So as there have been a slew of ulcer-related posts lately, I am going to compile all of the “need to know” information into one place.
Diagnosis
First, as most ulcer symptoms are a bit vague and could be a lot of different things, you should always get your horse scoped. This also helps with developing a treatment plan and knowing whether your horse has a mild case or a severe case. In case you aren’t aware of how vague these symptoms can be, they include but are not limited to: sluggish, poor performance, behavioral changes, spookiness, grumpiness, dull coat, girthyness, sensitivity on belly, colic symptoms, mild/prolonged colic, excessive lying down, going off feed, and the list goes on indefinitely. So, scoping or at least a proper diagnosis by a vet should be given before heading into the treatment and management phases of ulcers (because ulcers are expensive and it’s better to know you’re putting money in the right place than barking up the wrong tree).
Treatment
As most people know, who have given advice on ulcers, I am a scientific-based person so I am a Gastrogard/Ulcergard person. They are the only FDA approved treatment and preventative medications for ulcers, therefore have efficacy studies proving their results. Ranitidine is also used for treatment but has less efficacy than Gastrogard/Ulcergard. There are multiple other omeprazole-based treatments, including one by horseprerace and Abprazole and so on. Their efficacy has not been tested but some on here have had pretty good results. I would like to note that with all omeprazole products, the horse should be tapered slowly or they can experience an influx of acid in the stomach.
If you are working with a vet, as advised in the diagnosis section, you will go over a treatment plan. I wound up doing 28 days of a full tube, 14 days of half a tube, and 14 days of a 1/4 tube.
Feeding
Your best bet is to do as little grain as possible as grain causes an influx of acid in the stomach (causing ulceration in the foregut) and might not be completely broken down in the foregut (causing ulceration in the hindgut) unlike forage, which brings an influx of saliva into the stomach and acts as a natural buffer against stomach acid.
Forage should be fed at 1-2 lbs per 100 lbs of body weight. That means that a 1000lb horse needs 10-20 lbs of hay or grass a day. I try and lean towards 2lbs as long as the horse doesn’t gain too much weight. If the horse is hoovering down it’s hay you can use as slow feeding hay net easily purchased online through the big tack shop companies (this is also good if you need to feed less hay for a horse that is gaining weight).
Oat Hay 22.1% NSC
Barley Hay 20.4% NSC
Alfalfa Hay 11.3% NSC
Bermudagrass Hay 13.6% NSC
Grass Hay 13.8% NSC (not sure what “grass hay”)
Grass Pasture 12.1% NSC
As for feeding, since your horse will be provided with pretty much all of the NSC s/he needs through the hay, you should aim towards an NSC feed (NSC means non-structural carbohydrates, in short: sugar and starch). The biggest culprits in feed, behind the obvious (molasses) are the cereal grains:
Corn: 73.3% NSC
Barley: 61.7% NSC
Oats: 54.1% NSC
Wheat Middling: 32.0% NSC
Wheat Bran: 31.1% NSC
Rice Bran: 21.2% NSC
The lowest NSC percentages are from the forage category, along with soy.
Soybean Meal: 16.2% NSC
Beet Pulp: 12.3% NSC
Alfalfa Cubes: 10.2% NSC
Alfalfa Pellets: 9.3% NSC
Soybean Hulls: 6.3% NSC
I don’t actually advise L/S feeds unless you have an IR horse as they could be too low in NSC for a normal horse (thus depriving your horse of a properly balanced nutrition although we think “NSC BAD” NSC’s do play a vital role in a horse’s well being) but these are fairly low. I would also note that most horses do well on NSC ranges below 25%, I like to keep ulcer-prone horses between 10% and 20% so as to not spike the blood sugar or deprive the body or the “steady flow” of NSC the horse has been getting through it’s hay. So a few of the NSC grains from the “top” grain companies are:
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Purina Strategy Healthy Edge (17-18%) - Wheat Middlings, Dehydrated Alfalfa Meal, Ground Soybean Hulls, Cane Molasses, Dried Beet Pulp
Purina Ultium Competition (15%) - Wheat Middlings, Ground Soybean Hulls, Dehydrated Alfalfa Meal, Cane Molasses, Dried Beet Pulp - Purina Equine Senior (17%) - Wheat Middlings, Dehydrated Alfalfa, Cane Molasses, Ground Peanut Hulls, Dried Beet Pulp
- Triple Crown Complete (20.6%- a little high IMO) - Shredded Beet Pulp, Cane Molasses, Whole Oats, Soybean Oil, Dehulled Soybean Meal
- Triple Crown Senior (11.7%) - Alfalfa Meal, Wheat Middlings, Shredded Beet Pulp, Soybean Hulls, Cane Molasses
- Pennfield Fibergized (12%) - Wheat Middlings, Dried Molasses Beet Pulp, Soybean Hulls, Cane Molasses, Soybean Meal
- Penfield Fibergized Omega (12%) - Wheat Middlings, Soybean Hulls, Dried Molasses Beet Pulp, Cane Molasses, Soybean Meal
- Pennfield Ultra Senior (19%) - Wheat Middlings, SuperFlake® Barley, Dried Molasses Beet Pulp, Soybean Meal, Soybean Hulls (the next ingredient was cane molasses)
