# Diet for Ulcers



## Amo (28 February 2013)

Obviously this seems to be a hot topic at the moment so it may come in helpful for others.

My boy got diagnosed yesterday as having ulcers (following a scope) and has now started a 4 week course of Gastrogard. 

I want to start coming up with a better feeding plan to help keep a reoccurrence at bay in the future so was hoping people could help with what to feed and not feed in the future. 

At the moment he has a 1 scoop mixture of sugar beet and speedi beet (weaning him off the sugar beet slowly onto speedi beet to reduce sugar intake) with 1 scoop pony nuts in the morning and the same again in the evening with the addition of magnesium, veteran supplement, micronised linseed and Newmarket glucosamine supplement. He has ad lib haylage all night in his stable and over winter all day in his field. 

Is there anything here that needs to be stopped? Any advice at all gratefully received


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## frazzled (28 February 2013)

This kind of ties in with my post about pumpkin seeds. Have been doing some research and pumpkin seeds have been mentioned at good for aiding healing in ulcer prone horses. It is due to them being rich in nitrous oxide which is a powerful healing agent. Have not fed them myself but would like to know if anyone has.


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## Fintan (28 February 2013)

@ Amo

How to keep it short without going in circles? Sorry I am not a native English speaker.

First of all, a horse is by nature a permanent eater and it is producing permanent gastric acid.

This gastric acid has to be buffered by the production of saliva, saliva does contain sodium bicarbonate as a buffering agent.

As well the amount of saliva is dependent on the chewing acivity, as more chewing as more saliva.

Not enough chewing or too many hours of rest with no chewing will decrease the PH value in the stomach and the horse will start to "digest himself". this is the procedure of gastric ulcers.

The next thing is, haylage or silage is a feed that has a far lower PH value then hay. It will bring more acid into the stomach.

Further, haylage or silage has a far bigger moisture contend (slight acidic) and with the bigger moisture content the horse is chewing less and with this producing less saliva before it will swallow down the feed.

Less buffering activity.

As well the emtying rate of the stomach is important as well. The stomach has to be filled and "drained" in short circles for to guarantee the supply of fresh "material" and saliva in a constant process.

If this does not happen, the PH level in the stomach will decrease rapidly.


So, avoid nuts and pellets. Nuts and pellets will stick in the stomach up to 5 hours. By the motility of the stomach this type of feed will stick together like a nearly concrete pizza dough.
Gastric juices can`t go trough, the concentration will increase and the stomach walls will be more exposed to aggressive juices.

This is well explained in some veterinarian thesis like Dr. Hammond and also Murray. As well many others.

So, the diet for this horse should be hay 24/7. As well soaked beetpulp is beneficial, beetpulp has an "ingredient" called pectin and here up to 20%.

The pectin is building a protective liner in the stomach and when it is soaked the passage rate is very quick so that the horse will start to eat hay very quick after this.

With the Gastro Guard many gastric ulcers become relapse. It works in the moment you give it because the production of gastric acid is suppressed.

But at the same time there is a hormone on the plan, called gastrin. This starts to be active in the moment the level of gastric acid becomes to low, it will blow the horn for an increased production and this will take place in the moment you take the omeprazole away.

At the same time we have to ask ourself, why do we need gastric acid and what will happen if the supply is reduced?

Indigestion, bad uptake of essential trace elements, trouble to the metabolism because of many waste products by insufficient digestion and more.

IN some cases we might need things like gastro guard, but only as long as the horse will start to eat properly (hay) again. 
Then we should sneak it out step by step so that the gastrin will not start to be hyper active and the ulcers will not relapse.


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## Pearlsasinger (28 February 2013)

IIWY, I'd swap the pony nuts for soaked grassnuts fed with a chaff of some kind.  After the GG is finished, Aloe Vera juice will help to soothe the stomach lining (and is much cheaper!).

I don't like to feed glucosamine to horses as it is made from shellfish, rosehips might work as well.  Be careful, some people feed cider vinegar for joints but I've found that it is too acidic for horses with digestive problems.


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## maccachic (28 February 2013)

Dont Let Your Horse Develop an Ulcer



By Juliet M. Getty, Ph.D.



Last month*, I explained how a steady, constant supply of forage keeps your horses digestive system healthy. You read how the horses stomach secretes acid all the time, even when empty. Chewing creates saliva, a natural antacid. If left with nothing to eat, horses will chew on whatever they can, even their own manure, to neutralize the acid that is causing them physical pain and mental discomfort.



Horses in the wild do not get ulcers. The diet and lifestyle we impose on our horses are to blame for this disabling condition. The good news is -- we have the ability to prevent ulcers through proper feeding and stress reduction.



