Extruded Feed for Ulcer Horse

Does feeding an extruded feed help a horse that is suspected of having ulcers? Also, is it safe to feed alfalfa cubes to a horse while on Ulcer Gard ? 

Extruded feeds are considered to be easier on the stomach because they are manufactured in a manner to increase digestibility. They tend to have less sugar than mixed “sweet” type feeds, and are already processed unlike whole cereal grains, so they are easier to break down and access the nutrients. Extruded feeds can be a good choice for horses with EGUS. Alfalfa hay and cubes are also an excellent choice for horses with gastric ulcers. In addition to being very palatable, the high calcium level in this forage acts as a natural buffer for stomach acid. The prolonged chewing required to break hay down into easy to swallow boluses also increases saliva production, which is an important acid buffer in the stomach. It is fine to feed alfalfa to a horse that is receiving ulcer guard.

Melissa McKee, DVM

Behaviour Change

I have a horse that has just come back from a lease trial. While he was away his behavior completely changed, went from being a laid back, with the occasional ‘hot’ day, to being very excitable, almost uncontrollable, and very stressy. Now that he is back home, he has been back almost a week. Bringing him into the barn he is a nutcase to put it mildly, he is completely stressed, won’t stand still, works himself into a sweat. In addition to that he has had very soft, cow patty like manure. He is a 7 yr old TBx gelding. Any ideas?

Wow, it sounds like something at the other farm sure did not agree with him. I am not sure how “seasoned” or experienced your horse is with traveling and staying at different places, but if this was a new experience for him he may just be profoundly shaken and will need a few weeks to settle back in to his regular routine. Shipping, new housing/management situations, and diet changes are all factors that have been proven to predispose a horse to gastric ulcers and your boy sure sounds like a good candidate for this problem. The cow-patty manure is also due to elevated adrenaline levels- when the fight or flight hormone is released the body tries literally to lighten the load, so any manure in the colon is moved on out before excess water can be absorbed- hence the runny manure. I’m sure we all can relate to this sensation before an important round at the horse show! Right now, the best you can do is try to re-establish his routine, turnout with old buddies etc., and treat him for ulcers (talk to your vet about possible medications as the OTC stomach coaters don’t do much to actually heal an ulcer). You may also want to cut his grain and put him on a probiotic for the time being. Be patient as this may take several weeks to sort out but I’m sure you will get your old horse back. Going forward, this may be something to anticipate when traveling or showing- starting him on ulcer preventatives and probiotics before heading out.

Melissa McKee DVM

Anti-inflammatories for Ulcer Prone Horses

What anti-inflammatories are safe for ulcer prone horses?

A good initial strategy would be to try to prevent the use of non-steroidal anti inflammatories for as long as possible. Although I have not had trouble with oral glucosamine in ulcer prone horses per se, it is a good idea to minimize the addition of supplements that may discourage picky appetites. Instead of oral joint supplements you could try monthly shots of Adequan, Hyaluronic Acid, or Polyglycan to preserve joint health. Keeping him exercised regularly and regular hoof trimming will help him to stay loose and comfortable. If he happens to experience an injury, alternative methods for pain relief including cold therapy, laser, ultrasound, acupuncture, and manual adjustments can provide significant relief. If you do need to give him more powerful medications, there are NSAIDS that are easier on the stomach than bute, particularly ketoprofen (Anafen). Unfortunately, there is no difference between injecting these drugs and giving them orally, as their effect is on circulation and certain molecules in the stomach lining rather than by simply reducing gastric pH. Steroidal anti-inflammatories including dexamethasone, as well as opiods such as butorphanol are also potent pain relievers that have minimal effect on gastric mucosa. Veterinarians also have several other drugs on hand for particular medical situations that can be used with a lower risk of aggravating an ulcer problem. Should you have an emergency situation on your hands be sure to inform the treating veterinarian of the problem so they can make the best medical choices. Of course, the stress of chronic pain is a significant risk factor for the development of ulcers so every treatment decision must consider that factor also.

Melissa McKee DVM

Cracked Tooth

If a tooth were cracked what kind of treatment would be involved? How would you diagnose it? What would the approximate cost be for such a treatment?

The diagnosis and management for a cracked tooth depends on many factors, including the age of the horse, which tooth is involved, the configuration of the crack, and the degree of damage and infection to the sensitive inner structures. A cracked tooth can cause any number of signs, such as discomfort when eating, a foul smell coming from the oral cavity, external swelling or drainage from the tooth root, or based on a history of oral trauma. The first step is to have a thorough oral examination performed by your vet. The only way to do this effectively is to use a speculum that holds the mouth open so the vet can see clearly and explore the teeth and gums with a mirror and dental probes (kind of a supersized version of your own dental exams, minus the gritty polish and tasty bubblegum flavoured rinse). This will enable them to determine if the horse has dental caries (tooth decay), abnormal gaps between the teeth that trap feed, loose or abnormal teeth, periodontal pockets, and obvious fractures, as well as the usual ramps, hooks and spikes. If there is suspicion of a fracture, the next step would be to take some radiographs of the jaw to evaluate root involvement and evidence of infection. If a molar is cracked but the fissure does not involve the sensitive structures and does not appear to be infected, you may choose to simply monitor the situation regularly. Occasionally the crack will just be a small fragment shelled off the side of the tooth that can be removed with light traction. On the other hand, the crack may be deep and quite serious. At this point some decisions must be made as to whether to pull the tooth or leave it in place. Molar extraction can be very challenging, particularly in young horses where the roots are still very long and deeply embedded in the jaw. While this procedure can be performed in a well-sedated standing horse with lots of local anesthetic and patience, some are better done under general anesthesia. Aftercare can involve regular flushing and packing changes as the socket fills in, and the horse will require regular dentistry for the rest of its life since the opposite tooth will overgrow with nothing to grind against. I never underestimate the potential difficulty of dental extraction and I learned that one the hard way! I still remember the first one I attempted that looked like a straightforward crack down the middle of the third premolar. Well it turned out to be two mature teeth that were fighting for space in one socket in a very young horse- we ended up going to a general anesthetic and practically had to tie the teeth to a tractor to pull them out! I still break into a sweat thinking about it….Anyways, that was a VERY unusual case that was not apparent on radiographs but ever since then I have a healthy respect for suspicious teeth and the vets that choose to tackle them. As you have probably guessed, the cost can vary widely. A straightforward case involving manual extraction of a loose fragment would barely cost more than the actual exam, while a complicated surgical procedure with extensive follow-up would be in the thousands. If you are suspicious that your horse has a crack, your first step is to ask your vet to take a careful look in there.

