Around 75% of sessions I give, the horses test positive to the acupressure points. Common symptoms:
Kicking at stomach
Changes in emotional regulation
Sensitive around flank area
Not wanting to go forward
Not wanting to engage their core
UC Davis did a study that suggested 50-90% of performance horses struggle with them.
Most insurance covers treatment if you scope for them, but the treatment is almost always ulcer guard/omeprazole.
In a recent article in the journal Equine Veterinary Education, Dr Benjamin Sykes shared four major concerns associated with omeprazole administration:
Significant rebound in gastric hyperacidity
Changes in fecal microbiome
Increased fracture risk
And most commonly, Interaction with NSAIDs.
(Bute and other NSAIDs can contribute to the development of gastric ulcers, and many horses treated with these medications receive omeprazole as ‘preventative measures’).
“A recent study showed, however, that while omeprazole helps prevent gastric ulcers potentially caused by NSAIDs, this drug combination appears to cause hind gut issues such as small colon impactions and diarrhea that can potentially be fatal, especially when high doses of phenylbutazone are used,” said Sykes. “Considering this, my current recommendation is to avoid the co-administration of NSAIDs and omeprazole, or at least to use the lowest effective dose possible for both drugs. If concerns about the potential for NSAIDs such as bute to cause gastric ulcers persist in a particular patient, then sucralfate is a reasonable alternative to consider.”
Ideally, veterinarians, trainers, and owners would seek to use the lowest possible dose of omeprazole that maximizes outcomes.
Hind gut ulcers will often not come up from the scope and can typically only be visually confirmed by a trans-abdominal ultrasound.
The common and best known treatment for hind gut ulcers also happens to be sucralfate as previously mentioned above.
I’m not “anti-scoping”, but between the risks of omeprazole on the horses and the damages I’ve seen from a scope gone wrong, I personally air on the side of caution and treat my horses holistically first and then go toward scoping and heavier products if needed.
Also, finances have a HUGE impact on owner ability to be able to explore diagnostics and pharmaceutical treatment options, and I know this is normally the number one reason why horses go untreated. Exploring more cost effective and natural remedies is what my normal recommendation is to start.
Here is my go-to ulcer recipe, kudos to a client of mine!
Slippery elm bark tea
Marshmallow root tea
1 tea bag of each per one cup of water.
Steep for 6/8 hours.
Mix one cup of that blend with one cup of raw Aloe Vera juice. (Normally I’ll throw 6 cups of that tea mixture with 6 cups of the aloe and mix it together in a gallon jug to make it easy for several doses at a time).
Give on cup of mixture, twice a day for 30 days or until sensitivity in ulcer points go away.
Mixes really well in grain and even picky eaters tend to really enjoy it.
I’ve had this work dramatically on over 60 cases so far.
Here is a fantastic product for sucralfate for another option: https://abler.com/absucralfate
Allowing your horse adequate movement and access to feed are incredibly helpful in preventing ulcers.
(Tara Davis is an amazing educator around this).
Also - Hyper-tension in their low neck can cause significant dysfunction of the Vagus nerve and that can also be sneaky culprit.
All in all, let’s keep our horses tummies at the forefront of our minds, because: Gut Health = Mental Health.
**This is just a personal opinion from my own horsemanship journey and in no way meant to be a diagnostic or treatment plan and you should always talk to your Veterinarian about your horses personal needs and safe plans moving forward.**