Gastric ulcers typically are thought to be a problem of foals, but they are very common in adult horses, as well. It is hard to tell how frequently they cause symptoms, because an owner often will not recognize that there is a problem unless the horse shows overt signs or colic.
Other signs that are associated with ulcers include poor appetite and condition and vague attitude changes. It becomes apparent that these signs are related to ulcers after the horse has endoscopy and treatment permits the ulcers to heal.
Your veterinarian was correct to recommend endoscopy to determine whether your horse had gastric ulcers, but even with an endoscopic diagnosis, the horse's symptoms may not be due to the stomach ulcer.
In fact, the ulcer(s) may be secondary to another abdominal problem. I would be concerned that this is the case with your horse, since he continued to have attacks of colic while treated.
On the other hand, it may be that the horse did not receive enough medication. Cimetidine (Tagamet), like ranitidine (Zantac) and famotidine (Pepcid), are histamine type-2 receptor antagonists (H2 blockers), and these drugs block the secretion of acid by the stomach. In so doing, they permit healing of ulcers. These drugs differ in potency, and in the horse cimetidine is one-half to one-third as potent as ranitidine, which is about one-half as potent as famotidine.
Also, each horse responds differently to H2 blockers, with some horses responding only to high doses. I generally recommend treatment with ranitidine at three mg/pound (three grams per 1,000 pound horse), every eight hours.
In most cases, ulcers heal in two to three weeks, and in all cases in which colic is caused by the ulcers, symptoms resolve in 48 hours. If they do not, I then suspect that there is another, primary abdominal problem.
Regarding Carafate, it is only effective for ulcers in the glandular part of the stomach, and since most ulcers in adult horses are in the non-glandular part of the stomach, its use may not be indicated in your horse. Check with the veterinarian who scoped your horse as to the location of the ulcer.
Finally, will this be a lifelong problem for your horse?
That is difficult to say. Of the horses I have treated that are of similar age and use as your horse, most have not developed serious symptoms (colic) of ulcers again. However, that is not to say they do not develop ulcers again. They probably do!
Some horses, though, do present as a chronic ulcer problem, having recurrence of clinical signs. these horses have required long-term maintenance treatment, usually frequent administration of antacids.
Taken From Netpets
by Scott McClure, DVM
Why do horses get ulcers?
Equine gastric ulcers affect up to 90 percent of racehorses and 60 percent of show horses. Ulcers are the result of the erosion of the lining of the stomach due to a prolonged exposure to the normal acid in the stomach. Unlike ulcers in humans, bacteria do not cause equine gastric ulcers. A horse’s stomach continually secretes acid, which can result in excess when the horse is not eating regularly due to there being no feed to neutralize the acid. Horses are designed to be grazers with regular intake of roughage.
The horse’s stomach is divided into two parts. The bottom part is glandular that secretes acid and has a protective coating to keep it from being damaged by acid. The top portion of the stomach is designed for mixing of the contents of the stomach and does not have as much protection from the acid. This is the most common place to find ulcers.
Horses at Risk
Ulcers are a man-made disease. Stall confinement alone can lead to the development of ulcers. When horses are fed two times per day, the stomach is subjected to a prolonged period without feed to neutralize the acid. Furthermore, high-grain diets produce volatile fatty acids that can contribute to the development of ulcers.
Stress (both environmental and physical) can also increase the likelihood of ulcers. Hauling, mixing groups of horses and training can lead to ulcers. Strenuous exercise can decrease both the emptying function of the stomach and blood flow to the stomach, thus contributing to the problem.
Finally, chronic administration of non-steroidal anti-inflammatory drugs such as phenylbutazone can decrease the production of the protective mucus layer, making the stomach more susceptible to ulcers.
The majority of horses with gastric ulcers do not show outward symptoms. They have more subtle symptoms, such as a poor appetite, decreased performance and a poor hair coat. More serious cases will show abdominal pain (colic).
The only way to definitively diagnose ulcers is through gastroscopy, which involves placing an endoscope into the stomach and looking at its surface. To allow this, the stomach must be empty, so most horses are held off feed for six to 12 hours and not allowed to drink water for two to three hours. With light sedation, the endoscope is passed through the nostril and down the esophagus into the stomach. The light and camera on the end of the endoscope allows the veterinarian to observe the lining of the stomach.
Treatment and Prevention
Treatment is aimed at removing predisposing factors and decreasing acid production. When possible, horses should be allowed free-choice access to grass or hay. Environmental factors should be addressed. Horses that must be stalled should be arranged so they can see and socialize with other horses. Some horses appear to enjoy having a ball or other object in the stall to occupy their time.
More frequent feedings will help buffer the acid in the stomach. Decreasing types of grain that form the volatile fatty acids may help some horses. The energy from the grain can be replaced by using a feed higher in fat. In horses with lower caloric needs, free-choice grass hay with the appropriate vitamin and mineral supplements will help.
Medication to decrease acid production is only necessary in horses showing clinical disease or when the predisposing factors cannot be removed, such as with some horses in race training. While antacids sound like a good idea, to be effective, they would need to be administered six to 12 times a day. Antacids in feeds are relatively ineffective since they are ingested at the same time as the feed, which will buffer the acid. Multiple medications are available to decrease acid production. The most effective treatment is Omeprazole, which decreases acid production for up to 24 hours.
Prevention of ulcers is key. Limiting stressful situations, frequent feedings and free-choice access to grass or hay is imperative. This provides a constant supply of feed to neutralize the acid and stimulate saliva production, which is nature’s best antacid. When this is not adequate or possible, horses at greatest risk will benefit from medication to decrease acid production
Taken From Xcodesign