How to help prevent gastric ulcers (in the real world)

Courtesy of CopRice.

The stomach… all horses have one and, in the perfect world, it’s a super useful organ… not a source of pain or angst.

The stomach is essentially the first stop in the digestive tract – it holds ingesta (aka the food your horse eats) and kicks off the initial stages of digestion by secreting enzymes plus some fairly heavy-duty acid. In the perfect world, the mighty powers of the equine stomach are used only for good.

But if you’re reading this article, you probably know that your horse – and their stomach – does not live in the perfect world. Here in the real world, problems such as gastric ulcers are sadly, often a painful reality.

So, let’s dive into all things stomach… learn what causes gastric ulcers and more importantly, what you can do to help prevent them!

Horse stomach 101

First up, what are we dealing with?

Your horse’s stomach is made up of two distinct regions – the squamous (or non-glandular) region at the top and the glandular region at the bottom.

The squamous region is delicate and very sensitive to gastric acid, whereas the glandular region is more robust.

The next thing to understand is that horses evolved to graze pretty much all day long and this means 3 things…

1. Your horse’s stomach secretes acid continuously. This means that even if they aren’t eating, they are secreting gastric acid. And gastric acid = hydrochloric acid. It’s strong stuff!
   
   
2. Naturally, your horse’s stomach would rarely be empty – under natural grazing conditions it would always contains some fibrous gut fill, which would help to physically prevent acid from sloshing around.
   
   
3. When your horse eats, they secrete saliva. And saliva buffers (ie. neutralises) gastric acid. In other words, saliva makes gastric acid less acidic.

Empty stomach + exercise = problems

When your horse is exercised on an empty stomach, their stomach contains plenty of acid, but no gut fill to act as a physical barrier against acid splashing around, and not much saliva to buffer (or neutralise) gastric acid pH either.

That means the highly acidic gastric acid can easily splash or be squeezed up into the delicate upper squamous sections of the stomach and (if this happens repeatedly) it’s the perfect storm for creating gastric ulcers.

Ulcers 🙁

The technical term for ulcers in the squamous part of the stomach is Equine Squamous Gastric Disease (ESGD). (Note that ulcers can also form in the lower, glandular region of the stomach too, but we won’t cover that in this article.)

Some horses outwardly show the pain they feel from their ulcers and might struggle to maintain weight, perform well or have a reduced appetite. BUT there are plenty of horses with gastric ulcers who suffer without showing any outward signs.

Hence, the only way to really know if your horse has gastric ulcers – and where or how bad they are – is by gastroscope. Gastroscopy is where your vet uses a special instrument (essentially a long tube with a camera on the end) to check the stomach for ulcers. If you suspect your horse has ulcers, consult your vet.

Treatment

Gastric ulcers are typically treated with a drug called omeprazole (prescribed by a vet), which has been scientifically proven to stop acid production and allows the stomach to heal when used correctly. But it’s not without its drawbacks. Speak to your vet about the best course of action.

Prevention is better than cure!

By now you can see that your horse is not designed to have an empty stomach, so keep it topped up!

1. Feed hay before work (ideally lucerne hay)
   
   Provide your horse with 1-2 biscuits of a hay they enjoy eating (eg. lucerne hay) immediately before they’re worked – feeding it either in the paddock right before they’re caught or letting them munch on it while you tack them up is fine. Provide this pre-work hay even if your horse grazes pasture.
   
   
2. Hay, hay, hay
   
   Your horse should consume at least 2% of their body weight per day in forage (that’s 10kg of pasture, hay and chaff per day for a 500kg horse). The aim is to maximise the amount of time they spend eating throughout the day and night. If access to pasture is limited, provide frequent meals of hay and utilise hay nets or a slow feeder to help stretch it out (especially if your horse tends to guts their hay down fast!). If your horse is stabled, hay should be available the whole time. Using multiple hay nets within their stable has been shown to increase hay intake.
   
   
3. Feed ‘hard’ feeds little and often
   
   Ideally, feed supplementary (ie. ‘hard’) feeds in small, frequent meals. Feed no more than 0.5% of your horse’s body weight per meal (that’s 2.5kg ‘hard’ feed per meal for a 500kg horse).
   
   
4. Make it low NSC
   
   If your horse is prone to, has been diagnosed with or is recovering from ESGD, feed them a lower NSC diet (NSC = Non-Structural Carbohydrate, which is sugar + starch).
   
   
5. Allow rest when finishing omeprazole treatment
   
   Recent research has shown that horses can re-develop gastric ulcers once they have finished omeprazole treatment due to increased acid secretion. If your horse is finishing treatment, allow them 2-4 days of minimal to no exercise and plenty of hay to help prevent re-development.

Preventing ulcers in the real world

In the perfect world, your horse has the perfect stomach for their perfect, free-roam grazing lifestyle. After all, it’s the result of roughly 55 million years of evolution. But here in the real world where we ask horses to live in smaller paddocks, yards and stables, travel, and perform work in its various forms, we need to respect the way their stomach is designed and adapt our practices to help look after it. Hopefully the steps above can help you do just that.