Unlimited access >

Ulcers despite proper treatment??

Hi Everyone. My horse recently was on a 35 day supply of Ulcergaurd proscribed by the vet. He seemed to be getting better. Was back to his normal happy personality, coat looked healthier, was happy to do his job as my hunter horse. The last week however he has fallen back into his ways acting as though he has ulcers again. Sensitivity to my leg, brushing, pins his ears when I get near his stomach. I am puzzled. He is on Aloe Vera, and the Smartpak brand of the ulcer prevention. Has anyone had experience with this? I thought the Ulcergaurd and prevention would be a sure fix.

Took me over a year to get my horses ulcers to a manageable level and they still flare up. Ulcers are a lifelong battle and only a scope can confirm they are gone. You can also have ulcers around the pyloric sphyncter as well as the stomach. Sometimes a regular normal ulcerguard treatment is not enough, and sometimes, like my guy, they have to live on omeprazole! Personally, I’d scope to make sure the ulcers are actually cleared up!

3 Likes

I’d try Omeprazole. I have seen some respond better to that than the UlcerGuard, though it really can vary according to the horse. And I agree about scoping. That’s the only way to really know what you’re dealing with, and where. He may just have to stay on UlcerGuard or Omeprazole as a life treatment.

1 Like

^^^This.

i also had an older gelding with hanging lipomas in the hind gut — something else to consider:)

1 Like

Ulcergard IS omeprazole. And as long as it’s being dosed at a full tube, it is the GOLD STANDARD in ulcer treatment.

OP, did you taper carefully at the end of treatment? Going from treatment dose to nothing will cause a rebound in acid production that will pop your ulcers right back.

Also, if the reason the horse developed ulcers in the first place isn’t mitigated, all the treatment in the world won’t keep them them popping up again. Take a good hard long look at his lifestyle. Is he getting enough turnout? Enough hay? What sort of hard feed? Etc etc etc.

There are also additional pathologies…like delayed gastric emptying syndrome…that make treating ulcers a very difficult proposition. Your vet can help there, but a new scope is a good place to start.

Good luck!

4 Likes

Have you scoped?

I’ve also found most vets around here do not follow Merial’s directions for ulcer treatment and thus they never truly heal. Merial says scope, min of 28 days of GG at a full tube a day then scope again. Even at that only about 85% of horses are healed. Are you giving a full tube of UG daily? I was under the impression the recommended dose of UG contained was lower mg/kg of BW of omeprazole than GG but I could be totally wrong as I’ve never used UG.

As others mentioned, the biggest issue is if you do not remove the root cause of ulcers, they will reoccur. This means making diet, management and environmental changes which IMO are typically harder to address than the initial ulcers.

2 Likes

Stress can come in a multitude of forms, it is the horse that decides WHAT is the source of his stress. It is the human who has to try to guess what it might be for each individual horse. Environment and care are the first and most obvious options. Training and riding methods, competitive stress, turn out when the horse is accustomed to being in training, infections, pain, the weather, the horse in the next stall are also candidates as sources of stress. Some of these things you can do something about, some you can’t. Just like some people, it can be the stress of life itself that is the root cause, stresses that everyone else handles just fine. Look deeper into your horse’s mind. Good luck.

2 Likes

Ulcergard is exactly the same as Gastrogard, with different labeling directions. Many vets use them interchangeably with the direction to give a full tube of either to treat.

2 Likes

Ah okay. So did the OP give a full tube of UG or a 1/4 tube daily? That could make a difference in the effectiveness.

I had good results doing a 90 day course of Succeed. I used the paste but it also comes in a powder.

I am going to make this short, because I have written this story before. But the search function on this forum is lacking, so I’ll put it down again.

About a year ago, my 14 year old QH gelding was acting colicy. He is a modern QH, leggy and tall. He has no external stress that I can tell. He lives on my farm, has free choice hay or pasture grass. Is out in his 8 acre pasture with his buddy all day, and at night when weather is nice with free access to back door of stall. Works very lighly, and hauls out for lessons at most once a week. Hardly ever shows these days.

Took him to my wonderful vet, who said “that likes like ulcers to me”. We scoped him and sure enough, lots of stomach ulcers. Gave him 30 days UlcerGaurd, to the letter. Full tube a day. Expensive! Scoped again, and ulcers were healed.

Next, I did everything right, exactly as vet said. Tapered the UlcerGaurd. Put him on new diet with mainly alfalfa.

