Horse was diagnosed with squamous and glandular ulcers via gastroscopy. Prescribed meds resulted in full healing of both, however after 10 days off weaning dose of gastroguard the squamous ulcers are back. Back on meds now.
Horse has zero risk factors and vets are stumped.
Horse also has remarkably itchy butt.
Wondering whether his 1/2 cup of Ultium and Gro-N-Win may have something to do with both, one, or neither.
Anyone have horses with ulcers that healed, recurred, were retreated, and then managed on a grain free diet?
Anyone see their horse’s itchy butt improve on a grain free diet?
Was he scoped before and after to confirm they were truly gone? Perhaps putting him on a long term supplement coming off of the gastrogard would be good. How is his condition? Can he maintain weight without the grain? Free access to grass and/or hay at all times?
What do you mean “zero risk factors”? Being a horse is risk factor enough :lol:
But in all seriousness… Ulcers are usually a management problem, not a grain problem (though some grains can make things worse). That’s not to say that the horse is being taken care of poorly - many horses with ulcers have top notch care and high quality feed – but the care is not conducive to their best interest.
I have learned these are the biggest causes of ulcers:
Stalling (especially overnight or in traditional boarding barn)
Hard exercise
Lameness
Extended periods of time with no forage
Sudden change (pasture turnout, location change, or lots of traveling)
I recall hearing from a vet it takes as little as two hours without hay for a horse to start developing an ulcer. Do the math when most horses are stalled overnight, with only a handful of flakes at 8PM to tide them over until the next day at 7 AM…
Anyway –
What meds are you using, and how often? There is definitely a really important timing component for a lot of ulcer medicines.
I would think the itchy butt is unrelated - either worms, ticks, or – and this will sound left field but it’s not – cervical arthritis. I’ve now had two horses with c-spine arthritis with weirdly itchy tails (especially the end of the tail), and first learned it was a symptom on this forum.
I see horses treated for ulcers redevelop them all the time - as a BM it was frustrating as many owners did not want to change the management much - either they were worried the horse would get hurt with more turnout, or they thought the horse would be miserable without a stall. It is not enough to just treat the ulcers - you have to address whatever was causing them. If you don’t, you are just wasting your money.
So, my experience is ulcers areusually reoccurring unless there’s a drastic overhaul in management.
Some things that help significantly (on top of the medication):
Alfalfa pellets every feeding along with high quality low starch grain
No long periods of no food - constant 24/7 access to roundbale preferable
As much grass as possible
Minimize stalling
Maximize turnout (24/7 preferred)
Find them a friend *
The last one – I have had a hard time keeping horses in solitary management 100% ulcer free. I know it is simply not realistic when these are show horses, but horses are herd animals and thrive with the right turnout buddy.
What Beowulf said…mine had terrible ulcers (glandular and non glandular) plus pyloric ulcers which caused delayed gastric emptying! After years of treatment he’s as cured as he will ever be and very carefully managed. He does have to live on daily maintenance generic omeprazole…Turnout all day everyday with unlimited quality hay 24/7 (hay and grass outside plus haynet inside)…he can never not have hay in front of him, this the vet was adamant about and lucky for me my barn is willing to provide! He does also get, a good srs feed twice a day and beet pulp once a day (beet pulp is good for ulcery horses)! He has had NO reoccurrence since being on this program!
mine is stalled at night, and also doesn’t have a turnout buddy although our horses are rt next to each other in their paddocks! As long as they’re next to each other they do well"…we do have some that go into a field in a group setting, but they have to do well in the group…mine does not!
The itchy butt…I’ve not and never did see this with my horses ulcers! I’d be more wanting to check for some kind of worm infestation…which could also cause colic!
As far as itchy tail, make sure the horse is clean in his underparts and have his sheath cleaned too. Maybe wash the whole tail with Head and Shoulders which has zinc in it?
Itchy backside could be due to diarrhea dribbling which can occur from ulcers.
Corn and molasses irritate ulcers. Ultium has both. You’re feeding a really small amount, but your horse could be more sensitive than others.
Agreed with everything Beowulf said.
My mare is an OTTB, of course she came off the track with ulcers. Treated with Omeprazole - returned 5-6 months later. Treated again and removed grain completely from her diet. It kept the ulcers at bay for a good year-ish, but it was REALLY difficult to get enough calories in her to keep her at a good weight without grain. She is super picky, and she would NOT touch soaked anything (thank goodness that’s changed), so she got dry alfalfa pellets and a ration balancer and oils for more fat and aloe vera juice. After that annoyingness reached peak annoyance for barn owners, I hunted down a grain with no corn and no molasses (Tribute Kalm N EZ), and that was wonderful for a couple of years. However, as I boarded at the time, she still had a far less than ideal lifestyle (because almost no one in central Ohio turns horses out or feeds adequate hay), and they eventually returned.
