst - laying down, groaning in pain after a month of omeprazole - he only had a few minor stomach ulcers and that is when we did 90 days of succeed and another 60 of omeprazole - by the end he was better but it was also spring. That is what makes me believe we aren’t dealing with traditional stomach ulcers.

So I hear you @sascha about wasting a lot of time and money on omeprazole!

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When he was scoped did they look for pyloric ulcers?

I think I’d try sucralfate and succeed. I’ve had good results with Succeed personally. But I have had to feed it at the loading dose amount for a long while to maintain the good response. And perhaps a different pre/probiotic. Forco is a good option. I also like HorseTech’s Gutwerks and have fed it up to 2 scoops /day. Also fed it at the same time as Succeed or other support. Including doubling it up with Platinum GI. Yes, that’s a lot of supplements. After some time, I could drop the Gutwerks and then later the Succeed and I kept him on the Platinum also because he needed a v/m supplement at that time. My last horse would also get seasonal ulcer flares (and also from things like joint injections) and it was really difficult to get him off omeprazole.

But because you are also getting the colic type symptoms, sucralfate seems reasonable to add on rather than going back to omeprazole if he is ulcer free. Maybe ultrasound the small intestine too to look for inflammation. If he has pyloric ulcers, you may need both sucralfate and omeprazole plus hind gut support.

To be clear - he was scoped two years ago - since then we haven’t had major colic episodes just issues with weight and getting him to eat in the winter months.

When he was scoped they didn’t leave the stomach but the vet really tried to get to the back of the stomach and check all over - so I’m not sure if she would have had to leave the stomach to check for pyloric? or if you can see just at the exist of the stomach?

He just had a few low grad ulcers in the stomach and not much redness or scarring that you’d think given his symptoms.

Does anyone think there is huge difference between the syringe of succeed and the feed topping? I’ve historically given the syringe (90 days two years ago and 30 days last winter) but since he is eating pretty good now I’d be curious to try the top dressing since its easier for the BO.

Still thinking I’ll see if I notice any changes with the forco for a few weeks alone - will add in sucraflate - and maybe succeed? I’ve just never felt like after 2 weeks or month on the succeed he seems better - but he also never seems to get worse on it…

Sucralfate comes in pills or liquid. The pills are cheaper. The liquid is less of a PITA. I keep a bottle of the liquid on hand for stressful times (staying overnight away from home, sedation, nsaid usage) and give a dose before and after (and during if it’s days away at a clinic) and it seems to keep her gut happy and keep her eating like it’s her job. If I ever end up doing long term again, I’d probably suck up the PITA of the pills and go that way to save a few bucks.

I am shocked that some vets are still so far behind the times. Sucralfate is on the list of medications allowed during competition! It was new to horses half a dozen or more years ago. It is old hat now. And going back over 10 years, my small animal vet prescribed it for a cat with a giant ulcer.

Its not that the vets I know are familiar arent familiar with sucralfate but that they dont think it can be successfully use to treat hind gut ulcers - they say there is not treatment for hind gut - and to use omeprazole (GG or UG) for stomach ulcers and succeed for hind gut…

Ive asked about sucralfate before and was brushed off

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My horse has hind gut ulcers. He lives on daily sucralfate. I buy it compounded, in a flavored powder. It has changed our lives!

I understand what you mean. I was very, very lucky to have the vets I had 7 years ago. What is surprising is that the attitude of “no treatment for hind gut” etc. is still so pervasive. Someone really needs to do some research and publish some stuff so that everyvet can get on board :slight_smile:

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I started with Succeed using the challenge, which comes with syringes and granules. You are to start with the syringe and do a loading dose then switch to granules. I think the syringes are gross because the product separates from the oil, and I wound up only getting my horse to eat it by syringing it into his feed as a top dress anyway. I had good results but after switching to the granules wound up keeping the horse on the 2x dose for quite some time. I eventually got him down to the normal amount and then I couldn’t get him off of that for quite some time. Symptoms would recur within a week of stopping… same happened at first when reducing the dose.

After a long while, I could take him off Succeed and just rely on the other products I mentioned. But if I needed to do omeprazole for preventative purposes or during change in season and new shipments of hay and things like that, if I added Succeed back, I always did it at the 2 scoop a day dose. Stupidly expensive, but it worked better than Equishure (though Equishure did help when he was on rich grass for a time in the past), Relyne, and a variety of other things. I put off trying it forever because of the expense.

Long story short, you can totally do the granules. That said, I have not ever used the veterinary strength version of the product, which I think is only in syringes. But based on my experience, I don’t think those are necessary either.

FWIW, my vet and I looked into it for their colic endorsement program and she found lots of exclusions she wasn’t happy with so I didn’t try it. I’m still curious if anyone has actually used it and had luck with that part of it though.