The ulcer dilemma

[Kambcba]

Back story. Last March my mare lost her pasture mate, we moved barns and she was separated from her other pasture mate, all in the space of a week. She was upset, unsettled and almost unridable for nearly 8 weeks. She started sowing mild symptoms of ulcers. Mildly girthy (shifting her weight and tensing) and became very sensitive to my leg under saddle. She lots loads of weight but I put this down to constant pacing in walk and trot for weeks on end. Due to the stress she’d been under, I had her scoped. No ulcers were found. Although the vet did remark that she has an odd shaped stomach and there was a small area they could not see.

She was treated anyway. (Sucralphate). While I saw an improvement in her behavior, she was also settling into her new routine and barn and was put back into regular work. Did she have ulcers that were not found? Was it hind gut ulcers? Was is behavioral?

Another barn move in September. This time with the same pasture mates. She was so much more settled this time. But she did become sensitive again. No where near as bad as last time. Unwilling to extend in trot, trying to pop into canter instead. Some days she didn’t flinch doing up her girth, other days she shuffled around.

Mentioned to the vet and was told, “well she was clear when we scoped her 6 months ago.

She was then kicked and has just had two months off work. When I started riding again I noticed mild girthiness and she has been very sensitive to my leg. Slightest pressure and she pins her ears, tosses her head and tries to canter instead of extend. I continued riding 3 or 4 days a week thinking she was being naughty after 2 months off. But have been questioning ulcers.

So I experimented. I gave her 130ml of Mylanta at 7.30am and another 130ml 1 hour before I rode. Didn’t flinch when I did her girth up and was NO WHERE NEAR as sensitive to my leg. I actually made it several times around the arena in trot without her popping into canter. But I’m not sure if she’s just getting better because she is getting back into work again.

To me this tells me she has ulcers. I’m experimenting again today with just one dose of mylanta an hour before I ride. If she’s good I’ll not dose her for real next ride and see if she’s sensitive again.

She eats mccauleys Alam, outlast and daily gold. She has access to a lot of hay. There may be a few hours without but it’s only a few hours at the most. She’s a great weight, not moody and her coat is shiny and healthy.

Thoughts please?

[JB]

I’d say she is telling you a lot more than your vet who thinks a clear scope 6 months ago means anything today.

How much Outlast, and how many times a day?

I think your plan for dosing and riding, not dosing and riding, is a good one.

Sucralfate will coat ulcers/lesions, to allow them to heal. Outlast will raise the stomach pH above 6 for around 6 hours, which is why it’s recommended to feed 4x a day. If you can’t feed it 4x, then you can give another serving as you take her out to groom, which should help the pH while you ride.

Or, you can go with the Nexium/esomeprazole protocol for a month and taper down.

[Kambcba]

3 measuring cups of outlast a day. 1 and a half cups AM and same for PM. I do not have the option to feed 4 times a day (I wish lol). I will certainly try giving her some before riding. I will add it to a handful of alfalfa pellets.

I have been reading about a new product by Tribute. Constant Comfort. It has the same ingredients as outlast plus some extra and it also contains pre and pro biotic, which outlast does not have. They also offer a block that horses can nibble whenever they want. Thinking of changing from outlast to that.

Also had a lot of people suggest aloe Vera so I’m looking into that.

I do wonder if it’s more of a stomach acid thing rather than actual ulcers. Much like us getting heartburn or reflux. Her symptoms are not severe and can be worst or better from one week to the next.

While I appreciate that a clear scope 6 months ago means nothing now she is having the exact same symptoms. If they were different or more severe I’d be arguing with the vet. But I see her point. She’s doing exactly what she did 6 months ago and no ulcers were found. And 6 months ago we honestly expected her to be full of ulcers from the stress and being so upset and unsettled for 2 months. She has not been upset or unsettled since that time.

She’s pleasant, she’s happy, she’s eating etc etc , I can groom her. It’s just an occasional slight brace and feet shuffle when I do her girth up and this sensitivity to my leg.

I will keep experimenting

[JB]

@Kambcba

I have been reading about a new product by Tribute. Constant Comfort. It has the same ingredients as outlast plus some extra and it also contains pre and pro biotic, which outlast does not have. They also offer a block that horses can nibble whenever they want. Thinking of changing from outlast to that.

I have seen/heard mixed results with the Constant Comfort, including in contrast with Outlast, so you’ll definitely have to just try and see how it works for her.

@Kambcba

I do wonder if it’s more of a stomach acid thing rather than actual ulcers. Much like us getting heartburn or reflux.

But horses don’t reflux (or if they do, they are really sick!), and their stomach is designed for having constant acid production (though not with forced exercise lol). I’m not sure it’s been proven that a horse can have acid either too acidic (it’s down to 2.0 or less near the pyloric valve, and higher as it gets up closer to the non-glandular region), or even too much volume of stomach juices. I suppose it’s possible that it could be more acidic than usual near the top? I’m not sure on that.

[Kambcba]

I know they don’t get reflux lol. Was just referring it as an example lol.

