Suspected hindgut ulcers?

BritishEquestrian · August 12, 2020, 6:39am

Hi

I have a mare who in the spring was diagnosed with grade 4 gastric ulcers - she was then put on Gatroguard for 3 months decreasing the amount each month to wean her off it & was scoped clear after the 1st month & then 3 months later scoped again to see she had no ulcers still.*

She has now started showing the symptoms again (Refusing to go forwards, hates my legs on her, girthy etc) but there has been no change in routine/feed. It definitely is ulcers/stomach area related as saddle/teeth/Physio has all been checked.

The vet has given a weeks dose of gastroguard to see if that improves her at all (In case it is ulcers again) but I am now thinking that it could be hindgut ulcers? Has anyone had any experience with these & found they are more prone after having GG for so long & what was the treatment like?*

Thank you

keysfins · August 27, 2020, 5:50am

I think if you do a search in this forum you will find several posts describing adverse effects after or even during dosing UkcerGard/GastroGard. I will not be using UlcerGard casually, especially with my older horse.

He had a series of gas/impaction colics, and one thing the vets recommended was Arenus Assure. Our clinic will not recommend a specific product unless the vets really find they make a difference. Arenus Assure is a pre/probiotic specifically for hindgut health. It is in a psyllium base, and the psyllium can be very soothing to the gut. Maybe discuss with your vet about adding even straight psyllium for the soothing properties.

Others have had good results using sucralfate, KER Equisure, and/or Succeed.

eclipse · August 27, 2020, 5:50am

Agreed with above… If you know for sure you’ve got active ulcers ulcerguard/ gastroguard is very good but there can be adverse effects if you really don’t need the medicine or, at the very least you’re just throwing mega $$$ down your horses mouth for nothing. Only a scope can verify ulcers and when the scope is done make sure they check the pyloric region and see if they can see into the duodenum. Hind gut ulcers, if the scope is clear, are treated differently and there a lots of good threads

joiedevie99 · August 27, 2020, 5:50am

My vet does two tests to look for hind gut ulcers - a fecal occult blood test and an ultrasound of the colon (to measure wall thickness). She prescribes major diet changes, as well as Misoprostol and Sucralfate.

keysfins · August 27, 2020, 5:50am

JDV, what type of diet changes would your vet typically recommend?

wookie · August 27, 2020, 6:04am

sulcrafate worked wonders for me.

M_O_Connor · August 27, 2020, 6:04am

KER’s EquiSure specifically targets hind gut acidosis.

RiteTrac is a product containing Equisure, that protects the entire digestive tract from start to finish.

EmilyM · August 27, 2020, 6:07am

mine had uclers at the pylorus and 3 weeks of misoprostol cleared them after 7 weeks of ulcergard did not. He had been on sucralfate which seemed to do nothing to heal him as well.
also, feed low sugar diet, lots of grass and alfalfa if possible. I use ultium which is a high fat feed formulated to be low in sugar.

joiedevie99 · August 27, 2020, 6:08am

[QUOTE=keysfins;8382623]
JDV, what type of diet changes would your vet typically recommend?[/QUOTE]

Thankfully, I’ve never had to do it - so I only know general parameters. The idea is to remove all hay for ~60 days. The horse goes on a complete feed, and is supplemented with more easily digested roughage every few hours, like soaked hay cubes or soaked timothy pellets. They can have grass.

It’s kind of the opposite of what we do for stomach ulcers. The idea there is to keep roughage in front of the horse 24/7, and add alfalfa. (I’m sure you can find my thread re: my horse’s ulcers at the pylorus that refuse to heal)

Obsidian_Fire · August 27, 2020, 6:10am

[QUOTE=joiedevie99;8388560]
Thankfully, I’ve never had to do it - so I only know general parameters. The idea is to remove all hay for ~60 days. The horse goes on a complete feed, and is supplemented with more easily digested roughage every few hours, like soaked hay cubes or soaked timothy pellets. They can have grass.

It’s kind of the opposite of what we do for stomach ulcers. The idea there is to keep roughage in front of the horse 24/7, and add alfalfa. (I’m sure you can find my thread re: my horse’s ulcers at the pylorus that refuse to heal)[/QUOTE]

Yes. When we treated my boy for suspected (occult blood test) hindgut ulcers, we removed all hay, and he ate mash only. Vet also recommended psyllium. He was allowed fresh green grass (lucky it was winter, so soft and wet). I kept him off hay for about 4 mos before slowly introducing it back in. To this day he still gets mash as his primary diet, with hay as he desires. The mash is a combo of beet pulp, alfalfa pellets, timothy pellets, TC Senior, psyllium, magnesium.

