Prevention is much easier than treatment. It has been shown that turnout alone is poor at resolving gastric ulcers. In fact, some of the horses studied developed new ulcers. There are a huge number of products and supplements available that claim to heal or prevent stomach ulcers. Currently, the only treatment with widespread scientific validation is suppression of acid. For significant ulcers, suppression of acid levels seems to be crucial. In horses only omeprazole is registered for horses. Omeprazole also has the advantage of once daily dosing, compared to 8 hourly for ranitidine, and is the more effective of the two.
Omeprazole products
Duration of treatment varies depending on the gastroscopy findings, but at least 30 days at the full dose of omeprazole is recommended at this time.
Other products
Unfortunately, despite many products claiming to promote stomach health and prevent ulcers or help them heal, there is a deficiency of controlled studies published to support the effectiveness of most of these. There is some evidence that products containing seabuckthorn help, but for severe cases it cannot be recommended in isolation. It may be that there are other products available that do assist in ulcer healing or prevention, but until there is published data confirming this, it is difficult to recommend these above acid suppression.
Depending on the horse’s workload, once healing of the ulcers is complete it is better to stop acid suppressive therapy to allow the horse’s stomach to function as nature intended. This is when one of the supplementary products may be very worthwhile. However, if the horse is in strenuous work, or there are periods where the horse goes without feed or is under stress, preventative treatment is warranted. Racing horses, especially picky eaters are probably better to remain on a 3ml dose of ulcershield throughout strenuous training.
The most important factor in preventing gastric ulcers is to make sure the horse has a constant supply of roughage to eat. This buffers the acid and also stimulates saliva production, which is rich in bicarbonate. Before strenuous exercise, giving a handful or two of lucerne will help, because the fibre forms a mat that decreases the splashing of acid. Lucerne is superior because of the high calcium content, which also helps buffer the acid. When the horse goes out to compete it is important to allow access to hay straight after competition as well. Racehorses should be given hay between racing and transport back to the stable.
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