Prevention of Horse Ulcers
Several steps help prevent horse ulcers:
Maintaining a non-stressful environment helps prevent ulcers, but for active horses, UlcerGard is the only proven preventative. UlcerGard contains omeprazole, which is given at a concentration of 0.45 mg/lb of body weight (1 mg per kg). This usually equals about a quarter of a tube a day. Omeprazole at higher doses will treat ulcers. For example, ulcers are treated with omeprazole at 4 mg/kg, which is the concentration of GastroGard. Thus, ulcer treatment is the same as ulcer prevention, but at four times the dose.
Sucralfate is used for preventing ulcers in foals at the dose of 5-10 mg/lb (10-20 mg/kg), 3-4 times a day.
In addition to using GastroGard or UlcerGard to block hydrochloric acid production, it is helpful to coat the stomach with Sucralfate. Sucralfate tablets can be crushed and mixed in syrup so your horse receives 1 g/100 lb body weight 2-3 times a day. Sucralfate is also available as a liquid.
Sucralfate coats the stomach most efficiently when it is given one hour before feeding or two hours after feeding, and again at bedtime. Since Sucralfate only coats the stomach when acid is present, it should be given a half hour before Cimetidine or Ranitidine, which block acid production. Sucralfate should also be given at least a half hour before an antacid. Sucralfate can interact with some oral medications: Cimetidine, Tetracycline, Phenytoin, and Digoxin.
Avoid High Carbohydrate Diets
High carbohydrate diets can contribute to ulcers, so for some ulcer-prone horses it's best to provide calories from oils rather than from carbohydrates.
Phenylbutazone (bute) and Banamine Paste (flunixin meglumine) are the most commonly used non-steroidal anti-inflammatory drugs (NSAIDs). While most horses can tolerate these drugs at normally prescribed doses, some horses develop ulcers when using these drugs at even half the normal dose. If your horse has problems with ulcers, work with your veterinarian to set up a program to avoid NSAIDs, especially bute. If it's necessary to use an NSAID, Ketoprofen is less ulcerogenic than Phenylbutazone or Banamine. If continuing with Phenylbutazone or Banamine, consider using a lower dose.
Never use more than one NSAID at a time. For example, don't use Dexamethasone with bute. If possible, rather than using an NSAID, use other techniques to control pain. For example, work with your farrier to correct foot and heel pain. Consider acupuncture, chiropractic, and massage treatments to reduce muscle and bone pain.