Ulcers? Gas, Crazy Gut Sounds, Belching

Horse has seen 2 different equine vets since symptoms started 1 week ago and will be seeing again. Looking for guidance on what I should be asking them about and for, stories, suggestions on how to make my horse feel better in the meantime.

Horse: 24 year old Thoroughbred gelding, retired pasture puff that is normally outside most (if not all)the time. Was being fed a diet of hay, soaked alfalfa pellets, and senior feed 2x a day. Normally very energetic/active, albeit anxious horse.

Symptoms: extreme gut sounds in the upper right hind belly (constant, can hear them from the aisleway, lots of bubbling, gurgling) that are very abnormal for horse, gas, occasional burping (smells like broccoli), water intake is scarily low (1-2 gallons/day), appetite for pasture grass is good, limited/no interest in senior feed and alfalfa mash, limited interest in hay. Normally a big eater. “Depressed,” low energy, laying down to sleep (not rolling at all, but lays flat out and will do it in the stall with you there, which is not normal behavior for him). No fever, no increase in respiration, no lameness. Still pooping regular poops a few times a day. During gassy periods, he is resistant to move around in the stall and will look back at his gut, but doesn’t have any other colic symptoms. He has colicked maybe 3 times in his life before- twice tubing some oil and water into him resolved the issue within hours, another time we thought he was going to die but before the vet could even drive here he passed gas and went back to normal. No extra sensitivity to his stomach being touched/rubbed.

Treatment so far: both vets spent a significant amount of time doing a full body external exam. He was tubed 2x. First time with oil and then water, 2nd time (2 days ago) several gallons of water, electrolytes, and silium (to aide if he had partial obstruction). Given injection of banamine. Bute and acid reducer given orally daily for 1 week now. Has 24/7 access to hay, alfalfa senior feed mash, warm water. Also had a blood test done- WBC high normal.

He’s very lethargic and under the weather. Vets were not sure on a diagnosis, but wanted to start with the acid reducer and see how he did. Does anyone have any similar stories? Suggestions for what I should be inquiring with the vet? I’ve been doing a lot of reading and it seems like his symptoms may potentially indicate ulcers, and that the vets can do a scope to look at those. Anything I can get him in the meantime to relieve gas or soothe his stomach?

Stomach ulcers and hind gut ulcers are two different things.

Stomach ulcers do not directly cause gas in the large colon.

You can scope for stomach ulcers and then medicate to reduce stomach acid.

You can’t scope for colon ulcers and they are not caused by stomach acid as that had been neutralized way earlier.

I would test for bacterial infection as well.

This does sound like a form of gas colic but finding the cause is the huge question.

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Mine did exactly what yours did including the “burp” and foul breath, also severely coliced and was found to have severe stomach and pyloric ulcers so his stomach wasn’t emptying! Took over a year of treatment and finally months of antibiotics to get him “normal” (well as normal as he will be ) . If I had t had him scoped and just treated for colic he probably wouldn’t be here today!

I had my guy on omeprazole long term (5ish months, IIRC?) and it caused hind gut ulcers which eventually caused a pair of gas colics (right dorsal colitis both times). His symptoms were that he went off of his feed - especially his grain, his hay to a lesser degree, he also got generally pretty lethargic (though not under saddle), then he started laying down A LOT. And not only laying down, but when it was time to get him for his ride I would have to yell and shout and jump around to convince him to stand up. I had no idea anything was wrong at the time, and he felt totally normal under saddle, so I chalked it up to a minor bug or he was just getting weird in a new way. But in hindsight, he was in pain and dealing with the gas colic for days before it became acute enough to warrant a trip to the vet hospital.

But no burping, no bad breath.

I would not “just treat” for ulcers. I would scope the horse and go from there.

Thank you all for your responses. The vet has been out again today and unfortunately the situations seems to be pretty dire. He expected him to have reacted better to the antacid a week in if it were ulcers and is now suspecting a herniated diaphragm. We’re heading to Ohio State tomorrow for a definite diagnosis. Hoping for the best, as it isn’t a surgery that a 24 year old horse would be a candidate for.

Hugs and jingles.