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A Better Way to Manage Ulcer Risk in Horses

by Dr Clair Thunes PhD Nutrition
Consulting Nutritionist for EnviroEquine & PET
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Research indicates that as many as 92-93 percent of racehorses, 63 percent of riding horses, and 51 percent of foals have gastric ulcers. It is safe to say that a large majority of our horses currently have, have had in the past, or will have a gastric ulcer at some point in their life. It is very likely that such an ulcer will cause negative behavioral issues such as teeth grinding and a lack of desire to go forward under saddle, poor hair coat, lack of thriftiness, and possible colic. However, it is just as likely—in fact research indicates possibly 37 to 52 percent as likely—that your horse will display no symptoms at all. What we do know is that if your horse is displaying symptoms that could be an ulcer, chances are that it does indeed have one.

To date the only FDA approved treatment for ulcers is Omeprazole, sold as Gastrogard. New research is showing that this treatment alone may be ineffective if the issue is ulcers in the glandular portion of the stomach (the lower portion where acid is secreted). Research suggests that after 28 to 35 days Omeprazole alone has a rate of healing of 78 percent for ulcers in the squamous or upper region of the stomach, but only 25 percent over the same time period for glandular ulcers. Glandular ulcers require additional therapy and are now treated with Omeprazole in combination with another drug such as Sulcrafate.

Incidence of Equine Glandular Gastric Ulcer Syndrome (EGGUS) has been shown in studies to be reported in 47 percent and 62 percent of Australian racehorses and 57 percent in a mixed population of horses in Denmark.

With the existence of two different forms of EGUS and differing treatment protocols, scoping continues to be the only effective method of diagnosing both the existence of ulcers and their severity. While historically some veterinarians would suggest providing Omeprazole for a few days and seeing whether symptoms subsided as a form of diagnostic, this has never been the preferred approach. It is impossible to tell the type of ulcer or how severe it is using this method and the horse needs to be re-scoped when treatment concludes to insure that treatment has been fully effective. Some ulcers, especially in the glandular region of the stomach, may take longer than a month of treatment to fully resolve.

Obviously avoiding ulcers in the first place would be ideal and for that purpose many people use low dose Omeprazole retailed as Ulcergard when their horses travel or face other potentially ulcer inducing situations. For some horses that travel and compete often this can mean almost continuous administration of Omeprazole. In fact owners sometimes choose continuous treatment if a horse has a history of repetitive ulcers.

Omeprazole is a proton pump inhibitor and helps to treat and prevent ulcers by blocking acid production. With fewer active pumps producing acid, ulcers have time to heal and new ulcers are less likely to be formed. However, stomach acid has a couple of important roles. First, it activates the enzyme pepsin that is necessary for protein digestion and secondly, stomach acid kills off bacteria that have entered the digestive tract, some of which may be pathogenic.

Additionally, there is evidence from human research that long term use of Omeprazole impacts calcium absorption from the small intestine which has been linked to an increased risk of osteoporosis where bones become weak and there is the risk of fracture. This has caused some researchers in equine nutrition to question the long term use of Omeprazole in horses.

A recent study conducted by Kentucky Equine Research confirmed that indeed administration of a therapeutic dose of Omeprazole for 2 weeks significantly affected calcium absorption by as much as 20 percent. While the study only used 4 horses and was not conducted for long enough to determine if this decreased calcium absorption would negatively impact bone health over time, it clearly suggests that more research in this area is required in horses and that there might be cause for concern.

So what other options are out there for horse owners that want to avoid or reduce their use of Omeprazole? EnviroEquine offers options that are backed by science and supported by many favorable reports from owners. Firstly, the patented iFEED automatic feeder which mimics the horse’s natural grazing behavior by automatically delivering feed in up to 48 small portions over the course of each day and night at times that you schedule. iFEED can be used to deliver pelleted or textured feeds and supplements. This means that you could use it to deliver hay pellets to supplement or replace your horse’s daily hay intake or use it as a way of feeding concentrate feeds in more appropriate small meals. By using iFEED you can ensure that your horse is no longer standing around with no access to feed for long periods of time and faced with the deleterious health effects that may result.

Backed by independent research conducted at the University of Colorado, iFEED was shown to significantly reduce the severity and incidence of ulcers after 24 days of use when horses were fed their daily ration of just under 9 pounds of low starch concentrate feed in small fractions as opposed to twice per day. Barns that have iFEED installed report a 30 percent reduction in feed costs due to better feed digestibility. Using iFEED allows you to feed in a way that honors more closely the way your horse was designed to be fed.

