Ulcers

[shadesofbay3]

if you suspect ulcers… is it always necessary to scope for them before treating them? since the treatment is ulcer/gastroguard regardless, would it be okay to just treat proactively for ulcers w/o scoping?

i know we did that w my horse a few years ago, but not sure if my current vet would do that… she just had to come out for a late night visit tonight for my horse bc she was colicky, so i’m going to run this by her tomorrow. my horse has been though a lot of medical procedures lately, so if i can avoid her going through another procedure i’d like to do that

also - what supplements do you all use to support GI tract? again, will run by my vet, but am looking at smartdigest by smartpak

[leesa1]

It’s only necessary if you want a guarantee that they’re in there or a guarantee that the problem can’t have been ulcers if the issues remain after you dose her. For me personally, that means yes a scope is necessary.

One treatment doesn’t always cure ulcers either so after you dose her you don’t really know if she:

• had ulcers at all
• had ulcers and they were treated but the issue remains so the cause is something else
• had ulcers but one treatment didn’t do the trick and she needs another, but because the treatment “didn’t work” you may give up on the theory of ulcers and look for another cause
• had ulcers and they’ve now been solved so you can stop spending more money

Me personally, I’d scope if I suspected ulcers. It’s not far off the cost of treatment and once it’s done it’ll lead to one of two courses of action:

1. stop me spending any more money on ulcers being a possibility, or
2. confirm that there is actually a problem in there that needs pursuing.

[Amy3996]

@shadesofbay3

if you suspect ulcers… is it always necessary to scope for them before treating them? since the treatment is ulcer/gastroguard regardless, would it be okay to just treat proactively for ulcers w/o scoping?

Scoping is best practice. You don’t have to if your vet will prescribe GG without a scope first, but not all cases of ulcers are as simple as “28 days of GG and we’re good to go.” Other medications (misoprostol/Sucralfate) might be indicated in addition to or instead of GG depending on what type of ulcers are found, where, and the severity. IMO, it’s well worth the $250-$350 to scope if it means you’ll find that you don’t need to spend $1200 on GG in the first place.

As for supplements - Purina Outlast for ulcer prevention/ Mad Barn Visceral+ for GI. I personally haven’t had luck with anything from SmartPak for ulcers/digestive issues. What else is your mare being fed?

[js]

I have my horse on Sucralfate powder and U-Gard. We did scope to confirm before starting him on treatment though. Succeed is also a good treatment. Talk to your vet and see what they suggest.

[IPEsq]

Scoping is best, but I don’t always scope. Some examples why: Current horse had a mild colic where all diagnostics were normal. He’d been under stress and pain (we were trying to diagnose what that was about), and he’d also had a steroid injection, which in hindsight, he does seem to be sensitive to steroids. Due to the colic, vets thought that the stress of fasting and scoping would not be in his best interest, so idea was to try treatment for ulcers to see how he did. He didn’t colic again, but he also didn’t really improve. Because we had a big move coming up as well as a fire evacuation, I just kept him on Gastrogard for a couple of months. After the move, vet in new location thought his stomach was still NQR and suggested adding sucralfate 2x a day, with weaning off Gastrogard with a dose midday. After a few days, he became more relaxed and less spooky. We then started making more headway with his other issues. I still don’t know if he ever had ulcers, but he seems good now, a year later!

Previous horse I did scope initially. He had barely discernible grade 1 lesions in the stomach. Gastrogard was life changing for his behavior. He seemed to be seasonally sensitive in spring and fall and also sensitive around steroid injections. Based on his extreme sensitivity, we subsequently would just treat (or adjust preventatives when triggers were identified), because we did not expect a scope to reveal much. I suppose if he ever seemed to not respond to treatment in a predictable way, I would have scoped again.

I do know some horses with difficult ulcers that have taken months and different drugs to heal, requiring several scopes. Given that your horse has been through a lot, it would be reasonable to treat without scoping, same as why my vets and I didn’t want to stress my colicky horse with fasting and scoping.

[shadesofbay3]

Exactly. My inclination is to treat without scoping, however this morning after her policy episode last night she is pretty much back to normal (knock on wood), which my vet says is less likely an ulcer issue and more likely due to the factt that she had a CT scan yesterday.

I would prob just treat regardless instead of putting her through more procedures, since the outcome is the same regardless. It is such a double edge sword though

[Helicon]

Omeprazole is one of the most commonly sold medications for humans on the market. This is because digestive upsets are common. In human medicine it is not necessary to have a scope every time you have gastritis. I believe horses also get gastritis from stress, going four hours without food, or lack of grazing. I have not done a scientific study to confirm this, so this is just my opinion based on my observations of caring for horses for the last thirty years.

I do think if you do treat the horse with omeprazole and he is refractive to the treatment, then you might want to do a scope to figure out exactly what is going on. Even a scope does not see everything, as there are areas that it does not see and if no ulcers are found, how can you tell if you just have a horse that is sensitive to gastritis? If you find ulcers on the scope you know you have to continue treatment or your vet may try other drugs like misoprostyl or sucralfate. Some horses do not get better from one round of treatment, especially if they are in chronic pain from another issue.

I have had stomach ulcers myself and they were horrible to experience. The bad part about omeprazole is that it is addictive - in that I found it very hard to get off it after being on it for two months (maybe not addictive in the literal sense but in the practical sense). My gastroenterologist encouraged me to just stay on it, which I did not want to do either. I ended up using ranitidine to help get through the rough spots, which ultimately worked for me. Unfortunately ranitidine is off the market now (at least for humans; I am not sure about horses).

[leheath]

Previously, I was in the “skip the scope and just treat” camp especially if I had seen the same symptoms in the same horse in the past and treatment had worked. Now I’m more in the “scope first and know what you are dealing with” camp.

Current horse developed symptoms that seemed to be from ulcers shortly after I bought him. GG seemed to initially work then didn’t. Got scoped…he had bot fly larvae in his stomach (plus ulcers) and I had been holding off worming because I thought he might have had ulcers and didn’t want the harsh wormer to make them worse. Without scoping, I’d never have known. He also needed 2 months of GG and sucralfate to fully heal the ulcers even after he was wormed to get rid of the larvae.

My other horse had ulcer-like symptoms…gave a round of GG and she got worse…she had hind gut issues and the omeprazole exacerbated them.