It’s not a secret that many performance horses suffer from gastric ulcers. In fact, said Frank M. Andrews, DVM, MS, Dipl. ACVIM, equine gastric ulcer syndrome (EGUS) is present in up to 93% of performance horses. What’s worse, this condition is a real problem for training, nutrition, and overall health. Thus, successfully managing EGUS is key to ensuring horses can perform at their best.

Recently, Andrews, LVMA Equine Committee professor and director of the Equine Health Studies Program at Louisiana State University’s School of Veterinary Medicine, reviewed advances in treating and managing gastric ulcers in performance horses during the University of Maryland’s Department of Agriculture and Natural Resources’ 2016 Mid-Atlantic Nutrition Conference, held March 23-24, in Hunt Valley, Maryland.

Gastric Ulcer Basics

Most ulcers occur in the non-glandular mucosa (the upper portion of the stomach), which lacks protective elements to keep it safe from acid, such as thick mucus and bicarbonate layers.

Damage to the gastric lining occurs when aggressive factors, like hydrochloric acid secreted from the glandular portion (the lower region) of the stomach, overpower the defenses of gastric mucosa in the upper region.

The pyloric region (the opening from the stomach into the small intestine) is also at risk for ulcer development. If pyloric ulceration gets severe enough, cells can swell and cause delayed gastric emptying, a more acidic environment, and potentially colic. Delayed emptying of the stomach is a serious condition and difficult to treat.

Managing Ulcers in Horses

The pH of a horse’s stomach is more likely to remain below 4 (meaning it’s more acidic and, thus, more at risk of developing ulcers) when the stomach is empty. Keeping free-choice forage available helps maintain a more alkaline environment. Remember that horses evolved eating many small meals throughout the day, and consequently the equine stomach secretes acid 24/7. Consuming small, but frequent, amounts of forage helps buffer the constant supply of acid.

A common diet modification is the addition of alfalfa hay. The calcium and protein in alfalfa helps buffer acid and reduce the risk of ulcers.

“Alfalfa hay is a dietary antacid, it has high calcium,” Andrews said. “It does have an effect on reducing that acid load in the stomach.”

Many veterinarians and nutritionists recommend reducing the amount of grain concentrates in the ration and increasing forage. Forage provides more “chew time,” allowing the horse to produce more saliva, a natural stomach buffer.

Finally, stall confinement puts a horse at increased risk of colic and general stress. Providing turnout often helps a horse relax, and the exercise will help keep the digestive tract moving.

Treating Ulcers

Currently, the only U.S. Food and Drug Administration-approved products to treat and prevent gastric ulcers are GastroGard (omeprazole) and UlcerGard (omeprazole), respectively.

A multitude of supplements are marketed to help manage gastric ulcers, however data is limited regarding those supplements use. Researchers have learned that:

• A supplement containing sea buckthorn berry, pectin, lecithin, hydrolyzed collagen, aloe vera, and glutamine lowered non-glandular ulcer scores two weeks after omeprazole treatment and during feed stress.
• Pectin and lecithin administered for 30 days resulted in lower ulcer scores for supplemented horses compared to their unsupplemented counterparts
• Long-term hydrolyzed collagen administration (56 days) could lower ulcer scores; and
• Zinc is essential for a normal intestinal barrier and has some wound-healing properties, but might or might not help ease EGUS.

Take-Home Message

Work with your veterinarian if you suspect your horse is suffering from EGUS and seek the advice of an equine nutritionist to re-evaluate his diet.

Remember that each horse is an individual and could show different signs of EGUS. In general, providing turnout and plenty of forage will help reduce the risk of EGUS, but know the signs and keep an eye out for recurrence.