If she was showing mild ulcer symptoms but scope was clear then what is it

I’m going to do my Mylanta experiment a few more times. Then I’ll try a grass pellet and outlast (or constant comfort) mix before riding.

Thank you for your replies.

[Kambcba]

@JB

I have seen/heard mixed results with the Constant Comfort, including in contrast with Outlast, so you’ll definitely have to just try and see how it works for her.

It’s only been available since September so it’s hard to find much info or many reviews about it. But it can’t do any less than outlast with all the same ingredients and it has the added pro and pre biotic s which can surely only help.

[JB]

@Kambcba

If she was showing mild ulcer symptoms but scope was clear then what is it

It can be hind gut issues.

Was the scoping done on an empty stomach so you could see all the way into the pyloric valve?

@Kambcba

It’s only been available since September so it’s hard to find much info or many reviews about it. But it can’t do any less than outlast with all the same ingredients and it has the added pro and pre biotic s which can surely only help.

Except is does do “less” for some horses. That’s what I meant. A friend has had 4 horses on Outlast for a few years, and has done the whole on-off thing which proves the Outlast is what keeps them all happy. She put all 4 on CC (the pellet, not the block), and while 3 of the 4 have remained happy, #4 went back to unhapy.

The same ingredients don’t mean the same amounts. I’m unclear, but I don’t think there is any research proving what CC is capable of doing, like there is with Outlast.

Simply adding more pre/probiotics doesn’t always benefit, and in some cases, can cause problems. It could be that’s what upset #4 above, or it may be that the general overall makeup of the product just didn’t do what Outlast does for her.

[Kambcba]

@JB

Was the scoping done on an empty stomach so you could see all the way into the pyloric valve?

Yes.

[Kambcba]

@JB

Simply adding more pre/probiotics doesn’t always benefit, and in some cases, can cause problems. It could be that’s what upset #4 above, or it may be that the general overall makeup of the product just didn’t do what Outlast does for her.

We can only try. We will see. No issue with going back to outlast.

[Bogie]

My mare was treated last year for ulcers and scoped clean after treatment. Moved barns when I broke my ankle and she got some time off. The move made her anxious and when I started riding again she was showing ulcer signs again. I’d been giving her Gut-x and Outlast, but putting her back on Sucralfate has made her a lot more comfortable. Makes me wonder if she could get by with just that . . . Definitely your horse knows more than your vet about the state of her stomach!

[FitToBeTied]

Scoping doesn’t tell you anything about the hind gut. We have a barn full of OTTB’s and we know from studies that 90% that come off the track have ulcers. Our process is to use Alber Omeprezole once a day and Abler Sulcralfate twice a day (one hour before feeding) That has kept them all clean and a relatively low cost.

[GraceLikeRain]

@Kambcba

So I experimented. I gave her 130ml of Mylanta at 7.30am and another 130ml 1 hour before I rode. Didn’t flinch when I did her girth up and was NO WHERE NEAR as sensitive to my leg. I actually made it several times around the arena in trot without her popping into canter. But I’m not sure if she’s just getting better because she is getting back into work again.

To me this tells me she has ulcers. I’m experimenting again today with just one dose of mylanta an hour before I ride. If she’s good I’ll not dose her for real next ride and see if she’s sensitive again.

This seems like a really great way to get more information. I’m surprised your vet was dismissive. The stomach is far more dynamic and a clean scope a week ago doesn’t mean you don’t have ulcer today.

[Maude]

How much Abprazole do you use? My horse has chronic pyloric ulcers that will never heal. Bad ones. I now give her 1 packet at night check in a very small amt of Triple Crown Sr. AM she gets Sucralfate and Outlast. Outlast before riding with hay, and Outlast in PM feed. This helps alot. I’ve contemplated going up to 2 Abler a day. There is no point in scoping her for a 6th or 7th time. I think now in retrospect that I have bern giving her more energy than she needs. She only gets 1 qt TC Sr am & pm, but I was also giving her 4 Oz of Buckeye Ultimate Finish 40% twice a day. I’ve cut the Senior and zfat supplement is half and seen a change in her demeanor. Or, is it a mare thing and she’s finally in anestrus…

[JB]

@Maude

How much Abprazole do you use?

It’s omeprazole, so you need to dose like UG/GG. Abler has the dosing instructions on their site, based on the horse’s weight. An average horse gets 3 satchets a day, or 1 tube a day if using the paste.

So, 1 packet/satchet a day is a prevention dose for an average horse

Omeprazole also isn’t very good with most pyloric ulcers, You really may need misoprostol in addition.

If you’re only feeding 2qt of TC Sr (around 2.20lb) then I’d switch to a ration balancer.

If you want to try a soy-free option, try Triple Crown Balancer Gold, or Tribute Wholesome Blends Balancer

[Maude]

Yes. She has also had squamous ulcers. 8 months of Misoprostol didn’t change the scoping. The 1 pkt of Abler is to try to suppress a bit of acid production.