In addition to offering forage, free-choice, consider these protective feeding guidelines



·         Avoid oats and other cereal grains (corn, barley, wheat, rice, etc.). Starchy feeds can lead to ulcers by stimulating stomach cells to produce more acid, as well as encouraging acid production through bacterial fermentation. In addition, grains move through the stomach quickly, leaving an empty stomach that is vulnerable to acid. 



·         Feed beet pulp instead of cereal grains. It has as many calories as oats without the propensity for acid production found with starch.



·         If you feed extra fat, choose the right type. Vegetable oils such as soybean and corn oils, are the most popular fat sources but they promote inflammation due to their high omega 6 content. Instead, choose vegetable sources that are high in omega 3s such as flax (meal or oil) or chia seeds, to actually reduce the inflammation experienced with ulcers.



·         Provide high-quality protein. Legumes such as alfalfa, soybean meal, and clover will complement the rest of the diet, offering enough amino acids (building blocks of protein) to allow for proper maintenance and healing. Plus, alfalfa hay should be offered to any horse who is prone toward developing an ulcer (such as during stall confinement) because it is an excellent buffer.



·         Feed the hindgut microbial population. Fermentation products and yeast feed the microbes living in the hindgut (cecum and large colon). This makes digestion more efficient and promotes B vitamin synthesis to heal the digestive tract. 



·         Offer additional B vitamins. Stress uses up B vitamins at a rapid rate. Offer a B-complex preparation (there are eight B vitamins) that does not have added iron (there is plenty of iron in forage and supplementation is rarely needed).



You know what stresses your horse 



An unfamiliar environment, loss of a buddy, stalling, training, travel, and performance can result in more acid production. Did you know that a horse that is moved into a stall after being used to pasture turnout is likely to develop a gastric ulcer in less than a week? Make adjustments to your horses lifestyle that would reduce stress. Even a horse that appears calm can have an ulcer.



The best way to avoid an ulcer is to allow your horse to be a horse



And the best way to do that is to give him pasture turnout  the more time the better. It not only gives him a steady supply of forage, but it lets him walk around, have a chance to run and buck, and visit with other horses. I realize that it is not always feasible to give your horse all the turnout he wants, but keeping hay in front of him at all times while confined will go a long way toward protecting his digestive system. 



* If you missed last months issue of Forage for Thought, you can read the lead article, Free Choice Forage Feeding  Beyond the Basics, by visiting Dr. Gettys Nutrition Library at www.GettyEquineNutrition.com





The above article offers insight into preventing a ulcer along the gastrointestinal tract. For more details, please refer to Feed Your Horse Like A Horse:

·         Chapter 1  Ground Rules for Feeding a Horse. Entire chapter.

·         Chapter 14  Digestive Problems. Pages 230-249.

·         Chapter 17  Stress and Behavior. Pages 308-317 (stress from travel and training); Pages 318-319.


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## maccachic (28 February 2013)

And another:

This equine nutritionist suggests giving lecithin to horses on bute to prevent stomach upset and ulcers.


Dr. Juliet Getty and horse friend. | Photo Courtesy Dr. Juliet Getty
Anyone who has a horse has heard of bute, the equine version of ibuprofin. While it relieves pain and reduces inflammation, bute can also start a reaction that wreaks havoc with a horses stomach.

Equine nutritionist Dr. Juliet Getty offers a solution.

Lecithin Inhibits Bute-Related Ulcers
by Juliet M. Getty, Ph.D.

Your horse is in pain and needs bute. Bute causes ulcers  this we know. But knowing how it damages the lining of the gastrointestinal tract is the key to knowing how to prevent its damaging impact.

Your horses stomach  an acid production machine

First, understand that most ulcers can easily be prevented by appreciating the way the horses stomach is designed. The lower portion (glandular region) is lined with a protective mucus layer, but the upper portion (squamous region) does not, which makes it especially vulnerable to stomach acid.

Most ulcers occur here because the horses stomach continuously secretes acid, even when empty. A steady supply of forage  all the time, all day, and all night  will put the acid to its proper work and protect your horses stomach. This is the way horses are meant to eat  they are forage grazers.

But even when horses are fed properly, administering non-steroidal anti-inflammatory drugs (NSAIDs) such as bute (phenylbutazone), Banamine (flunixin meglumine), or aspirin, can create ulcerations along the entire gastrointestinal tract. This has to do with the way they reduce pain and inflammation.

We tend to assume that it is bute itself that is directly irritating the stomach lining. In actuality, the damage happens after the bute has been absorbed. Bute inhibits the cyclooxygenase enzymes; some of these enzymes reduce the formation of various prostaglandins, some of promote inflammation and pain. But others maintain the integrity of the entire digestive tract by stimulating the production of molecules known as phospholipids. Phospholipids form a barrier to help prevent stomach acid from damaging the underlying epithelium.

