An ulcer is erosion in the lining of the oesophagus, stomach or small intestine. Stomach ulcers are more common and usually occur in the non-glandular (Squamous) area of the stomach and less commonly in the glandular (fundic) area of the stomach.

All performance horses are at risk of developing ulcers. Thoroughbred and Standard bred race horses are most susceptible but show jumpers, dressage and show horses have also been diagnosed with ulcers.

Research suggests that up to 93% of racehorses get stomach ulcers, and almost 60% of other performance horses have ulcers with 30-40% of these being engaged in dressage.

Up to 57% of foals have stomach ulcers during the early months of life and 50% of ponies on concentrates had ulcers, whereas ponies on hay diets did not. 50% of horses with ulcers show no obvious signs of gastrointestinal discomfort.

Horses constantly produce hydrochloric acid but only produce saliva containing a buffer while chewing. So insufficient feed intake, particularly of fibre may result in ulcers.

Other causes include stress as a result of training and competition, transportation, stable confinement, change of home or loss of a companion, chronic disease and boredom.
Performance horses are often stabled for long periods with discreet meals of concentrates which typically have a high sugar/soluble carbohydrate content. This results in increased levels of acid in the stomach and that together with the intervals between feeds both at home, while travelling or at competitions, increases the acidity in the stomach.
Working at speed: Intense exercise increases acid production in the horse\’s stomach and exercise reduces blood flow to the stomach.
Another performance related cause suggested by Dr. A. M. Merritt, a researcher in equine gastrointestinal problems, is a mechanical phenomenon caused by an increased exposure of that region of the stomach to acidic gastric contents during exercise. The theory is that the increase in intra-abdominal pressure during exercise pushes gastric contents up into the Squamous-lined proximal region of the stomach exposing the mucosa to acid resulting in ulcers.
Ulcers can be caused by toxicity from non-steroidal anti-inflammatory drugs: It is common practice to give racehorses frequent doses of NSAIDs both for injury and prophylactically. NSAIDs block the release of prostaglandin, which protects the glandular lining of the stomach from the hydrochloric acid and pepsin, which it secretes.

Most frequently cited signs are poor performance. Show jumpers may exhibit a change in jumping style e.g. hitting jumps, twisting or jumping left or right over a fence. Dressage horses were found to resist work and training.

Foals may exhibit tooth grinding, excessive salivation, a potbelly appearance (worms may be the cause), interrupted nursing, lying on the back, rough coat, and poor growth rate.

Other signs include colic, poor appetite and loss of weight, behavioural abnormalities, and apparent back pain.

Usually the horse is referred to the vet on physical signs and the diagnosis is confirmed by gastric endoscopy.

The treatment of stomach ulcers involves a combination of changes of management, the most important being the feed regime. A reduction of stress and possibly medical therapy may also be advised.

Management and prevention: Pasture keep, grazing horses rarely develop gastric ulcers. Horses should be given maximum turnout/access to grazing. If concentrates are fed, they should be fed in small amounts at frequent intervals (4 x day).  Steam extruded feeds and sugar beet shreds (an intermediate feed), may be fed which increases chewing time and saliva production. High fibre content feeds are the most appropriate feeds with at least 1% of bodyweight or 50-70% of the total feed intake as hay or forage being offered.
Reduce stress by ensuring that horses have companions or buddies. Consider carefully before selling on or changing the horse\’s home. Provide comfortable, species appropriate stables, shelters and travelling arrangements.

Avoid the use of anti-inflammatories.

Without drug administration, a 4-month period at pasture will usually resolve ulcers, but they usually don\’t heal in horses that continue in training, and will re-occur if changes to the management of the horse are not made.

Herbs that have effectively been used for ulcers in horses include; Comfrey leaf, Marshmallow Root, Liquorice, Meadowsweet and Slippery Elm. These all have properties which provide a mucous protective layer in the stomach. Aloe Vera, algae and kelp also share these properties.

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