Equine Stomach Ulcers, Diagnosis Continued

So, I lied. Well, I didn't lie, I was just incorrect in my outline. I was supposed to talk about whether or not to scope in the last post and then I forgot. Apologies. There are two ways that you can diagnose ulcers clinically. First, you can have the horse "scoped", which is a procedure in which the vet runs a 3 meter long endoscope through the nose, and then into the stomach, and examines the lining of the stomach. Second, you can treat the horse for ulcers for a short amount of time, and if you note improvement in the behavior, then assume there are ulcers and continue treatment.

Personally, I think the scope is a valuable tool, in certain circumstances. If the horse is colicing on a regular basis and waiting it out isn't wise, if the behavior is genuinely dangerous, or if there is another situation where you absolutely need to know. Also, if your horse is insured and you plan to file a claim, and thus money is somewhat less of a concern, it's great to be able to re-scope after treatment so that you can see if they have been cleared up or not. (Note: if you do choose to file a claim, remember that the insurance company will then put an exclusion on the stomach, so colic surgery will not be covered until you can get the exclusion off the policy) If the horse's health is at stake, if YOUR health is at stake, if you just really need to know, the scope is the way to go. However, if you are considering that your horse has ulcers because of behavioral issues that are more minor, you might consider treating the horse for a few days to see if there is a response. I have found that within 3 days of full-dose gastrogard, I can see a significant improvement, but some horses take longer. Of course, you can take the combination approach and treat the horse for a few days, and then decide based on the improvement or lack thereof if you want to scope.

If you do choose to scope, the procedure is as follows: the horse will have to fast prior to the procedure, generally about 12 hours, but different vets like different amounts of time. Be sure to follow your vet's recommendation on this. You can either sweep all the shavings out of the stall or leave the bedding in and put a muzzle on. I favor the muzzle approach not only because it means less sweeping and shoveling for me, but also because after that amount of time with food, most horses are grumpy and the muzzle means they can't bite. I have the bucket-style muzzle, I think most of them will work. You will also have to withold water from the horse starting 4 hours prior to the scope. The fasting, I think, is the major downside to doing this- having an empty stomach is very stressful to the horse and will exacerbate any ulcers that are there. There's certainly that trade off to consider.

Ulcers Part 2- Diagnosis

I remember the first time I thought my horse might have stomach ulcers. I was perched on top of a stepstool, brandishing my clippers at Lego, who at that time was alternately trying to bite, kick, and body slam me against the wall of the wash rack. I located two strong men, who held up a leg to try to keep him still, twitched him, and ran a chain through his mouth, so that I wouldn't get hurt...again. As I was trying to get at the left ear, always his least favorite, the man holding the twitch and the chain mused, "I wonder if his stomach bothers him..." In my time owning the horse, he had hurt me so often that it was a running joke in the barn that when I rode him, the midget toss began. The spook, spin, and tear off bucking got me every single time, and the horrible behavior on the ground just kept getting more aggressive. I was trying to sell the bastard, but I thought I would give him one chance, so I booked an appointment to have him scoped. Now, that was the first time I treated him for ulcers. I probably went through it ten more times after that, and I became the go-to 'ulcer person' in my barn of 80 something horses, so I learned to look for the more subtle signs. It's far better to catch them early than to wait until the horse is turning himself inside out because of the pain.

Now, here comes the part that is completely unvalidated by any kind of study, but most horsemen will agree- not every horse is bothered by stomach ulcers. Studies do show that the vast majority of performance horses have stomach ulcers, as do many foals, but not every horse shows discomfort. For some, they are just there, and they don't cause them pain or poor digestion to any degree that we can tell. You can, of course, treat these horses, but the horse does need stomach acid for efficient digestion. Over treating an ulcer means not enough stomach acid, so the food doesn't get broken down, and it ferments in the hind gut and causes an ulcer there. So, if your horse is not showing symptoms, but a scope shows an ulcer, consider just turning a blind eye to the endoscope screen and look at a happy healthy horse instead.

However, if you are reading this page, chances are that your horse isn't one who has an ulcer that does not bother him. (Note, for purposes of this series, I am assuming a male horse, they affect mares just as often) I tend to think of symptoms of ulcers as being split into two categories: Behavioral and Physical. Behavioral problems tend to stem from the pain of the acid on the raw stomach lining, whereas physical problems come from the decreased digestive efficiency.

Behavioral problems run a whole span from a reluctance to go forward under saddle to bolting. Trying to make a list of them is impossible, but when a horse is in pain, they will generally show it in some way. I will say that horses tend to react differently to ulcer pain than they would to pain from a lameness or a cut or something of that nature, so consider it a separate matter. If your horse's behavior on the ground or under saddle suddenly takes a turn for the worse, consider that they may have an ulcer. Often, symptoms are worse when they are being ridden because stress causes an increase in acid production, which means pain. Any other situation that is stressful will have the same effect, so trailering, showing, visits from the vet or farrier, etc. all can be times when the pain is more severe. All of that said, there are certain behaviors that are particularly indicative of an ulcer:
  • Grinding Teeth
  • Girthiness- I think it is the combination of something on their stomach and the anticipation of being ridden that causes them to object to the girth when their stomach hurts.
  • Cribbing during or after feeding
  • Objection to grooming over the stomach
  • Poor Appetite
The physical signs, however, are much more clear cut, and thus they don't require an excessively wordy explanation on my part.
  • Hard Keeper
  • Dull Coat
  • Frequent Colic, often mild
Will treating your horse for stomach ulcers turn a rank horse into an angel? It's unlikely. Will the elimination of pain eliminate the behaviors that are caused by pain? Yes. It's impossible for us to know which bad behaviors are caused by pain and which are just bad behaviors until we eliminate the pain, but doing so can make a difference in horses who are hurting and acting out. As for the physical symptoms, I have noticed huge differences in the amount of food horses need to eat to maintain condition pre and post treatment. If you have a very hard keeper who never looks good no matter what you do, he's probably not utilizing his food well, and an ulcer is a very likely reason.

Equine Stomach Ulcers, Part 1

Hello everyone. Sorry about the silence- my big bay horse is done with his show career, and the process of moving him out to the back 40 and cleaning my show tack and putting it away in the trailer has not had me in a writing mood. However, I know that stomach ulcers are a scary thing for a horse owner to deal with, and having been there and done that, I thought it might be nice to share what I do know with the public. And so my writer's block vanishes.

Now, to get this out of the way: I am not a vet. I never have been one, I don't have an animal science degree, I did not even stay at a Holiday Inn last night, so please take any commentary of mine with a big grain of salt. Possibly dig out the rock salt that you bought for making ice cream- you know you're never doing that again. Making ice cream is just not a good plan, in my opinion. It always turns out with this weird texture that is like if you threw a milkshake in the freezer. Anyways, that is beside the point. I have no qualifications to dispense advice, consider me the nutty guy on the street corner who claims to have lost a leg in Vietnam, just for the love of god do not sue me. That is all.

I hope for my series to include:
  • Diagnosis- What are the signs of ulcers? Should you scope? What does the scope report mean?
  • Medicines- Why is Gastrogard so expensive? How long do I have to give it? Does it really work? What else is out there? Does THAT work?
  • Management Changes- What can I do to keep this from coming back? How on earth can I give my show horse a less stressful existence?
  • Supplements- What is in them and do they work?
  • Why the heck do you know all of this?
  • What worked for you?
I would love nothing more than to get some questions from the peanut gallery on this one. My big bay horse had recurrent ulcers, and I spent a whole lot of my life hunting down information and trying to treat them, so if I don't know the answer to your question, I can probably direct you to someone who does.
 

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