Antacids have a downside

Our tendency is to get rid of the acid by administering antacids, H2 blockers, or the proton-pump inhibitor omeprazole (GastroGard®). But stomach acid is actually importantit is there for two reasons: First, it is necessary to initiate the digestion of protein, a nutritionally critical function. Protein digestion provides amino acids (building blocks of protein) for your horses overall health. And second, acid is your horses primary defense against all of the microbes that he picks up off the ground, some of which are potentially infectious.

If ulcer prevention is your goal, it makes sense to replace the phospholipids that have been reduced by NSAIDs.

Enter, lecithin

Lecithin is the common term for a phospholipid known as phosphatidyl choline (PC). It is a naturally occurring substance; it is the most abundantly found phospholipid in animal and plant cell membranes, and is most commonly derived from soybeans. Chemically, it primarily consists of essential fatty acids (both omega 3 and omega 6) along with a molecule of choline (an essential B vitamin-like nutrient).

Lecithin has been well studied in its ability to treat ulcers. Researchers at the University of Texas Health Science Center in Houston examined the administration of PC along with NSAIDs and found that not only does PC significantly reduce gastrointestinal injury, but in some cases, it even eliminated gastrointestinal ulcerations. Furthermore, it offers this protection without altering the efficacy of bute (or other NSAID).

Lecithin is easy to feed

You can buy lecithin granules in any health food store, or in bulk through online providers such as BulkFoods.com. I recommend offering 1/2 to 3/4 cup of lecithin with each dose of bute (for a 1000 lb horse). It can be mixed with any feed and is quite palatable. Another option is SBS Equine Products lecithin-based supplement called Starting Gate.

In addition to offering gastrointestinal protection, lecithin boosts the health of all cell membranes, including those of skin, hair, and hooves. And the body can also use the choline component to produce acetylcholine, a neurotransmitter necessary for proper neuromuscular function.

Summary

When pain relief is necessary and you rely on an NSAID such as bute, protect your horses digestive tract by replacing what bute diminishesphospholipids found in the epithelial layer of the digestive tract. Phospholipids act as a barrier to acid damage. Lecithin (phosphatidyl choline) is a naturally-occurring phospholipid that can be easily supplemented to protect your horse against ulcers.

About her: Juliet M. Getty, Ph.D. is an internationally respected equine nutritionist available for private consultations and speaking engagements. Dr. Getty is the Contributing Nutrition Editor for the Horse Journal.

Also at www.gettyequinenutrition.com, sign up for her informativeand freemonthly newsletter, Forage for Thought, read articles, search her nutrition forum, enroll in upcoming teleseminars and purchase previously recorded events. Contact Dr. Getty directly at gettyequinenutrition@gmail.com.

Categories: Illness and Injuries.

Tags: bute, Dr. Juliet Getty, equine, equine nutritrionist, horse, horses, lecithin


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## Fintan (28 February 2013)

Lecithin yes.

And a very good source for this is soy bean oil. Rapeseed oil as well.

Lecithin is made in most cases from either soya or rapeseed as well

You have to feed your horse anyway and oil is a very good cool energy source.

So stir in to the beet pulp about 250 ml soy or rapeseed oil and you do feed and cure at the same time.


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## SCMSL (1 March 2013)

A diet for ulcers is actually very similar to any other diet for horses with laminitis, EPSM, or any other "long term" condition.

The basis is low starch and low sugar. Anything above 10% starch is out for me. 

I am still getting to know all feeds available but will be switching to Rowen and Barbary's Solution Mash as soon as it arrives. It is slightly lower protein and energy then what I need so I will be supplementing with alfalfa cubes and Sumo MB. The Sumo is 20% starch but because its such a small quantity, when you take into account the alfalfa and mash, the diet is only 6% starch.


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## lyndsayberesford (1 March 2013)

Have a look at pure feeds

the feed that i use of theirs is pure fibre balance, having completed the online equine nutrition course i feel confident that this is a good feed that has all the vitamins and minerals in that he may need as well as being low in starch (8.5%), calciumhosphorus ratio is the correct way, also contains brewers yeast and Pro feed prebiotic

http://www.thepurefeedcompany.com/products/pure-fibre-balance


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## Erin (1 March 2013)

Having the correct Ca ratio in your bucket feed is no good if your hay/grazing doesn't (as is most likely the case)


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## Amo (2 March 2013)

Thanks everyone for the responses.

