Feeding Horse With Ulcers

Question:


What to feed a thoroughbred with ulcer problems. Recently bought a horse that has a history of ulcers. He was in minimum work and now that we have bought him his work will increase. He sleeps out, blanketed. Needs to pick up condition. At present he is getting. 2kg 10% Blenheim cubes, 2kg Chaff.


Answer:

Having a dad who is a specialist gastroenterologist, we grew up listening to conversation around the dinner table perhaps a little different other kids of my age. We listened to talk of bile ducts, liver disease and ulcers as we tucked into dinner. While I studied Vet Nursing at Onderstepoort, I was always keen to include my dad in 'gastro-stuff' and can still remember the great interest and perhaps a little amusement he showed when we scoped a horse for ulcers and he was there to watch and ask questions!
Human and horse ulcers differ a little in that the bacterium Helicobacter pylori is now thought to be important in the pathogenesis of 90% of duodenal ulcers and about 70% of gastric ulcers in man, however the causes of ulcers in horses are more related to diet, stress, bile reflux and the use of certain medications.
An ulcer is the break or erosion of the lining of the stomach, oesophagus or small intestine and can vary in depth and thus severity. Most of the clinical signs of ulcers go unnoticed in horses and include : poor athletic performance, weight loss, lower appetite, behavior problems, slight diarrhea and colic. In foals, signs are teeth gnawing, salivation and a study has linked stomach ulcers in foals and crib biting. (Although it was unclear from the study whether the crib biting was causing the ulcers or the ulcers causing the crib biting!
Diet has a major role to play in the prevention and management of ulcers in the working horse and once the owner has an understanding of the factors involved, he or she should be able to formulate an eating plan that will be of benefit to the horse and possibly even reduce the need for treatment by drugs. Drugs are effective at reducing acid production, and diet has a buffering role once acid is produced.
One of the biggest contributing factors to ulcers in horses as it relates to feeding, is that the horse is not allowed to eat small amounts of food throughout the day. The horse evolved as a 'trickle feeder' and should naturally spend a large portion of his day grazing. By replacing natural food sources with high concentrate feeds and leaving the horse to spend a bigger portion of his day without some form of roughage to chew on, the buffering effect of saliva and food in the stomach is lost and the acids in the stomach erode the wall. A feed plan based on a high concentrate and low roughage ratio also means that the pH in the stomach drops and causes damage not only to the lining of the digestive tract, but can also cause a drop in the numbers of bacterial flora in the intestines which in turn can cause a host of problems.
Certain types of roughage have been shown to increase the stomach pH more than others and Lucerne is an example of this. It is suspected that the cause of this is due to the higher protein and calcium levels in Lucerne, however studies are ongoing to try and find out why it works so well.
Stress in the horse, be it due to travel, hard training or competition, has been linked to ulcers due to the increased release of corticosteroids and subsequent decrease in blood flow to the stomach lining. This interferes with the natural protective mechanisms and results in more damage from stomach acids. Exercise reduces the amount of blood flow to the digestive tract and thus can reduce the protective function of the stomach lining. The pressure in the abdomen during exercise can also force stomach acid higher up in the stomach, casing the ulceration.
Medications such as Bute can cause ulcers as well, and before using any medication for an extended period, the owner should make sure that the Vet is consulted about possible side-effects such as ulcers.
There are a number of treatment options available to the owner and these should be discussed with the vet. Because of the prolonged use of the drugs, treatment can become very expensive, and often after treatment, the horse will develop ulcers again because the management practices causing the ulcers have not been changed.

As a rough indication, the following should be used as guidelines:

- Always feed at least 70% of the total diet as roughage and try to limit concentrate feeds if ulcers are confirmed.

- Spread meals over the entire day : four small meals are ideal, as opposed to two bigger meals
- Introduce fats as a means of cutting back on concentrates and yet maintaining the caloric value of the feed.

- Increase the amounts of Lucerne being fed by either offering it as a hay, or by adding it as a chaff or pellet to the feed, however do not substitute the entire daily roughage intake with Lucerne as that will cause an entirely new set of problems! An American Veterinarian has suggested that the horse be fed 0.5kg of Lucerne after every grain meal as a buffer and has had good results from that. I would add Lucerne chaff to the grain feed, as a way of encouraging chewing plus the benefits of the Lucerne itself.

- Allow the horse to graze as much as possible or alternatively, offer a source of roughage ad-lib.

- Pelleted and finely ground up feeds tend to move faster through the stomach, so as mentioned above, adding Lucerne chaff or feeding a 'rougher' concentrate will slow the process down a little (and will ensure the horse spends a little more time chewing)

- A probiotic supplement should be fed daily to maintain the health of the gastric flora.

- Sugar beet is also a good option to increase roughage in the feed yet maintain caloric value, thereby allowing one to decrease the amount of carbohydrates being fed but still maintaining bodyweight.

- Be aware of possible stresses in your horses management routine and try to minimise them (these could include being separated from a friend or being lonely, travelling, shows, changes in daily routine and even a change of groom!)