Supplements that help with ulcer prevention

We have a mare that had hindgut ulcers. We are treating with gastro guard and sucrulfate. As this wraps up do you have any recommendations for supplements to help keep her happy and healthy? Thus far I’ve purchased Outlast, Gut-X and have her on smartpak’s smart digest. My IG feed is flooded with gut supplements now and I’d love any input on products that are tried and true with science backed proof.

In the future we are modifying things by feeding her outlast prior to riding, prior to trailering (she won’t eat on the trailer) and hand walking her much more while at shows.

RIP to my bank account after this round of treatment. I of course want what’s best for her but would definitely prefer not to have to pay to deal with this again.

What’s her environment like? How much time in a stall vs turnout? Free choice hay/on grass? Any known environmental stressors?

She gets turnout for about 9 hours per day. When it gets too hot out they bring them inside for lunch.

I’m sorry, I’m new to horses so I’m not sure what free choice is on the hay but the barn feeds high quality Tim/alf and something else. She seems to root around and find the alfalfa to eat first. She’s fed on the ground. Her paddock does not have grass.

The big stressors for her I assume are shows and hauling. I’ve since come to the conclusion that we will only do one week shows, I’ll make sure to show up a few hours early prior to hauling to make sure she has a full belly. I’ve purchased Gallagher’s water and chugg electrolytes to make sure she’s staying hydrated thought this gal truly is the epitome of “you can lead a horse to water…”

She’s jumped once per week and flat work 2-3 days per week. The rest of the time she has off.

Diagnosed how?

GG (omeprazole) doesn’t do anything for hind gut issues, and can make them worse.

What was the presumed cause of the issues? What symptoms did she have?

I’d say Outlast is a good one to use, as you can use is before and during a more stressful event. You can also make sure she’s got plenty of hay in her stomach prior to work, that alone reduces acid sloshing to help prevent squamous ulcers

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Vet scoped her and recommended the treatment plan.

No presumed cause that anyone can pinpoint.

you can’t scope the hind gut. You can ultrasound to see intestinal thickening or some other abnormalities.

Did the vet actually say “hind gut” ulcers?

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My Arab was scoped for gastric ulcers but we didn’t find any and he was diagnosed with HG ulcers. Like @JB said, gastroguard doesn’t treat them. We did sucralfate and misoprostol.
He lives out 24/7 and has free choice forage (pasture or hay depending on time of year). He gets no grain and gets a handful of outlast and some alfalfa to munch while being tacked up. He gets sucralfate before anything super stressful like trailering as well as getting Outlast and Stress Free forage while we’re at rides, etc.

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Can you upload the medical notes? Scoping cannot see the hind gut. Do you have a follow up scope to look at the health of the stomach post treatment?

It sounds like you’re panic throwing half a dozen supplements towards everything. Keeping hay in front of horses as much as humanly possible is always step one. Is the hay fed in a pile or bag? Does your horse have leftover hay in the morning by the time they get their grain or is the bag/pile gone? What happens if they finish their hay during the day?

You’re new to horses but showing at multi week venues? Some context on this plus how much support you have from the barn may be helpful in terms of guiding recommendations. Are you attending vet appointments or receiving a summary from your trainer?

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I guess not.

Grade 1 ulcers at fundus.

Multiple hyperemic flat ulcers of the pyloric mucosa.

No ulcers at margo plicatus.

Sorry- my daughter is actually the rider. I am the bill payer. New to horses in that we’ve owned her for a year now. (In the past we leased) Lots of barn support but I dislike not understanding everything.

I’m sort of panic throwing ideas out there but these were also suggestions from vet and barn. Vet suggested outlast and gut x or relyne after treatment. I don’t think it’s a bad thing to try to inquire with the hive mind and get other opinions. Hence the post.

We re-scope 6/17 which is beyond her treatment time but due to schedule conflicts that is just when it’s happening.

I’m trying to learn more to help prevent this from
Happening in the future.

I think when I heard she did not have stomach ulcers I perhaps drew an incorrect conclusion that it was hindgut.

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I was at the scope appt. The trainer was unable to make it. It was the first time I had ever heard the word sucralfate and I was honestly just a bit overwhelmed and didn’t know what to even ask at that point. In the past two weeks I’ve tried to read forums and use google to educate myself.

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only partially helpful, unfortunately. The fundus has both glandular (lined) and squamous (unlined) portions. Omeprazole is suitable for squamous, but not glandular. The fundus sections are in the stomach, but glandular vs squamous requires different drugs. Sucralfate will at least coat lesions in the glandular area which is where the stomach acid and food sit.

Given that there were also pyloric issues, which isn’t helped by omeprazole, it’s just not clear what the vet intended with that combination of drugs. Sucralfate is useful for all kinds of lesions along the entire GI tract. Misoprostol is often needed to address pyloric issues, and sometimes, you need all 3 drugs

I totally understand being overwhelmed with terms you’ve never heard! Sucralfate is also a human drug you might know as the Carafate brand, used to treat intestinal lesions/ulcers.

