Gastric Ulcers WHAT ARE EQUINE GASTRIC ULCERS? ‘Equine Gastric Ulcer Syndrome’ describes the erosion of the horse’s stomach lining, due to the prolonged exposure to the acid produced by the stomach. Gastric ulceration is a common, serious condition that can be fatal in foals and can also seriously affect an adult horse. Despite negatively affecting appetite, temperament and overall health, Equine Gastric Ulcer Syndrome remains an under-diagnosed complaint.
The signs of gastric ulcers can be vague and vary from one horse to another and whilst it’s generally known that around 90% of racehorses in training have ulcers, it’s perhaps less well known that about 60% of performance horses and 40% of leisure horses are also affected.
HOW AND WHY ULCERS FORM Horses were designed as ‘trickle feeders’ with free access to light grazing. In contrast, depending on the level of work and yard regime, our modern horse in work is usually stabled, often with restricted access to food.
Whilst, like humans, horses produce saliva when they eat, an important feature of equine ulcers is that horses secrete gastric acid continuously in the stomach, whether or not they are eating. An adult horse will produce approximately 1.5 litres of gastric acid per hour and with restricted access to food, continued secretion means the pH level can rapidly become very acidic and ulcers can begin to develop.
In contrast, horses constantly eating hay or grass have a higher average stomach pH providing a much healthier environment. It can take up to 24 hours for the adult horse’s stomach to empty completely after a forage meal, whereas a cereal based diet will pass through much more quickly.
WHAT ARE THE RISK FACTORS? A variety of factors may increase the risk of gastric ulcers; these include the diet, physical stress and illness associated with transportation, relocation or stable confinement, and medication such as NSAIDs as well as exercise. ADDITIONAL FACTORS Research has also shown that regular exercise and training has an effect on stomach acid levels. Exercise increases the pressure in the stomach and decreases the gastric pH. Exercising on an empty stomach can exacerbate this.
In addition to the feeding regime and exercise, other factors that can influence the formation of ulcers are transportation, relocation, hospitalisation or separation from their usual group. The use of anti-inflammatories has also been shown to be a possible contributing factor to the formation of equine ulcers.
DIAGNOSIS AND TREATMENT If a horse is suspected of having gastric ulcers, a gastroscopy using a video endoscope will confirm the presence, severity and location of the ulceration. Although the most common location for ulcers is the upper region of the stomach, they have been known to develop in other areas, including the duodenum.
Ulcers are graded from 0 to 4, reflecting the severity of ulceration. Grace 0 is a normal healthy stomach, and grade 4 demonstrating extensive lesions with areas of deep ulceration. A 28 day course of the prescription medicine containing omeprazole has shown to be the most effective treatment for gastric ulcers. After
completion of the treatment, the horse is then usually re-scoped and in most cases the ulceration will have healed.
RECURRENCE AND PREVENTION Many owners and riders note a significant improvement in their horses, sometimes within days of treatment commencing. However, once the ulcers have healed, unless changes are made to the horse’s management, training and/or environment, it’s very possible that they will recur. For a horse in hard work, ulcers can start to reappear as quickly as three to four days after the end of treatment, however even subtle changes to their daily regime can make a difference.
We should try to emulate the horses’ natural environment as closely as possible. Free access to hay and daily turnout – even for short periods – can help significantly, as can splitting hard feeds into smaller quantities fed more frequently i.e. the same total amount given in four instead of two feeds.
Studies have also shown that travel, and separation from peers are also high risk factors for gastric ulcers. In addition to management modifications, or where risk factors cannot be avoided, your veterinary surgeon may recommend that horses receive a preventative daily dose of omeprazole to keep them clear of ulceration.
HOW DO I KNOW IF MY HORSE IS SUFFERING FROM GASTRIC ULCERATION? The signs of a gastric ulcer can be very difficult to recognise, but they may include one or more of the following: Poor appetite Weight loss Poor performance A dull coat Behavioural changes or depression Mild or recurrent colic Free ‘risk assessment’ web tool helps you help your horse Answering a simple questionnaire may help to determine your horse’s potential risk of gastric ulcers. Visit www.gastriculcerrisk.co.uk to take part and find out more about the disease, its prevention and treatment.
Once you have received your horse’s potential risk level by email, print it out and bring it in to discuss the findings of this risk assessment with us, as gastric ulceration is a serious condition.
Information for consumers Danielle B ARDELAY (International Society of Drug Bulletins) Please do not quote or publish without the permission of the author. Paper prepared for delivery at the conference on European Integration and Health Care Systems: A Challenge for Social Policy . A conference organised during the Belgian Presidency of the European The recent stir over the po
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Gastric Ulcers