We moved to Florida, got our own farm, and unfortunately Tribute grains are way more expensive here than they were in Ohio. I’ve done some playing around with grains to find one that won’t irritate ulcers but keeps her weight up, and I’ve settled on one that does have corn, but does not have molasses. However, to balance the corn potential for irritation, she gets soaked alfalfa cubes with the grain at every meal, and she is out 24/7 on grass and with a round bale. To be safe, I give her Ranitidine for a few days before a show, during a show, and a few days after.
There is no such thing as “no risk factors” for horses that are ridden. I feel that I’ve finally managed to get my mare’s lifestyle as ideal as I can for her, now that I have her at home, but she is still ridden/worked six days per week and she shows. There’s always stressors that can induce the recurrence of ulcers.
All horses are candidates for ulcers based on the way we keep them.
There are some husbandry things that can help. Feed hay and feed at ground level to help keep the horse’s head in a natural grazing position. This helps to create saliva to buffer the horse’s stomach. Keep hay in front of the horse if they are not out on pasture.
How long was the horse on Gastrogard? Some horses need to be on it longer than others. What was the dosage as that can make a difference as well?
My horse had glandular ulcers. He scoped perfect on the follow up scope. The internal medicine specialist said a 1/4 tube of gastrogard daily for prevention.
Pain somewhere can cause ulcers; my gelding developed them from hock/back pain every fall when the weather patterns started changing from summer to winter, and once started on firocoxib, ulcers healed with medication (ranitidine) and didn’t reoccur until he developed a sinus infection a few years later (has a low pain threshold). He now gets 3-4 oz of aloe vera juice w/2 tsp of slippery elm bark mixed into his evening bucket. This horse is maintained on beet pulp, alf pellets, tim pellets, white salt, Diamond V Yeast, whole flax, and a maintenance dose of a vit/min pellet as his “bucket food” and has done much better on this combo than on any ration balancer or senior feed–
Thanks for all the suggestions! I appreciate the information.
We’ve had three gastroscopies, so are on top of how things started and progressed.
As to risk factors:, he is eating alfalfa hay as 1/3 of his diet, alfalfa pellets and I’ve stopped grain, he has access to hay 24/7, is turned out on grass as weather permits, is turned out daily 14 hours on pasture or in all-weather paddocks with hay available, turned out with his buddy, very little trailering (basically to vet hospital in the past year), no showing since last year. So, sure, no horse has zero risk factors, but he’s living a pretty easy life.
We tried ranitidine and aloe vera - didn’t see a difference. Tried him on RiteTrac - didn’t see a difference.
He doesn’t need grain at this point - he carries extra weight anyhow.
He’s ridden 4x per week, and each ride includes a hack on the buckle - at least one of his weekly rides is just a hack. Does not display any behavior under tack that would make you think he doesn’t like his job - no tail swishing, no balking, no rude behavior, etc.
He’s been evaluated repeatedly for lameness and does not present with any discomfort in his body on exam, or under saddle.
Will see what the next week or two bring with a grain free diet, and will see if I can disentangle his ulcer issues and his itchy butt!
I read on this site that someone’s horse had an itchy butt when his dock wasn’t as clean as he wanted. I started really paying attention to my gelding’s dock and he stopped trying to scratch it. I hope your situation ends to be that simple. Cervical arthritis… YIKES!!!
This is not a knock on you. Stalling is one of the biggest hurdles in management issues when it comes to ulcers, in my experience… Stalling is convenient for us and mandatory in most boarding barns - but it is not what is best for the horse.
So I would not be surprised to learn, that the ulcers are reoccurring in a horse that is stalled.
I have found horses stalled, rarely have 24/7 hay access. Unless there is someone checking on them every 2 hours to give them 4+ flakes of hay from 8 PM to 6 AM the next morning when they go out… It seems standard policy to bring horses in to a stall with 2 flakes and that was all that tides them over until next morning.
That is nowhere near enough. A bale, more like. A horse with good dentition can eat an average flake (~4lb) in 15-20 minutes.
So I might double check with your boarding barn, and see if he really is getting hay all the time – that’ll definitely help. Keeping their stomach busy is important and good.
Can you expand on what medicines, how often you treated/time frame? Like JB said - I’m curious for the GG, and also, for how long and often you administered the ranitidine.
I have not had aloe vera make much of a positive difference. I have seen it make things worse; or at least be present/fed at a time that ulcers have worsened. Until there’s more literature there about aloe actually helping, I consider it a waste of money.
If you want a supplement while you figure out what works and what doesn’t, Ulser-Shield is the one supplement I have seen actually make a difference. I never saw a difference with others like U-Gard or Assure.
