Managing recurring ulcers

What it says on the tin! Sorry this is long!

6yr old OTTB mare, been off the track since Spring 2022. I got her from an aftercare program in August 2022. She is lovely, I love her, but she is also a problem child. She has very significant vaccine reactions, she had unilateral IMMK in an eye that was already congenitally blind so I opted for enucleation, she has headshakers, she has mild anhidrosis, she has bad feet, and she’s got some SI issues.

She recently went to New Bolton for a sports med/neuro workup that resulted in a bone scan that said her feet were causing a lot of pain and her SI was causing a lot of pain. We medicated both (OsPhos for feet, injections for SI) and have been working on her feet with changes in angles, pads, DIM, etc. Her sole depth has improved and her lameness symptoms have largely resolved.

At a previous barn, where forage was a major issue, she had a mild suspensory strain in Sept 2024, and in November 2024 as we began tack walking, she put me in a wall for tightening the girth, followed by going off her feed, so I scoped and she had grade 3-4 non-bleeding ulcers. Not wholly surprising given the pain+lack of forage. We treated for 30 days with omeprazole and sucralfate, rescoped and she was clear. I put her on Protek GI from mid December through end of February. The cost was too high for me and I transitioned her to a Smartpak supplement.

She moved in January to a new barn, and we did Gastrogard ahead of the move, during the move, and after the move to ensure a smooth transition.

Recently she has begun to be girthy again, a little pissy about the leg, and chewing on her run-in shelter. She had a mild colic episode on Sunday. I rescoped today and she had Grade 2.5-3 squamous ulcers. Non-bleeding but very evident.

She is turned out for 18 hours a day, in a huge grass field with friends. She cannot be out 24/7 in the summer because of anhidrosis. She has free choice hay and my barn feeds hay very very generously. She is on a low NSC balancer. Her workload is very light, 3-4 days a week, all walk trot right now.

I’m at a loss for how to keep her from getting ulcers again. Is it all her foot pain/SI pain this spring that caused this again? How else can I be better managing this horse?

She IS kind of a stressy horse. She seems super happy at this barn in this herd, but she is an alpha mare type who is worrying about where everyone is and what everyone’s doing. She has some riding anxiety and I try to keep her workload very light, very low pressure, very flexible as a result.

Preempting a few questions:

  1. She was on Outlast when she got severe ulcers last year, so I have not gone back to it. But maybe I should.
  2. She is not currently on alfalfa and my barn doesn’t have it, but I could buy my own and provide it in a second hay net if we think that’s a good use of money.
  3. Her current supplements: SmartGut, Biotin, Copper/Zinc, Calmakazi, One AC, salt, apple a day electrolytes.

Appreciate all thoughts.

We have some like this who just have to live on Nexium. It’s not the ideal state, but it keeps them
happy.

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How are her heats? I feel like regumate helped my mare alot. She used to hardly eat her hay in heat because she was so distracted. She is so much less stressed, less worried about what other horses are doing, and I feel like that has to help with keeping the ulcers away.

Her heats are intense. She was on regumate but because my barn adds to food, we were having absorption issues. We just did the oxytocin protocol and she’s stayed out of heat so far.

Maybe some training to help her self regulate her mental state might help. TRT or Warwick Schiller.

In my very limited experience recurring ulcers are a response to another issue in the body. Anxiety can also be a sign of other issues. You have identified and treated other pain, she might be operating on ingrained patterns of behaviour. Sometimes keeping things too low key doesn’t allow the horse to learn to handle stressor in their life.

Any type of pain will cause an anxious horse to have ulcers in my experience.

I’ve had good luck with having a strict schedule and strong focus on learning how to just be.