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Sucralfate will actually work on hind gut ulcers.

yes, but the vet notes aren’t about hind gut issues, and it doesn’t seem as if anything was actually diagnosed as even a potential hind gut issue, only stomach/pyloric issues were found

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The context makes a lot of sense! You sound like a very supportive mom. You’re diving into the deep end of a complex hobby looking at a very complex sub topic where there is the intersection of science and supplements/care/opinion.

For now, I’d try to keep lots of hay in front of the horse, aim for a nice consistent routine, and wait until the next scope. As noted, I’d emotional prepare that there’s a chance you won’t have full healing as ulcers sometimes need multiple medications and an extended treatment protocol.

More broadly, ulcers are unfortunately common with these big beautiful not so great at surviving animals. If you’re at a competition barn with a lot of travel, there may be a real learning curve for what this specific horse needs. You listed a lot of great supplements and may find one or more helpful. The tricky part is that if you don’t have a reoccurrence it doesn’t necessarily tell you it’s working and if you have a reoccurrence maybe the supplements made them less bad than they could have been.

Once you have confirmation that the stomach is happy, I’d personally start with outlast and talk with your vet about how gastroguard may be used to support travel. Personally, I’d rather have my horses diet be 95% hay and then use the smallest volume concentrated source for vitamins and minerals to balance. If the horse is currently getting a large volume of grain, you could also ask your vet about increase forage (hay or grass) to offset calories and switching to a “ration balancer” or “vitamin and mineral supplement like California trace plus soaked alfalfa pellets”.

Keep asking questions and know that your horse is lucky to have landed in a family where they get to be loved on by a kid and have an adult as their advocate.

Best of luck!

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I have a mare that is very ulcer prone and it is highly exacerbated by travel/showing. Even though she lives an ideal “ulcer preventative” lifestyle at home (out 24/7 with friends, free choice grass/hay, low grain/starch diet) she still turns up with ulcers every year when we start traveling more for lessons and competitions.
I have learned that this horse needs preventative omeprazole every time she steps foot on a trailer. She needs a full dose too, not the 1/4 dose that works for some for prevention. If we are going for more than a day trip she might start her treatment the day before we leave and continue through a day after we return home. Obviously with weekly lessons and at least once monthly overnight shows, this adds up money wise. I have had good luck with Abler omeprazole, and the paste tubes are about a 1/4 the cost of name brand gastrogard.
I have tried multiple gut supplements with her over the years and while some seem to work sufficiently for support at home, nothing seems to work once we add in the additional stress of travel. Its been a 5 year long trial and error process, and I am still tweaking her routine! So don’t give up hope if something you try doesn’t work or seems to work for a while and then stops.

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Thank you so much. I really appreciate all of the tips.

Have you ever used a Porta grazer? Our trainer doesn’t like hay nets but I’m trying to find a solution to have extra hay always available to her. I know show stalls are smaller than her normal stall and some people think any ground clutter is a no no.

I understand no solution is perfect nor is it no risk but trying to figure out a solution that keeps her with hay ALL THE TIME.

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You’re right there’s no perfect solution. I know several people who use and love their porta grazer. I believe at least one puts a few bricks in the bottom for extra weight to keep her gelding from getting curious if he does empty it. Horses can hurt themselves on anything but I haven’t personally heard of any porta grazer incidents.

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I have one of these slow feeders and absolutely love it. It’s stupid easy to fill, and you’re always filling behind the old hay (not putting new hay on top of old): https://savvyhorseproducts.com/products/the-savvy-slow-hay-feeder.

I have one data point with abler - a client horse is on it and we scoped her and she has no ulcers. Maybe it’s the abler? Maybe it’s her lifestyle?

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This may not be an alternative for shows depending on the outlet proximity, but autofeeders have been a godsend for us. My guy is an easy keeper and only gets 14lbs hay/per day. He gets an 8lb bag in the morning when he goes to his dry lot, a 6lb bag with dinner, and then we have the iFeed that dumps a quarter pound of Unbeetable Forage Only pellets about every 90 mins from 9PM to 8AM. That totals around 3-4lbs in addition to his hay. If your mare doesn’t have to watch her calories, you could do a larger amount with smaller intervals. The hopper holds up to 12 lbs of food.

IF you mare eats her hay quickly, it may be difficult even with a portagrazer to keep her stomach full. I have used one in the past but I needed it to slow my guy down, which it didn’t. I need the tiniest hole hay nets to slow him down. I don’t know what the trainers beef with nets is, but there is a lot of research out there clearly showing their benefits.

When we have traveled I don’t take the auto feeder with us, I have a full bale hay bag that he gets for overnight. We do overnights so rarely that the increase in hay hasn’t been an issue.

This is what I have and its been worth every penny: https://ifeednaturally.com/