The Equine Gastric Ulcer
According to Pipers, gastric ulcers form quickly--in 48 to 72 hours—and very significantly. Horses on pasture tend to have normal, healthy stomachs without ulcers, while horses confined to their stalls on a near 24-hour basis tend to be prime candidates for gastric ulcers.
A variety of factors can contribute to gastric ulcers. For instance, prolonged stall confinement, a change in hay or feed, shipping, a change in environment (stress), training and competition stress. Race horses and other non-racing equine athletes, such as Olympic-level three day event horses, have gastric ulcers, with 50% to 90% of those ulcers in the severe ranges. Nearly 60% of non-racing performance horses have shown to have ulcers, Pipers said.
“There is evidence of a severity and increase in ulcers as the severity of the training increases,” Pipers said. “Treadmill training seems to induce ulcers; although cause and effect association has not yet been determined.”
Horses with gastric ulcers will invariably become poor eaters over time, and as a result, will often be classified as “bad keepers.” A diminished appetite, a lackluster coat, a lethargic attitude, chronic diarrhea, recurrent colic, and weight loss are all clinical signs of intense gastric ulcers in horses.
Pipers said that the primary objective in the treatment of these ulcers is to reduce and neutralize the acidity in the equine stomach, thus allowing the lesions within the stomach to heal.
“Gastric acid secretion can be inhibited by certain drugs,” Pipers explained. “Omeprazole can inhibit acid secretion by 90 to 99% for up to 24 hours, and this in turn stimulates rapid ulcer healing with a long duration of action and very few side effects.”
Omeprazole is the active ingredient in the world’s leading human anti-ulcer medication (Prilosec in the United States, Losec elsewhere).
Up until a few years ago, equine gastric ulcers were generally always treated with cimetidine and ranitidine, although neither were approved for use in horses. Both are approved for use in humans as Tagamet (cimetidine) and Zantac (ranitidine), and both are known commonly as histamine (H2) antagonists. These antagonists are used by chemists within these specific medications to help inhibit gastric acid secretion in the equine stomach.
It was typically recommended to administer cimetidine and ranitidine orally or intravenously; cimetidine four to six times daily and ranitidine two to three times daily, for a period of ten to 20 days in order to ensure complete healing. This “H2 antagonist” therapy was often recommended for as long as
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