There is some evidence that aloe (quality aloe, not just “we whiffed some aloe by the water”) can help heal ulcers, but it just falls far short of omeprazole (that was the comparison study).
It can be useful in helping prevent ulcers from returning - again, quality and purity matters. Fruit of the Earth doesn’t cut it :lol:
There are some herbs which have known (researched, tested, proven) properties that improve the health of the stomach lining. Papaya and slippery elm are 2.
Sucralfate long-term also works to increase prostaglandin production, which is part of what creates a healthy stomach lining (which is why prostaglandin-reducing drugs, like bute, help cause ulcers).
I did not have my horse scoped, but he was clearly ulcery and I treated him with full tubes of gastroguard/Ulcerguard for six weeks, then tapered, kept him on a protocol of starting Ulcerguard 48 hours before shows or out of town travel. Etc. Had him on gastrotek supplement as well. He was on 24/7 turnout but still had ulcery behavior and dangerous explosions. At an away show last fall, day three of full tube Ulcerguard, he exploded the last time. I had to figure out how to fix him or sell him before I got seriously hurt.
I pulled the Cavelor grain I was feeding at the show and had his bodyworker out when I got home. I told her was going to change feed and she suggested I read a blog on going No Grain. Pulling all supplements, feeds, balancers, treats, salt blocks, etc. that had any grain, grain byproducts, or added sugars. I was desperate. I figured I’d give it a a couple weeks and see what happened. That was last September. I have been completely converted and convinced. My horse has not had one explosive moment or hint of ulcery behavior since I pulled all grain. He looks fantastic. He is in full work schooling the entire GP dressage test and I have not given him a drop of Ulcerguard since last September. I got my horse back and have saved a boatload of money on medicine, feed, and supplements. Instead of treating the symptom (ulcers) and fixed the cause (inflamed gut and unhappy microbiome from feeding grain and grain byproducts).
I have put all four of my horses on this protocol and all are doing great on it. Numerous (maybe 30 or so) friends and friends of friends have tried this diet and so far I have only heard of one person who has gone back to feeding grain (not someone I talked to directly so she may not have been truly grain free, and I know she did not try it for long).
In addition to my and other FEI dressage horses (including one belonging to a judge who had seen my horse explode at a show last year and was impressed by the improvements), Gardenie who posts here has her Intermediate eventer and other horses on this protocol and is thrilled.
Its a leap of faith until you try and see the convincing results that I and my friends and trainers are seeing (my eventing trainer has converted her barn and numerous clients), but it turns out the horses don’t need all that crap that is being marketed to us!!!
What am I feeding?
All the grass hay or pasture my four horses want, naturally mined salt (Himalayan or Redmond’s, NOT the block salt that has binders in it), 4-5 pounds of alfalfa (I feed hay but pellets or cubes are fine), and one pound per day of dehulled soybean meal. The alfalfa and soybean meal are legumes that province the full spectrum of amino acids needed to build muscle and repair tissue. I do occasionally feed one of the four horses a bit of Coolstance when he started to get a bit lean, the other three haven’t needed it.
The only treats I give are Mini Alfalfa Cubes that contain ONLY alfalfa. Or occasionally salted, toasted peanuts (also a legume).
No carrots or apples or cookies or peppermints. No supplements.
Yesterday I did 87 two-tempi changes in a row out in a grass field. My horse is thriving and comfortable and I’m not scared of explosions any more.
These are the blogs that changed my horse management forever and let me enjoy my unicorn again. Scroll down and read from the oldest first. Particularly good to get started are “why horses should not be fed grain” and “chronic protein deficiency in horses.” Note that Dr Tucker’s thinking has evolved over the two or three years he’s been writing these blogs, so I recommend reading them all. Also read the comments and discussions after each blog for more info. If you are really interested in the nittygritty, he has an online nutrition course that’s under $50 bucks, less than two tubes of gastroguard. Lots of info here, and it may seem really strange at first, but I’ve seen proof positive that horses fed ONLY grasses, legumes, and natural salt can perform better than ever. Good luck!
Dosing: Gastroguard, full tube for 6 weeks, 1/2 tube for 6 weeks, 1/4 tube for 6 weeks. I’ve done two full cycles of this dosing regimen. First time was before gastroscopy, and when he declined again, we did the procedure and discovered both kinds of ulcers, requiring GG and misoprostol.
He lives with me, at home, so I manage his care. I can assure you that he has hay in front of him all the time - as evidenced by hay remaining in his stall/paddock in am/pm. I check him probably 8 times per day to make sure he has hay. Yep, I’m a little obsessive. :: The larger portion of hay is a 8-10% brome and from the same farmer for his entire life. (also gets alfalfa hay every day - 5 pounds-ish). He gets a packet of Equiotics every morning, and a SmartPak colic care supplement, because my insurance company ‘fired’ me after the claims submitted this past year. Has a Himalayan salt block in his stall all the time and he loves it.