- Buckeye Nutrition Safe n’ Easy (12.5% pelleted) - Soybean Hulls, Wheat Middlings, Oat Mill By-Product, Heat Processed Soybeans, Dehydrated Alfalfa Meal
- Buckeye Nutrition Safe n’ Easy (16.5% texturized) - Soybean Hulls, Wheat Middlings, Whole Oats, Soybean Meal, Dehydrated Alfalfa Meal
- Buckeye Nutrition Senior (16.2% pelleted) - Soybean Hulls, Wheat Middlings, Ground Corn, Oat Mill By-Product, Heat Processed Soybeans
- Buckeye Nutrition Grow n’ Win (13%) - Dehulled Soybean Meal, Heat Processed Soybeans, Wheat Middlings, Maize Distillers Dried Grains, Dehydrated Alfalfa Meal
- Buckeye Nutrition Grow n’ Win Alfa (16%) - Soy Hulls, Wheat Middlings, Heat Processed Soybeans, Ground Corn, Maize Distillers Dried Grains
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Blue Seal Trotter (20.1%) - Dehydrated Alfalfa Meal, Soybean Hulls, Wheat Middlings, Cane Molasses, Oat Mill By-Product
This is just a short list, click here or click here for more information on NSC grains. They’re a bit out-dated in part, but are fairly well put together lists.
Some horses don’t respond well to soy, and may do better on a beet pulp and alfalfa cubes/pellets mix with added vitamins and minerals rather than a feed concentrate.
Alfalfa is also the staple of an ulcer-prone horse’s diet because it’s high in calcium and is theorized to act like tums on the equine stomach. This also means that you need to be aware of your horse’s phosphorus intake as the horse’s calcium : phosphorus ration should be 1:1 or 2:1. Phosphorus can be added through rice bran, the lowest NSC of the “cereal grains”, or by adding the proper supplement for what your horse needs.
Management
So once you have the diagnosis, treatment, and feeding down; then comes management. This is the hard part. An ulcer prone horse can develop ulcers in as little as 3 days in response to stressful situations. The problem is identifying what your horse’s stressors are. Common stressors can be, but are not limited to: moving barns, horse shows, leaving the farm for any reason, stall/pasture buddy leaving/moving, positional change in the herd, more intense training, being put into private turnout, being put into group turnout, and I could go on forever with this list. The point is, you need maintenance care.
Some people keep their horses on a low dose of omeprazole, or a product like SmartGut Ultra (I’m a big fan of SmartPak products simply because they have a 100% happiness guarantee). There’s also SUCCEED, U-Gard (and U-Gard Pellets), Neigh-Lox (and Neigh-Lox Advanced), TractGard, U-7 Gastric Aid, Grand Digest, Allay, Level pH, and more.
If your horse is going to be under stress for a few hours (say traveling to a clinic, being ridden, and going home), your best bet is Ranitidine given and hour before load-up and given every 8 hours until your horse returns home. For particularly anxious horses you might be advised to dose the horse onces the night before for maximum efficacy.
If you are traveling for an extended period of time or moving to a new place, take care to provide your horse with omeprazole during the whole endeavor. I have always been told to give half a tube a day for three days before travel and continue until three days after returning home (taper to 1/4 tube for the 3 days at home at the end of the endeavor). If this is a move to a new barn, you may need dose for longer. Three days beforehand, and then up to a week or two once arrived and settled in at the new barn, depending upon the horse. Make sure to always taper off omeprazole for the above stated reasoning in the “treatment” section. You may also need to treat with ranitidine or omeprazole when making big changes at the barn for the horse such as switching stall buddies or pasture mates or starting heavy training.
Ulcer horses should also be kept out as much as possible with forage available 24/7. As state above the saliva helps to coat and protect the stomach from the stomach acid; being outside also reduces stress. Being confined to a stall is considered “stressful” to a horse and can agitate ulcers. For an ulcer-prone horse that is required to stay in for long periods of time, having hay free-choice and toys can be a stress reliever.
Final Notes
Ulcer horses are complicated. They’re like balancing a pyramid upside down. You’ll constantly have to tweak your “program” for your ulcer-prone horse and just when you think you’ve got it right, s/he’ll decide to get ulcery just because s/he can.
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disclaimer
[INDENT]I am in no way a veterinarian and advise seeking a professional opinion before doing any treatments or ulcer care. This is all accumulated knowledge from research and experience and in now way the “only way” of dealing with an ulcer-prone horse. I am also in no-way responsible for a horse owner’s lack of judgement in treating ulcers after reading this column, or the death or injury of a horse based upon information provided here (whether followed correctly or not).[/INDENT]
