GASTRIC ULCERS

Sep 01, 2011

 

Gastric Ulcers are astoundingly common in thoroughbreds in training(TBIT). Literature suggests approximately 75% and up to 90% of TBIT will suffer from gastric Ulcers. Ulcers in horses are attributed primarily to the design of the horse’s stomach. The horse’s stomach is designed to handle small amounts of forage eaten consistently over the day. As a result the stomach of the horse will produce as much as six cups of gastric juice per hour over a 24hr period. This gastric juice contains the necessary acid and enzymes required to aid in the breakdown of food. The horse’s stomach has two distinct portions. The lower part of the stomach which is always in contact with gastric juice is called the glandular mucosa. This surface has the ability to secrete a protective mucous that in most cases protects its surface from the harmful effects of exposure to gastric acid. The upper part of the horse’s stomach is called the non-glandular mucosa. This surface has no way of protecting itself against the harmful effects of exposure to gastric acid and is the most common area of the horse’s stomach that is prone to ulceration.

Due to the unnatural lifestyle of the TBIT, its stomach is quite prone to suffering varying levels of gastric ulceration. There are a number of factors that the TBIT is exposed to that contribute to ulceration:

Intermittent feeding: The grazing horse has the opportunity to be digesting food consistently over time, whereas the TBIT has to go for periods of little to no food. The combination of consistent levels of grass and saliva in the stomach in the grazing horse both absorb a great deal of gastric juice and also act as a buffer to the low pH content of the stomach. Whereas the TBIT does not have constant intake of grass.

Feeding Regime: The high starch diet of the TBIT contributes greatly to the increased incidence of gastric ulceration. The TBIT is essentially fed a relatively high starch diet. The bi-products of starch/sugar digestion are volatile fatty acids that have an irritant effect to the unprotected part of the stomach making it more susceptible to ulceration by the low pH gastric acid of the stomach.

Intense and repetitive exercise: During periods of intense exercise the stomach volume is reduced and also the highly acidic contents of the lower part of the stomach tends to “slosh” around causing the unprotected part of the stomach to be increasingly exposed to gastric juice.

Non Steroidal Anti Inflammatory Drug (NSAID) Use: It is thought that the use of NSAIDs in TBIT cause significant lowering of the production in the secretion of protective mucous in the lower portion of the horses stomach. When being treated with NSAID’s the risk of ulceration to the entire stomach of the horse is significantly increased.

With the assistance of John Walker and Associates and Randlab Veterinary Pharmaceuticals, it was decided that the stable run a significant trial to determine the incidence of ulcers, and establish the most cost effective regime to treat the problem.


ULTRASHIELD TRIAL STUDY AT AWN RACING STABLE

A sample of twelve horses was selected with the criteria that all the horses had to be likely to be commencing what was to be a full preparation. These subjects had no known previous ulcer history, nor were they being treated with ulcer medication at the start of the trial.

The trial was to be run in two phases.

Phase One was to gastroscope and record an ulcer score of each horse in the trial. All subjects were then to be treated for three weeks with Ulcershield (6ml), an omeprazole medication manufactured in Australia by Randlab Pty. Ltd. The subjects were to be re scoped at the end of this period and their ulcer score recorded.

Phase Two of the trial was to then continue dosing the improved horses on a maintenance dose of Ulcershield (3ml) and continue to aggressively treat horses that still showed significant signs of ulceration.

Results

The results of the trial were very interesting. Primarily all the horses that started in the sample group had levels of ulceration that were considered clinically significant, which indicates that most horses in training have to be considered prone to gastric ulceration.

We also learned from this trial that in about 33% of cases, three weeks of full treatment was not enough to have all horses return to the “healthy” level of less than clinically significant ulceration, and that this group of horses required ongoing treatment doses of ulcer medication to achieve sub-clinical levels of ulceration. In the group of horses that improved dramatically after a month of treatment, these horses were at least maintained or continued to improve with only a maintenance dose of treatment.

The more acute group had all returned to clinically “healthy” levels of ulceration after six weeks of treatment dosing with Ulcershield but going forward we would continue to consider these horses as being at risk of ongoing ulceration. This group of horses would require ongoing management and regular ulcer scoring on ensure ongoing gastrointestinal wellbeing.


SO WHAT DOES THIS FINDING MEAN TO TONY NOONAN RACING GOING FORWARD?

The need to implement an effective ulcer treatment regime with the least cost possible.

The new proposed ulcer treatment regime will involve all horses commencing training start on a treatment dose of Ulcershield (6ml) for a period of one month. Following this month of treatment all horses are scoped and scored and their ongoing treatment regime is determined based on this information. Those horses with clinically insignificant ulcers after 1 month would be maintained on the treatment dose of Ulcershield (3ml). Those horses found to still be at risk of ulceration would continue being treated with Ulcershield (6ml) on an ongoing basis.

Obviously this aggressive ulcer plan is targeted mainly at horses entering a preparation where they are likely to race. Yearlings and 2y.o’s going through educational preparations are unlikely to receive these levels of treatment.

If you wish to discuss this research findings or treatment further feel free to contact Boo Harvey on 0407 403 952.