What are Ulcers?
An ulcer is like a sore in a horse's stomach lining. The stomach has two parts:
One third is called the Oesophageal or Squamous part, which doesn't produce any secretions.
The other two-thirds is the Glandular (lower) region, which does produce a mix of acids and mucus, along with a protective layer of mucus.
Science say ulcers in horses shouldn't just be called "ulcers" because they're not a single disease—they have many different causes and symptoms. They're now calling them Equine Gastric Ulcer Syndrome (EGUS), which initially referred to ulcers in the squamous region. But now they've discovered that ulcers can form in both parts of the stomach. Ulcers in the Glandular region are called Equine Glandular Gastric Disease (EGGD).
So, there are two areas in the stomach where ulcers can develop, and they have different causes. Ulcers in the Squamous region are most common, often caused by a lack of fibrous feed. This part of the stomach is constantly exposed to acid from the Glandular region, which can damage it because it doesn't produce protective substances like mucus and bicarbonate.
When a horse doesn't get enough fiber in its diet, the acid in its stomach isn't balanced out by food, which can damage the stomach lining. Racehorses are often diagnosed with ulcers because their diets are low in fiber and high in carbohydrates, which move quickly through the stomach. However, studies have found ulcers in grazing brood mares that don't show signs of distress. So, stress isn't always the cause of ulcers. But it's true that a stressed horse may not eat well, which can trigger ulcers.
In the Glandular region, ulcers can form due to imbalances in acids and antacids, as well as disruptions in the stomach wall's structure caused by medications like Bute and NSAIDs. These drugs can alter cell formation, particularly affecting Phospholipids, which are essential for the protective mucus. Keeping the stomach lining healthy and protected is crucial for preventing ulcers in horses.
What are the Signs and Symptoms of Ulcers?
Not all ulcers in horses will have obvious symptoms. Tests have revealed that horses can have ulcers even if they don't show any external signs of discomfort. When ulcers do cause pain, horses will display signs of discomfort. Their behavior may change from being sensitive and defensive to becoming irritable and aggressive. Research has explored the impact of feeding soya fats on improving horse behavior, and later studies found that lecithin from soya can protect the stomach from ulcers. Consequently, when pain is alleviated, behavior tends to improve.
The signs of ulcers can vary depending on the level of pain and the horse's natural disposition. A horse might become touchy, experience a change in temperament, grind its teeth, engage in wind sucking, or even lose weight. Performance horses, like those in competitions or racing, may exhibit reduced performance. However, these outward signs could also be caused by other sources of pain. The most direct way to diagnose ulcers is to have a veterinarian perform an endoscopy examination. During this procedure, a tube with a camera is passed down the throat and into the stomach to visualize any ulcers. Ulcers are graded based on their severity, and the vet can determine whether they are causing the observed symptoms or not.
Ulcers in Foals
Foals can develop ulcers, which can lead to severe problems and even death. Foals start producing stomach acid just two days after birth, and the acidity levels are high. The main cause is often a lack of milk intake (from the mare) due to various reasons such as an intolerant mare, a weak or sick foal unable to nurse properly, excessive resting, or disruptions during feeding. These ulcers typically occur in the squamous region of the stomach. Additionally, an imbalance between acidic and antacid factors can also contribute to ulcers in the glandular region. Signs that a foal may have ulcers include sporadic nursing, colic, poor physical condition, and diarrhea.
If any of these signs are observed, it's important to contact a veterinarian promptly.
Treatment of Ulcers
Antacids are the initial treatment for ulcers in horses. Veterinary care is necessary, and vets typically prescribe a product containing Omeprazole, which is a Proton Pump Inhibitor, similar to drugs like Losec or Zantac used in humans. This medication is administered daily for 28 days to block acid production and promote healing.
During this treatment period, the absorption of calcium is reduced by Omeprazole. Therefore, it's crucial to provide a complete mineral formula containing at least 20 g of calcium twice a day. Feeding only calcium is not recommended as it can disrupt important mineral ratios. Alternatively, feeding lucerne chaff along with a daily dose of minerals can be sufficient.
While Omeprazole helps heal ulcers, it's not intended for long-term use to prevent them. Long-term reduction of stomach acid is detrimental because horses need stomach acid to initiate food digestion and defend against potential infections from grazing. Scientific research has shown that preventing ulcers in horses involves maintaining the integrity of cell membranes, particularly through phospholipids, which play a key role in cell membrane structure.
Prevention of Ulcers
The widespread belief that mycotoxins in grass can lead to horse ulcers and result in horses being kept away from grazing naturally on pasture can actually increase the risk of ulcer formation. Restricting a horse's access to pasture and keeping them confined can cause stress and prevent them from engaging in natural behaviors like grazing and socializing with other horses. In many cases, hay is provided as an alternative, but this doesn't always make sense as hay might not be available continuously, whereas pasture usually is. It's better to allow horses access to pasture and provide supplemental feed to aid in the digestion of grass.
To reduce stress in horses, it's important to analyze their environment and use natural calming products when needed. Seeking professional help with horse training and handling, and maintaining a calm demeanor yourself, can also help reduce stress levels.
Ensuring that horses have access to forage (such as grass, hay, chaff, etc.) 24/7 is crucial for their digestive health. If a horse is stabled or penned, they should have access to hay during that time. It's recommended to wash hay before feeding it to horses. Additionally, limiting the use of pain-relieving drugs like Bute is advisable if possible.
Calcium plays a key role in reducing the likelihood of ulcers in horses' stomachs by adjusting pH levels and reducing acidity. Legumes such as lucerne and clover naturally contain calcium. Feeding lucerne chaff and a high-quality mineral supplement can provide all the calcium needed. It's important to note that calcium only works while it's in the stomach, so consistent intake is necessary for effectiveness.
Phospholipids, like lecithin, can provide protection for the stomach lining between feedings. Lecithin, which is found in soybeans, strengthens cell membranes and acts as a short-term barrier to stomach acid in the glandular region. Liquid lecithin is ideal for adding to a horse's diet and has been shown to support the gut mucosa.
In summary, preventing ulcers in horses involves maintaining a diet that includes legumes like lucerne on a 24/7 basis, preferably in combination with pasture. It's beneficial to reduce the use of grains and cereals and increase fat in the diet, such as soya bean oil. Avoiding excessive use of pain relieving drugs and providing nutritional support in the form of lecithin or other phospholipids can help support the structure of the stomach wall. When considering ulcer solutions, be cautious of products that don't contain phospholipids or lack scientific evidence of efficacy.
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