Ulcers in horses
January 9, 2009
Equine ulcers were first recognized in horses more than 30 years ago. Now we know that gastric (stomach) ulcers affect many horses in stressful performance careers, even though some horses do not show obvious signs. Reports in the Equine Veterinary Journal in 1989 and 1996 by Dr. Michael J. Murray and his associates stated that gastric ulcers affect up to 93 percent of racehorses, and about 60 percent of horses in other performance careers, and up to 59 percent of foals – particularly in foals raised in confinement. Subtle symptoms may go unnoticed. The best way to properly diagnose this condition is to look inside the horse’s stomach with an endoscope.
Dr. Rick Mitchel did a two-year study on ulcers in sport horses and presented his findings in 2001. The purpose of his study was to determine the presence of ulcers in hunter/jumper and dressage horses that show poor performance and health related issues, and to help veterinarians identify horses that should have endoscopic examinations and treatment. The horses in his study that were found to have ulcers were treated for 28 days with omeprazole (originally marketed as Gastrogard and now called Ulcergard) and most of them improved and didn’t have to be treated again. A few continued to have ulcers on follow-up exams until significant changes were made in their training, feeding and competition schedules to reduce stress levels. In most horses a lower dose of omeprazole was adequate for maintenance therapy after initial healing, to prevent recurrence of ulcers during stressful conditions such as rigorous training, competition, or shipping.
Even though cheaper products are often used in an attempt to prevent or treat ulcers, omeprazole is still the only prescription medication approved by the FDA for horses. Ulcergard is the same drug as the earlier Gastrogard, but packaged in a way to make it more useful and easier to administer. The dosing mechanism allows you to treat a horse with active ulcers, giving the whole tube, or use it as a preventative – giving just a quarter tube per day to the average 1,200 pound horse. This dosage is an effective preventative level, according to information presented by Dr. Gary White of Salisaw, OK at the 2003 meeting of the AAEP in New Orleans.
“I’ve actually done two trials on this, using Ulcergard,” says White. The second trial was looking at an eight day dose for prevention, which also proved to be beneficial. “The one I talked about at the AAEP meeting was a trial in which we looked at horses that were just beginning in race training.” These were young horses just starting into a stressful period of their lives, and vulnerable to ulcers.
“We scoped all of these horses prior to the start of the trial, to make sure they were all free of ulcers,” said White. “Then they began their training. These were two-year-olds, being broke and trained for racing. Some of them received ¼ dose of Ulcergard instead of the full therapeutic dose. Some of them received a placebo treatment – a paste that had no medication in it. We did this daily, for 30 days, then rescoped the horses.”
This was a blinded study, in which he was not aware of which horses received the medication or the placebo, during the trial and the scoping, until the study was finished.
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“We found most of the horses that were on the low dose of omeprazole did not have ulcers, and most of the horses that were on the placebo paste did have ulcers,” said White. “In the placebo treated group, 35 of 39 horses had developed ulcers. In the low dose group, 31 of 38 horses had no ulcers.
“All of the omeprazole studies have been some of the most dramatic results I’ve ever seen, since these were all blinded studies (not knowing which horses received the actual treatment and which did not). When you have a blinded study and find that a treatment has worked that well, it is really amazing,” he says.
He feels that the trial he did was important because it allows the horseman to prevent ulcers at a much lower cost than using the therapeutic dose of treatment. “It’s $10 rather than $40 per day,” he says.
White treats a lot of horses for ulcers in his practice.
“We have a performance horse practice; our patients are almost all in competitive careers – racehorses, barrel horses, rodeo horses, western performance horses, cutting horses, etc. We see ulcers across the board in all of them,” he says.
The lifestyle of these horses, which includes confinement, high level competition, high energy diets rather than pasture, etc. contributes to ulcers, in that these all lead to some stress.
“These horses are confined and worked hard,” says White. “I’m not sure whether it’s the confinement itself or just the stress related to the confinement that makes the horse vulnerable. Horses turned out on pasture are usually ulcer free.” They lead a more natural life and can eat whenever they want.
“In our hard-working horses we feed them large amounts once or twice a day and load them up with a high energy diet,” he says. “Some people feel this may have something to do with ulcer development.”
Strenuous exercise may also be a factor. “Exercise churns up the acid in the stomach and splashes it up into the non-glandular part of the stomach at the top. This unprotected area gets burned by the acid, and ulcers can get started,” explains White.
“I always encourage people to use a drug that has been tested and FDA approved, if at all possible,” he says. “Even though everyone would like to save money, to me there is nothing more costly than an ineffective treatment.”