He is on full turnout when weather permits - when it’s icy/freezing here, or hot and insanely buggy, there is no value that I can see. Even with shade and run-ins, it’s going to be 100 degrees this weekend, and the horse flies now are like no year I’ve ever seen. There is an ROI with turn out - if he’s going to be tormented or potentially at risk of wiping out on ice, I can’t think that’s a better solution than some stall time. His stall is about 14x17, so better than many.
I switched to only alfalfa pellets and no grain for about 10 days now … can’t say I see a noticeable difference yet, but perhaps he’s a little less itchy? The GG is definitely working and has been for the past week at least and he is super generous in his body under saddle, and back to being lovely while being groomed, touched, etc.
I have been feeding carrots but have been considering that they need to go by the wayside. I do give alfalfa cubes while I’m grooming, and I’m estimating he gets about 5 pounds of alfalfa hay every day. I also use Nutrient Buffer prior to riding.
One other issue I’m facing is a possibility of being a wee bit pre-IR. He has always had some fat stored at his tail head, and we have been working (post surgery and in rehab/back to work) to get more exercise, limit some calories (but not at the expense of keeping hay in front of him) to lose some weight. He’s graded a 6/9, and weighs approximately 1275, standing 16.2. This also is part of the challenge in turn out. The grass in my big(ger) fields is pretty lush, and my vets and I are in agreement that even with a muzzle it is just too much to expect him to survive turnout in spring/summer grass. So, he and his buddy go in a field that has less lush grass, with access to hay the whole time they are out. There is grass, but they cannot get big mouthfuls and have to work a little harder. I do use my all-weather paddocks when field is sloppy, and they have plenty of hay when they are out - in bags and on the ground so there is always clean, dry hay for them.
The main ingredient in Equiotics is dextrose which is sugar, I think corn sugar. Something I would definitely avoid if trying to be grain and sugar free.
Is the colic care supplement Smart Digest? That is far from grain free as it has Corn Distillers Dried Grains with Solubles and Stabilized Rice Bran plus Vegetable Oil, which is inflammatory.
Carrots have a lot of sugar. If you are trying to avoid grains and sugars they are need to be eliminated.
Gastroguard/Ulcerguard changes the gut acidity and depletes the population of healthy microbes needed to get the most nutrition out of forage. It won’t be until after those meds are pulled and all grain products and sugars are eliminated for several weeks that you will really know how he’s doing on a truly grain-free protocol. So if you aren’t yet seeing the changes you had hoped for, it may be because you haven’t yet completely deleted grains, meds, and added sugars from the diet. Good luck!
Sucralfate works on existing ulcers by coating the lesions. The aluminum component is activated by stomach acid and turns “gooey” and is attracted to lesions and sticks to them. It’s not a well-digested chemical, but what is digested helps increase/improve prostaglandin production which is part of what creates a health stomach lining.
I see it has red algae, and they talk about it’s “unique honeycomb structure”. Purina Outlast also talks about the unique honeycomb structure of its seaweed-derived calcium. I wonder if the Outlast seaweed is also the red algae.
At a 7gm serving, the amount of dextrose isn’t anything I’d be concerned about. It’s likely there to support the pre/probiotics. https://www.scirp.org/Journal/PaperInformation.aspx?PaperID=82812
"In aerobic condition, most strains cultured with FOS or lactulose did not grow optimally compared to dextrose "
Is the colic care supplement Smart Digest? That is far from grain free as it has Corn Distillers Dried Grains with Solubles and Stabilized Rice Bran plus Vegetable Oil, which is inflammatory.
DDGs are not at all the same as the original grain. And at a 15gm serving (roughly 1/2 oz) there’s nothing to be concerned about with inflammation-supporting ingredients.
Even very, very small amounts of things like shellfish, peanuts, or wheat can produce reactions in people with allergies to those things. A friend of mine says it doesn’t matter if she has a single shrimp or a pound of shrimp, she’s still sick. Going completely grain-free versus nearly grain-free with horses can make a difference depending on the individual’s sensitivity to lectins and sugars. And you don’t know what the difference can be unless you pull those remaining ingredients. Worth reading all labels very carefully and being aware.
The larger portion of hay is a 8-10% brome and from the same farmer for his entire life. (also gets alfalfa hay every day - 5 pounds-ish). He gets a packet of Equiotics every morning, and a SmartPak colic care supplement, because my insurance company ‘fired’ me after the claims submitted this past year. Has a Himalayan salt block in his stall all the time and he loves it.