But a few months, later, same signs. This time, I did not take to vet. Gave him Banimine, and changed his diet again. Prior to the first ulcer incident, I had taken him off TC Senior (my feed store quit carrying it) and SmartGut (not sure of the name, the expensive one). So put him back on TC Senior. But importantly, I started him on low dose EquiShure, which is for hind gut. He does not get the recommended amout – he gets a bit less than half of that. Just once a day, mixed in his feed, which I have always watered. Thanks to this forum, I also started him on low dose Nexium mini caps. Just one capsule in his feed, once a day.

That was about 9 months ago. He is doing great. Is fat, and seems happy and comfortable,. I know these are low doses, but it made me a believer in hind gut issues and EquiShure to help with them. Note these are low doses, but it seems like all he needs.

ETA: It was SmartGI Ultra that he was on before his first colic-seeming incident. As I recall, it shares a hind gut protecting ingrediant with EquiShure. If I could not get TC Senior, I would put him back on the SmartGI Ultra I think.

2 Likes

Have you looked into making changes about daily care and routines? I’ve had to make changes that are less convenient for me but my horses are better. Went from stall board to a larger paddock arrangement; hanging hay bags and reducing grain and processed feed intake; adding a daily dose of liquid prebiotic; using acid buffers instead of full out blockers; there’s more, but you got the idea. I’m interested to know how it is going? Ulcers and ulcer-like symptoms are something many of us have to work through, any insight is appreciated. I"m still working on it.

2 Likes

Aloe and supplement preventatives can only help so much. The best preventatives are lifestyle changes: 24/7 turnout; free choice hay; alfalfa hay; removing corn and molasses from grain feed (Tribute Kalm N EZ is a good option).

I know it is omeprazole, but I still feel like the compounded omeprazole powder has been more effective for me. Could all be in my head, who knows; but I feel like it does a better job. :stuck_out_tongue:
also very true about needing to deal with the reason for the ulcers, not just symptoms.

I can’t find the article, but I read even something as simple as a herd change can cause horses to develop ulcers. I think it said that half a herd went to a new location so the other half had to establish herd ranking and that cause some of them stress.

Fwiw, Omeprazole was an expensive waste on my horse. Sucralfate fixed her up. Pre/pro-biotics, aloe, alfalfa, and regener EQ (for stressful times) keep her in good shape.

Just because a treatment is the gold standard doesn’t mean every horse read the research papers :smiley:

Scope the horse. I know everyone wants to save the money and hassle, but it really is important.

Gastroguard is not a sure thing. My understanding is that it is far more effective in non-glandular ulcers, and ulcers around the margo, than it is in glandular ulcers - like my horse’s pyloric ulcers.

After 9 months of Gastroguard full tube, Sucralfate, and Misoprostol, my horse’s pyloric ulcers only showed a small bit of healing on the scope.

It can also be easy to confuse symptoms of stomach ulcers and hind gut ulcers - and the treatments are, in some ways, the opposite of each other.

Hi everyone thank you for the advice! I have completely changed his diet. Have him alfalfa to help absorb acid, he is being scoped the 21st, and we will go from there. Have him on a slow feeder for hay, and keeping him on preventatives too for now.

1 Like

That is a lot different than saying compounded omeprazole is better than Gastrogard :lol: :smiley: :yes:

Thankfully, someone has actually looked at compounded products vs the real thing. @PercussionQueen here is the abstract: https://www.ncbi.nlm.nih.gov/pubmed/14649361 Note that 2 of the three compounded omeprazole preps were wholly ineffective. Only one tested was as effective as gastrogard (not better!) Here’s another one, showing compounded omeprazole ineffective compared to gastrogard: https://www.ncbi.nlm.nih.gov/pubmed/12387383

Sounds like you’re approaching it the right way, RyanAtlas! Keep us posted! :slight_smile:

Skimmed the thread so maybe you mentioned your feeding schedule and I missed it. Dexter had a recurrence of ulcers and I did a second 28 days of GastroGard with a two week taper after. Then added U7 twice a day for 60 days. He gets one scoop of that a day now and gets Purina Outlast with his morning and evening feedings. The study report on Outlast says it buffers several hours longer than alfalfa. He also gets a scoop of equishure in the morning and in the evening. Giving him free access to something to keep him chewing is essential as is several smaller feedings a day as opposed to two larger ones.

Hope your horse improves soon!