EnviroEquine’s GastroBalance Plus is a daily supplement that not only supports gastric health but the health of the entire gastrointestinal tract. The main ingredient sodium calcium aluminosilicate has an alkaline pH and calcium content that may help reduce gastric acidity by buffering hydrochloric acid production.

Clays may also reinforce the physical mucus barrier providing some protection against diseases that originate in the digestive tract. Goblet cells in the intestinal mucosa release mucin which acts as a first line of defense to protect the intestinal cells from infections. Smectite clays have been shown in pigs to modestly increase the size and number of goblet cells in the gastrointestinal tract lining. Not only does mucin protect against the negative effects of pathogenic bacteria but in the stomach it is released by the cells that secrete gastric acid to protect them from erosion and development of glandular ulcers.

Additionally, smectite clays have been shown to reduce post-operative diarrhea in horses with colic associated with the large intestine. They bind fumonisin and aflotoxins that can occur naturally in feeds. Unless removed, these toxins absorb quickly from the gastrointestinal tract after consumption and may cause a number of problems including lack of appetite, weight loss, poor performance, depression, as well as reduced fertility and growth rate.

GastroBalance Plus provides a complete serving of prebiotics and live yeast. These ingredients have been shown in research to not only help remove potentially harmful mycotoxins, but also to improve feed utilization and maintain a robust immune system. Gastrointestinal stress and overall physical stress increases inflammation and depresses immune response. The gastrointestinal tract is one of the body’s first lines of defense and therefore if gastrointestinal health is compromised inflammation may occur both in the gastrointestinal tract and beyond.

Zinpro® Performance Minerals which are amino acid complexes are included in GastroBalance Plus to further support gastrointestinal as well as whole body well-being. These trace minerals are attached to the amino acids methionine and lysine respectively improving their absorption as it allows the minerals to leave the gastrointestinal tract via pathways meant for amino acids rather than those used by all minerals. This reduces competition for absorption. Zinpro® has performed more than 200 peer reviewed studies into the effects of their minerals in a number of species and have shown improvements in hoof health, improved feed utilization, immune function, skin and epithelial health and improved production response in stressful conditions. In one study feeding Zinpro® Zinc Methionine reduced the number and severity of gastric ulcers in horses as compared to zinc sulfate when the horses were faced with heat stress.

Having GastoBalance Plus be part of your horse’s daily nutrition program, either in combination with iFEED or alone, will support your horse’s gastrointestinal health and may reduce the need for reliance on pharmacological methods of support and their possible side effects. The results and feedback from those using the EnviroEquine products speak for themselves. Marilyn Little individual and US team gold medalist says about using EnviroEquine products “Between the GastroBalance Plus, the ElectroBalance and pre/probiotics you won’t find a tube of Gastrogard or Omeprazole in our barn. We’ve been really thrilled and I think the proof is evident in the horses themselves. Our horses compete all over the world successfully. It is expensive, but when you think that Omeprazole is $40 a day, it’s money well spent.”

Consulting Nutritionist for EnviroEquine Dr. Clair Thunes is passionate about her profession—one that she decided upon at the age of 14. After earning a Bachelor of Science with Honors from Edinburgh University, and a Master of Science in Animal Science and a PhD in Nutrition from the University of California, Davis, Dr. Thunes went on to found Summit Equine Nutrition LLC an independent consulting company in 2007. An experienced nutritionist and accomplished scientist, Dr. Thunes understands the vital role that nutrition plays in managing horses today. Most importantly, she believes in making nutrition accessible to everyone and removes the guesswork so that owners have the peace of mind that their horse’s diets are optimal for maximum health and peak performance.  Her clients include all horses from competitors at the 2016 Rio Olympics to retired pasture friends, mules and miniature donkeys. She writes a weekly online commentary for theHorse.com and her nutrition articles have been published in noted publications including: The Horse, Equine Wellness, Trail Blazer, Horse & Rider and The Horse Report. Besides consulting she teaches equine nutrition and equine exercise physiology in the Animal Science Department at UC Davis and equine health at Cosumnes River College.  Clair continues to be involved with The United States Pony Clubs, Inc. and she is currently the Regional Supervisor for the Sierra Pacific Region.

Top Photo: © Konstantin Tronin; Anatomical Photo: © decade3d / 123RF Stock Photo