Equine balanced veterinary care: acupuncture and manipulative therapy

Equine Balanced Veterinary Care: Acupuncture and Manipulative Therapy
Barbara Wiborg DVM
Gastric (Stomach) Ulcer Fact Sheet for the Horse
What are gastric ulcers?
Gastric, or stomach, ulcers result from the breakdown of the stomach, or in some cases, intestinal, lining
from the production of gastric acids. These acids are imperative to proper digestion, but sometimes if horses
are either managed improperly or there is excessive production of acid, it can “eat away” at the stomach
lining, causing painful, and sometimes bleeding, wounds. There is a wide range in severity of ulcers from
very mild to severe. If severe, they can be a cause of colic and can eventually lead to perforation of the
stomach lining. In a lot of cases they inhibit proper digestion.
Why do horses get stomach ulcers and how common are they?
It is estimated that 90% of racehorses and greater than 60% of performance/backyard horses have some
degree of ulceration in the stomach. The most common cause in non-performance horses is the way they are
managed. Horses are not like people, in that they do not secrete acid in their stomachs in response to eating
a meal. Instead, they are secreting acid 24 hours a day, regardless of whether or not there is feed in their
stomachs. This is because they are animals designed to be grazing all day. One of the “easiest” ways to
help alleviate a stomach ulcer problem is by increasing the number of times per day a horse is fed, without
necessarily increasing the total quantity of hay/feed. This may not always be “practical” from a
management standpoint.
Stress is a huge component of ulcer development in performance horses, as it may increase the production of gastric acid. Stress can come in many different forms from traveling, to feed changes, to weather changes, to changes in exercise regime, injuries, etc. Regardless of feeding management, these horses generally need to be on a recommended treatment for gastric ulcers.
Some drugs, particularly NSAIDs (bute, banamine, etc.) have been linked to ulcers, especially when given for lengthy periods of time.
How concerned should I be if my horse has gastric ulcers?
Unless the horse has a very severe case of gastric ulcers, they are not a huge worry for me in my practice as
long as they are treated. Treatment can be very inexpensive and relatively easy. It does not have to cost
thousands of dollars.
How do I know if my horse has ulcers?
Diagnosis of stomach ulcers is confirmed via gastric endoscopy, whereby a “scope” is inserted through the
nose, down the esophagus, and into the stomach. Horses need to be fasted (off feed) for this procedure.
Though relatively painless, they do need to be sedated for this procedure and it generally needs to be done in
a referral clinic, given the length of the scope needed.
I feel very confident in my ability to diagnose ulcers based on my acupuncture and chiropractic examinations, as there is a definite pattern that horses can follow when they have ulcers. You may also suspect them in horses that are very nervous and seem to carry a large amount of stress. The “worrier” personality seems to be the most prone. I have seen several cases of hind end lamenesses that were actually caused by stomach ulcers…once the stomachs were treated, the lamenesses disappeared. This makes sense from an acupuncture standpoint, as the Stomach Meridian is an important part of the hind limbs.
Some horses may be “skinny” and lack a great appetite, often leaving large portions of their meals. When ulcers get quite painful it can be a double-edged sword…the horses are painful and therefore don’t want to eat. Because they aren’t eating, and there isn’t any feed in their stomachs, the ulcers get worse.
You may notice your horse to have diarrhea, loose, watery, or dark feces.
One other observation is that you may notice some pain in the horse’s back (lumbar region) during grooming, saddling, and/or mounting. It is important in these cases to not disregard the pain and seek help for a diagnosis, as there are many other causes of this behavior.
How are gastric ulcers treated?
Probably the most well-known treatment is Omeprazole and comes as either GastroGard® or UlcerGard®.
This drug can be quite costly and may cost over $1000 to effectively treat and eliminate ulcers in your horse.
Omeprazole is what they call a proton pump inhibitor, thus preventing cells in the stomach from making
more acid. It generally comes in a paste form and during the initial stages of treatment, one full tube of the
paste is given each day for anywhere from 14-21 days. At roughly $45/tube, the cost adds-up quickly.
There are other drugs commonly used, such as Ranitidine and Cimetidine (Tagamet®). Both of these also inhibit acid production, but by a different method and are not as effective as Omeprazole.
Calcium and Magnesium in combination are quite effective in reducing acid production and pain related to stomach ulcers. There are products available in feed stores that combine Calcium and Magnesium with bismuth (known to have antibacterial properties) and aloe vera. These products are generally inexpensive and effective in most cases.
Aloe vera gel or liquid (in oral form) is another, probably least expensive, option I recommend. It provides a coating and healing action for the stomach and intestines, as well as exhibits some joint protective qualities. It is easily found in health food stores and is generally very safe to give to horses over the long term. The major drawback to aloe vera liquid is that it needs to be refrigerated.
How long does my horse need to be treated and what will I notice during treatment?
The duration of treatment varies depending on the individual horse. Some horses need to be treated pretty
aggressively initially then maintained on a less expensive “management” therapy over the long term. Other
horses may only need to be treated for a few weeks, particularly if management practices were the cause and
appropriately changed. I feel pretty confident in using my acupuncture examination to help monitor the
progress of ulcer treatments, so a recheck may be in order if there is ever a question.
In some cases there can be a profound change in the horses’ attitude once treatment begins, causing them to be much more calm and relaxed under saddle and in their surroundings. In other cases, hind limb lamenesses will disappear and/or the hind end will begin functioning much more strongly. Appetites may increase to where horses who hadn’t typically finished their meals, now start finishing them. You may also notice less sensitivity over the back (lumbar) region during grooming, saddling, and mounting. Overall, you generally end up with a much happier and healthier animal!

Source: http://www.dr-barbie.net/Ulcer_Fact_Sheet.pdf