how what why: Charlie + Ulcers

It is a truth universally acknowledged, that should you and your horse ever struggle in some inconsistent, hard-to-pin-down manner, the Greek chorus of internet horse forums will unfailingly reply with some sing-song variation of the following mantra:

Saddle fit!

Teeth or Dentist!!

Ulcers!!!

Plus, frequent bonus armchair diagnosis:

Hoof angles and/or something to do with shoeing!!

Tho of course, depending on where you live, you're also just as likely to hear tell of various common tick-borne illnesses like Lyme! or Anaplasmosis!

it was recently brought to my attention that this property's owners permit riders on the driveway. helllll yesssss!!

On one hand, it's almost become a joke. Or like you could create some devilish sort of drinking game by guessing how long it takes before somebody suggests one of the above in response to anyone even so much as whispering about horse struggles.

On the other hand, tho, there are very real reasons for that, right? Like, there are reasons why these ailments often top the list of suggested pain points whenever owners run into problems.

Mostly, it's because these comprise most of the lowest hanging fruit. Common issues that can cause low grade but persistent nagging problems without the obvious acute indicator of a head bob or tree trunk leg. (Well, except anaplasmosis haha.... if your horse busts out with lethargy, a big fever, and four swollen legs outta nowhere, well... call a vet LOL).

And the symptoms are often easy to miss bc they can be as generic or general as "not wanting to go on the bit," or "won't go forward," or "kinda more pissy / spooky / grouchy / fussy than usual." Really, symptoms can be even minor deviations in behavior, soundness, or even general condition.

So.... I figured I'd talk a little more about one of those ailments - Ulcers.

This is by no means intended to be a substitute for talking to an expert or professional - I am (obviously) neither. Nor is this intended to be a thorough, comprehensive or definitive medical guide on the subject of gastric ulcers in equines. I am not offering advice here, or suggesting ways to diagnose your horse.

the passage through to the driveway is unbelievably softy and cushy despite our intense drought

Rather, I want to talk about my own approach -- the choices I've made, my experiences, and my plan for Charlie.

And, in the meantime, if anything I say here makes you feel unsure about your own horse's behavior (under saddle or otherwise), soundness, or general overall wellness, by all means - talk to someone about it. Your vet, coach, trainer, other vet, barn manager, riding buddy, working student, slightly scary but veteran older boarder, invisible friend, emotional support toaster, .... whoever, right? Ask around, phone a friend. See what people say.

Honestly, my experiences with horses have impressed upon me the idea that... there are many right ways to go about horse care and maintenance, and generally very few truly wrong ways.

Sure, there are some horse people who are blessed with knowing exactly the correct way of doing literally anything and everything. And who will judge you for deviating even slightly from their prescient prescriptions. It's true! I can tell you for a fact that there are regular readers here who check in for no reason other than to see if I've managed to murder, maim or otherwise mess Charlie up yet (shout out to my girl Denise!!).

And, ya know. To those folks, may you always feel smug and secure in your convictions. For the rest of y'all... Well. It turns out there are actually a shit ton of different options if you think your horse's particular woe stems from gastric ulcers.

tho ya know, there's a certain amount of charm to our normal pasture lanes <3

If y'all are worried about ulcers, again, best bet is to talk to somebody about it (even if that somebody is the google). When I'm thinking about horsey symptoms, my thoughts range across the following (in no particular order):

- has my horse's attitude or behavior changed?
- is he more spooky and/or grouchy? girthy?
- is he nervous or unsettled on the ground and/or under saddle?
- having trouble holding weight or coat looking dull?
- reactive and/or reluctant to go forward under saddle?

Which... Well. Charlie is a sleek glossy fatass dadbod panther on his post-lunch nap break. So.... Hm.

BUT! Beyond superficial symptoms, there are other indicators -- specifically revolving around lifestyle!! Any of the following lifestyles can make an otherwise sturdy horse vulnerable or prone to ulcers (in no particular order):

- not enough turnout
- not enough forage and/or grazing
- stall rest or prolonged confinement
- solo / individual turnout
- travel in the trailer
- competitions and/or intense training sessions

We're getting closer here. I'm more or less satisfied with Charlie's amount of turnout (would prefer more particularly in winter) and forage. And he's out in a big herd that he absolutely loves, but in a secure and confident way that doesn't leave him buddy sour.

this is charlie trying to look sad after i tubed him. tho ya know, try to ignore the giant grass stalks stuck up in his snackamore after what was an unabashedly indulgent gallop/graze through the woods lol

The travel tho? Yeeeaahhhhh that's kinda the biggie. I do everything in my power to try to always have two horses on board when I go places, bc I feel pretty strongly that being alone on the trailer is harder on Charlie than when he has a friend. But research shows that actually any amount of travel (esp if it involves crowded horse shows, even if the horse isn't actually competing at said show) can increase a horse's vulnerability to ulcers.

So.... Charlie travels, right? According to my budget workbook where I track lessons, clinics, shows, etc, we've averaged 2 trips/month this year. Realistically tho that number is higher in summer and lower in winter. Meaning we've been closer to 3x per month more recently. And actually, we had 3 trips in an 8 day period last week... So. Yea. The travel.

For this reason alone, knowing that any horse I manage - be it Charlie or Isabel - will travel frequently... My approach has been to just plan on treating for ulcers annually.