So I guess to start with, I continue to move him from sugar beet to speedi beet which will reduce both sugars and starch and look at introducing something like chaf or hi fi to increase his fibre intake and make him chew more. Hopefully that will bring his hard feed in under 10% sugar/starch overall.

I have to do everything quite slowly as he can be a picky eater. 

Does that sound ok?


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## TPO (2 March 2013)

Re the reply about joint supp ( can't quote in phone) look at Aviform website for their glucosamine. Exactly the same as Newmarket js but 1/4 price and vegetarian; so not feeding animal derivatives to equines.


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## Amo (2 March 2013)

TPO said:



			Re the reply about joint supp ( can't quote in phone) look at Aviform website for their glucosamine. Exactly the same as Newmarket js but 1/4 price and vegetarian; so not feeding animal derivatives to equines.
		
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Will do thanks. I must admit I never knew it was made from shellfish, I dont like the idea of feeding animal derivatives to horses who are not designed for them.


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## SCMSL (2 March 2013)

Your plan sounds great, but I would feed Alfa A Molasses Free instead of any Chaff or Hi-Fi, as it has more calories so will help keep weight on your boy. I don't know about you, but for my ulcer-prone its always quite hard to keep condition on her.


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## Slinkyunicorn (2 March 2013)

The management of ulcers is long term.

Having tried many different supplements and feeding regimes my gelding - who also used to crib and windsuck when I got him - is now on a permanent diet of hay, alfalfa and Lifeforce. The improvement has been immense - no more grumpyiness and discomfort and no more cribbing or windsucking. The Lifeforce ensures effecitve hind gut fermentation and the effective digestion of fibre and also ensure a stable and efffective gut environment.

There is no added oil, molasses or cereals EVER and he gets turned out year round.

He is now cheaper to feed than ever and looks great and has plenty of energy

His diet is as close to 'nature' as can be


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## bouncing_ball (2 March 2013)

Fintan said:



			Lecithin yes.

And a very good source for this is soy bean oil. Rapeseed oil as well.

Lecithin is made in most cases from either soya or rapeseed as well

You have to feed your horse anyway and oil is a very good cool energy source.

So stir in to the beet pulp about 250 ml soy or rapeseed oil and you do feed and cure at the same time.
		
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Do you need to feed 250ml of oil a day per horse?

Seems quite a lot.

Think most cheap veg oil in supermarket is actually rapeseed oil, so is this suitable (assuming it says rapeseed oil in small print in the ingredients).


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## SCMSL (2 March 2013)

250mL was the amount the vet who scoped my mare recommended as "maintenance dose". She said I could bring it up to 0,5mL if I supplemented with Vit E, which I do anyway.

Some horses just can't manage the hay - alfalfa diet without anything else.


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## Fintan (2 March 2013)

@ bouncing ball

250 ml is not a lot. People think it is a lot when they see the amount, but you have to see it in the relation of the total feed per day.

When a horse is eating about 10 KG (Hay e.g.) per day, this is only about 2.5% of fat in total in the diet.

OK you have to calculate the fat from the hay and also if you feed oats in as well.

But a horse will easy do well on a diet with a total amount of 5 - 7% fat depending on the work.

And yes the supermarket oil is mostly rapeseed oil. It is for human consumtion and with this it is also good enough for a horse.

You should avoid sunflower oil, thistle oil and also maize oil because the fatty acid composition in there is not realy beneficial, well for human consumption also not.


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## bouncing_ball (2 March 2013)

Thanks, I saw a link to a study where they fed horses 45ml (3tbsp) a day of corn oil and this seemed to reduce the acidity of the stomach. Which seems like a lot less.

I guess 250ml is a cup full.

It just seems like a lot if buying 5 litre bottles of oil from supermarket - one will last about 20 days.


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## bouncing_ball (3 March 2013)

Fintan said:



			@ bouncing ball

250 ml is not a lot. People think it is a lot when they see the amount, but you have to see it in the relation of the total feed per day.

When a horse is eating about 10 KG (Hay e.g.) per day, this is only about 2.5% of fat in total in the diet.

OK you have to calculate the fat from the hay and also if you feed oats in as well.

But a horse will easy do well on a diet with a total amount of 5 - 7% fat depending on the work.

And yes the supermarket oil is mostly rapeseed oil. It is for human consumtion and with this it is also good enough for a horse.

You should avoid sunflower oil, thistle oil and also maize oil because the fatty acid composition in there is not realy beneficial, well for human consumption also not.
		
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Thanks, what about feeding micronised linseed (I feed this for weight gain and coat shine). Does that have the same benefits as rapeseed or soya oil?

Is maize oil the same as corn oil, and both not so good?

Thanks


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