Research has shown that among racehorses and performance horses, ulcers are very common. More than 90% of racehorses (thoroughbreds and standardbreds), more than 60% of endurance competitors (in season) and more than 50% of show horses typically have ulcers. The risk factors include limited turnout, prolonged period without feed, and stress — including competition, trailering and strenuous exercise.
With horses that live outside, in herd environments and are mostly used for pleasure riding, the risk falls to about 11%. So, when Zelda started acting a bit off, the last thing I considered was ulcers. Freedom? He’s always been a worrier. Zelda? She and Curly have a nice life with plenty of grass and supplemental hay. She doesn’t get a lot of concentrate and by most standards, doesn’t work all that hard.
I was wrong.
Ulcer Symptoms
What I first noticed was that Zelda was “girthy”. When I saddled her up, she snapped at me and put her ears back. Zelda is a love, so this behavior was a red flag. I thought it might be saddle fit, but nothing looked amiss and she showed not tenderness or reactivity except in her girth area. Plus, it happened only when I saddled up. When I walked her off and tightened her girth, she didn’t react at all.
The only other sign I noticed was some agitation when trailering. Not on our way out, but on the way back. She started pawing in the trailer and moved around a lot. I have a camera in the back, so when she seemed upset, I stopped to check on her and she appeared agitated. These weren’t long rides. The farthest I’ve taken her this fall was 15-20 minutes.
She does get excited when she hunts — there are times when she quivers while standing in the trailer — but this behavior was not new.
It was only when I spoke to some friends, after a trail ride, that someone suggested ulcers. It turned out three of the other four horses had had them in the past!
While behavior changes are often a result of ulcers, other symptoms — none of which Zelda exhibited — include:
- Poor appetite;
- Dullness;
- Decreased performance;
- Reluctance to train;
- Poor body condition;
- Poor hair coat;
- Weight loss;
- Excessive time spent lying down;
- Low-grade colic; and
- Loose feces.
Diagnosis
The only way to know for sure if your horse has ulcers is by scoping them — inserting an endoscope through your horse’s nose and down into their stomach. Some people choose to treat without scoping (the cost for the scoping is about $350 plus a vet visit and sedation) but the cost of the drugs is even higher, so I opted to know for sure.
Zelda is not all that amenable to having a tube inserted into her nose, so a fair amount of sedation was required. The exam was interesting. And clearly showed areas of irritation. She definitely needs to be treated.
Treating Ulcers
There is only one FDA-approved treatment for ulcers: Omeprazole. The paste has an efficacy rate of almost 80% and works by suppressing stomach acid production. Zelda is getting one dose daily for 30 days. I’ll need to devote a second post to innovative strategies to syringing medication into the mouth of a reluctant horse every day. She is also getting Misoprostol powder twice a day, which inhibits gastric acid production in horses.
I’ve also added some alfalfa to her diet, either in the form of soaked alfalfa cubes, hay or alfalfa pellets. The calcium in alfalfa helps buffer stomach acid and it has been shown to both heal ulcers and prevent them
The good news is that Zelda will be fine. She’s been on her meds now for six days. I haven’t ridden her yet, but that’s because the weather has been very cold and snowy. She’s looking bright eyed and happy and her appetite is normal — which means she is very excited for her meals.
Of course, once her ulcers are healed, the trick will be to keep them from coming back. My friends who’ve treated their horses for ulcers in the past use products like Purina Outlast, which is formulated to support gastric health and proper pH. It can be fed with grain but also given as a treat before a ride or trailering. Zelda seems to like it, and given what I now know about ulcers, I’ve also been giving some to Freedom.
What has your experience been with ulcers?
We usually do a round of compounded omeprazole from Precision Pharmacy from our vet. It’s $25 a tube and has 3 doses.
For preventatives, I did Equimast for a couple years, but it seemed to not work at all this year, so I stopped feeding it. I’m back to U7.
I have heard good things about Lifeline too.
Thanks! That’s a good price for the Omeprazole. I paid double that :(.
Thanks again for terrific insights. I don’t think either of my horses have ulcers BUT what you wrote seems like it would be helpful for all horses. So I just bought a 40-pound bag of Outlast. I’ll use it as a topping. You never steer your readers wrong.
Thank you, Jacqueline! I appreciate your faith :). I have started topdressing Freedom’s grain. He already gets alfalfa cubes because he likes them better than regular hay. He gets very worked up when his girls leave, so feeding him a handful of Outlast seems like a good preventative.
Ompremazole (sp) is a PPI. Protein Pump Inhibitor. These days, if you even think of telling a gastroenterologist that you have heart burn, or GERD, or a hiatal hernia, they’ll put you on this stuff. (trust me, I speak from experience as I have all three). They work…yes. BUT when you stop (and while the doctors say it’s okay to spend the rest of your life on them, the company that makes them says no more than 30 days.) when you stop, your problems come back 300% worse. Ask anyone who is trying to wean themselves from the drug. Some people literally are unable to stop taking them. In addition, they have been implicated in bone problems in women (again, like me) who have osteoporosis.
I hope they work for Zelda, but I also worry that her ulcers/etc will return once you stop with the PPI. Good luck
Agree, I worry about it too. I think the answer is a long term maintenance solution that will include a change of diet (more alfalfa), and a maintenance product such as Outlast. I’m looking into the various supplements and feeding strategies now.
Oops I meant Proton Pump Inhibitor.