Obviously Charlie was fresh off the track when I bought him, so treatment was a priority and happened in the first ~2 months. A year later, he was coming off surgery and stall rest and it made sense for another dose. I'm about 90% sure I did a treatment last summer too after the whole Plantation fiasco, but I didn't tag it in any blog posts and can't find it in my paypal payments (thank god for modern vets LOL) so maybe I didn't.

Regardless, I'm pretty much all aboard the "treat first and ask questions later" train here.

apparently liquid fucking gold

Essentially, there are two different tracks you can take when it comes to ulcers: treatment and prevention / maintenance.

The most common treatment drug is omeprazole - an inhibitor. I'm pretty sure this is one of the only FDA approved treatments (tho sucralfate I believe is commonly used in instances where there are hind gut ulcers?? idk, see above "not an expert" comment LOL). As an inhibitor, this drug is not generally recommended for long term (daily) usage.

For prevention, there are loads more options. Generally, in this case we're talking about barriers or blockers, rather than inhibitors. Ranitidine (yes the same shit you can buy in bulk at Costco, your horse just eats like 15 at a time lol). Calcium. Magnesium oxide. Purina Outlast. Slippery elm bark. Aloe juice. Alfalfa. Tums haha.

The prevention stuff is good on a daily basis, especially in the period immediately following a treatment since the absolute last thing you want after inhibiting acid production for a month is to have a giant wave come splashing through when the drug suddenly vanishes from the horse's system (taper, yo!!!!).

There are a couple different varieties of omeprazole available on the market. For use in horses, the most common are the Gastrogard / Ulcergard tubes. They're also the most jesus-christ-this-shit-is-expensive option. Liquid fucking gold, apparently.

The Canadian company Abler has a really nice selection of omeprazole products too, including their unique "pop rocks." I ordered from them a few times for Isabel and was generally pretty happy with the service (they also threw in a few free packets of sucralfate).

MUCH more reasonably priced, dear god

I've also read of bloggers using Nexium, with the idea being: it's maybe easier/cheaper to get a hold of, and if the horse responds positively to it then that's a good indicator to invest more heavily in treatment.

I personally tend to do some combination of the above. One of my vets sells 30 day supply jars of generic omeprazole for $95. Compared to a 4 day tube of Ulcergard that sells for $37.... Well, that's a no fucking brainer haha.

Except.... I've been told by more than one vet that there's something about Ulcergard / Gastrogard's proprietary formula that seems more effective than the generic, including the Abler products. It's not really clear why.

So Charlie's plan involves a few days of the proprietary Ulcergard, half tube per day, at the same time we introduce the generic omeprazole to his 2x daily supplement cups. Then we'll downgrade the Ulcergard to a standard dose, while maintaining the full treatment dose of generic omeprazole powder for a couple days.

Then, when the Ulcergard is finished (I bought two total tubes that should last about 6ish days per my plan), Charlie will just be on 2x daily doses of the omeprazole powder. I measure out his supplement cups every 8 days so I have some options for fine-tuning the amount per day based on whether (or not) I see any changes in the horse. This will continue for about 30 days, at which point we'll taper off.

charlie's supplements are getting out of control these days. farriers formula per usual (forever and ever, amen), some electrolytes to finish out the year, and also a top line muscle supp, since multiple vets have said over the years that he's predominantly a muscular case vs joint case. right now we're doing this pro elite stuff, but i'm probably gonna switch back to purina's supersport once this is done. i felt like it made charlie run a little hotter, a definite advantage LOL

To be honest... I don't expect changes tho. Like. Charlie is just not an ulcery type TB. I've treated him multiple times before and it never made any iota of a difference. And generally speaking, he's the friggin King of the Dings -- stoic he is not.

But... We do it anyway. Maybe I'm just a little liberal with the drugs. Or a little risk averse. Or maybe this will be the time when Charlie says, "Actually, thanks - I needed that!" Whatever, right?

For some horses tho, this treatment is the actual literal manna from heaven, the silver bullet. It can be a life changing difference maker. In the off chance that Charlie shows big changes with treatment, I'd probably proceed to scoping his guts for actual confirmation of the existence of ulcers.

This is important for a few reasons, first bc it would tell us where the ulcers are located. For instance, hind gut ulcers require more involved treatment to actually fully heal than what I've described above - tho symptoms could be soothed at least in this plan.

Likewise, I believe if a horse is insured, diagnosis confirmation is required via scoping in order to get the cost of treatment reimbursed.

i've been using 1lb deli tubs for supplements as a way to assuage my first world environmental guilt. they're working out great and the barn staff are happy with them!!

Generally speaking, tho, the plan I've laid out for Charlie will tell me a few things. If he responds in a big way, I will know it's worth investing more to look more closely. If he doesn't really respond, I'll still feel like I've done my due diligence in ensuring he's thriving in the lifestyle I offer him.

In that same vein, it'll give me confidence in my training with him when things get tough. Which, let's be real, that's mostly what this is all about. Making sure that I've got all my i's dotted and t's crossed so that when push comes to shove, I'll do my goddamn job in the saddle haha. Riding is hard enough already, ain't none of us need to be preoccupied by wondering if our horses are actually uncomfortable or in pain.

So. That's the plan. I'll let you know how it goes LOL.

What do you think, tho? Have you wondered about your horse and ulcers? Or treated?

Charlie isn't particularly ulcery, tho Isabel was, but seemed easily managed. Maybe you have had similar experiences? Or maybe you have a horse that's way less easily managed? Or experiences that were completely different from what I described above? Anything you'd like to share with the community of horse people who are curious about how folks have approached this issue?