One thing I’ve noticed is that he is keeping much easier now. He has put on weight and keeps it on. I was a little concerned about adding alfalfa hay back into his diet (as opposed to pellets/cubes which are soaked) but he is doing just fine. I am just careful to source out hay that is soft and not coarse stemmed.

BritishEquestrian · August 27, 2020, 6:22am

[QUOTE=Obsidian Fire;8389348]
Yes. When we treated my boy for suspected (occult blood test) hindgut ulcers, we removed all hay, and he ate mash only. Vet also recommended psyllium. He was allowed fresh green grass (lucky it was winter, so soft and wet). I kept him off hay for about 4 mos before slowly introducing it back in. To this day he still gets mash as his primary diet, with hay as he desires. The mash is a combo of beet pulp, alfalfa pellets, timothy pellets, TC Senior, psyllium, magnesium.

One thing I’ve noticed is that he is keeping much easier now. He has put on weight and keeps it on. I was a little concerned about adding alfalfa hay back into his diet (as opposed to pellets/cubes which are soaked) but he is doing just fine. I am just careful to source out hay that is soft and not coarse stemmed.[/QUOTE]

But what do you feed as a substitute for hay in the stable? She can be turned out in the day but not at night - we do soak her hay & sloppy feeds etc.

Had her on a weeks gastro guard to see if it could be stomach ulcers but perhaps a little imrpived girthyness but no improvement when ridden - ears flat back every time I ask for bend or a transition, swishing like mad and just keeps stopping then refuses to walk but definitely pain related - not back/teeth/saddle. Vet is also suggesting hormones but never had her being mareish or noticed her in season so personally not convinced!

Obsidian_Fire · August 27, 2020, 6:23am

[QUOTE=BritishEquestrian;8393308]
But what do you feed as a substitute for hay in the stable? She can be turned out in the day but not at night - we do soak her hay & sloppy feeds etc.

Had her on a weeks gastro guard to see if it could be stomach ulcers but perhaps a little imrpived girthyness but no improvement when ridden - ears flat back every time I ask for bend or a transition, swishing like mad and just keeps stopping then refuses to walk but definitely pain related - not back/teeth/saddle. Vet is also suggesting hormones but never had her being mareish or noticed her in season so personally not convinced![/QUOTE]

At first I didn’t “replace” the hay. (and gastrogard will do NOTHING for the hindgut and could make it worse).

Hay pellets, and beet pulp, all digest in the hindgut. What they say regarding hind gut issues, is to let the colon “rest” by not putting so much bulk thru it.

Think of pellets as pre-digested hay. It’s finer than even the horse can chew it. The psyllium is great as it pulls along moisture with it, which helps the intestinal mucosa, which is what coats the intestinal wall, which soothes the inflammation and allows it to heal.

I fed 4 meals a day. Sometimes he didn’t even clean it all up. He maintained weight just fine.

You don’t need to worry about “replacing” hay at this point because feeding pellets/beet pulp is basically the same thing to the horses gut. Be sure to get rid of any grain as that can be very irritating.

After a couple of months I did add in thoroughly soaked hay cubes, to give him some ‘chew’. Honestly tho my horse doesn’t like cubes.

Eventually I replaced his lunch meal of mash with hay, I started out still giving him his mash but a handful of hay just for fun, and gradually reduced the mash and increased the hay.

What I said about 4 meals a day - my boy was in a paddock and not out to pasture, only grazing during the time I was at the barn to supervise him. If your horse has GOOD pasture all day long, then that is the best scenario. What is your barns feeding/turnout schedule like?

This is what my guy eats: Haystack special blend pellets (a pre-mixed pellet of beet pulp, timothy, alfalfa, rice bran, flax, canola oil), Triple Crown Senior, psyllium pellets, magnesium, salt, smart pak smart digest ultra, hoof supplement, equis ultramin (vitamin supp), vitamin e/selenium supp, brewer’s yeast. About 8 lbs alfalfa per day, plus grass hay both local and eastern oregon, soft stemmed (meaning, not first cut. I look for 3rd or even 4th if I can get it).

My other issues with him are he’s older, a TB, and has poor teeth.

keysfins · August 27, 2020, 6:25am

[QUOTE=Obsidian Fire;8393806]
At first I didn’t “replace” the hay. (and gastrogard will do NOTHING for the hindgut and could make it worse).