Melissa McKee DVM

Difference Between Pre-Biotic and Equi-shur

I had not heard of Life Force before this thread and the only hind gut supplements that I knew of (and veterinarians had seen results with) were Succeed and Equisure.

Succeed is far more expensive than the other two. Can you tell me what the difference is between the 3 types of supplements and if they are targeted for different uses?

Life force and Succeed (and Pur-a-Yeast) are all prebiotics, intended to promote the growth of beneficial bacteria in the hindgut and provide nutritional support for the cells lining the colon. Good quality prebiotics contain glutamine, yeast (source of mannan oligosaccharides), and a proprietary mixture of other substances including specialized yeast strains, amino acids, lipids, minerals, and vitamins. Succeed is available in an oral paste form, which may facilitate actually getting it into the picky eater, while Life Force is in a top-dress format. There are newer versions of these originals available, for special needs and performance horses, some of which are available at the feed store and other only through veterinarians. The choice is yours, they are all good quality products.

Equi-shur is quite different. It is an encapsulated form of sodium bicarbonate that is able to pass through the digestive tract intact until reaching the large colon. It is here that is create a beneficial effect by raising the pH of the colon contents, supporting the growth of healthy digestive bacteria and suppressing the populations of pathogenic strains that thrive in an acidotic environment and produce more gas in the colon. I have frequently used a combination of a prebiotic and equi-shur for horses with signs of hindgut acidosis- frequent gas colics, irritable/reactive temperament, poor performance, poor weight gain and haircoat. Once the situation seems under control, I am often able to back off the Equi-shur and just use the prebiotic.

Melissa McKee DVM


Not Chewing Hay Properly

About a week ago my horse suddenly stopped eating hay. He had his teeth done, and the hay is good quality. He takes a mouthful, rolls it around and then spits out. He s eating grain and hay nuggets, and drinking water. It started very suddenly, could you suggest what it might be?

Did this happen before or after his teeth were done? Either way, this kind of problem is a dental issue until proven otherwise. Unless a full dental exam with a speculum was performed at the time of dentistry, you can’t know for certain if the mouth is problem-free. And, if he stopped chewing hay right after being floated, it’s possible that something went wrong during the procedure that needs to be addressed. He could even have a small stick wedged in his teeth that makes processing large volume feeds impossible (true story- I’ve seen this!). Some horses with oral pain have trouble coping with long stem forage even though they are fine with chopped hay and concentrates. In addition, sneaky weeds like thistle and foxtail can turn a horse off their hay, so you may want to take a good look at the flakes when you break open the bales.

If there are truly no problems with his mouth and the hay is fine, I have seen this kind of problem rarely in horses with neurological disorders, particularly EPM. If he also starts to have trouble swallowing water and other materials, call your vet right away. Difficulty swallowing is a sign of rabies virus, so check on your guys vaccination status just to be sure he’s covered.

Melissa McKee DVM

Strangulating Lipoma

My horse has had several colic episodes this winter, she has been able to lunge all of them off after about 15-20 minutes when the gas starts to come out. She is 21 and when I had the vet out last year she did the rectal and thought she felt a ‘band’. The research I did said this could be an indicator of a strangulating lipoma. Could this be the problem?

The horse’s small intestine is suspended in the abdominal cavity by thin sheets of tissue called the mesentry. As a horse ages, the mesentery can accumulate benign fatty tumours called lipomas, which can become quite large and heavy. The lipoma can exert enough traction on the mesentry to create a cordlike stalk on which is can swing like a pendulum. In unfortunate cases, the lipoma will swing tightly around a piece of small intestine several times, sort of like how Indiana Jones would snag things with his whip. The stricture is so tight that the intestinal segment and blood supply are completely cut off. Since this type of colic tends to occur in older horses, who are generally pretty quiet and stoic, you may not always observe the immediate violent signs we see with other acute abdominal situations. As pressure builds in the upstream part of the small intestine, and it becomes severely compromised due to loss of blood supply, increasing pain levels will occur. These horses often reflux extensively when a stomach tube is passed, have red abdominal fluid on belly tap, and multiple loops of tightly distended small intestine on rectal exam.

This type of colic cannot be resolved without surgery to untwist the strangulating cord of tissue. By the time a horse gets to surgery, the damage is so severe that a portion of the intestine has to be removed.

I am quite sure that the colic episodes you have observed are not caused by a strangulating lipoma because she has recovered with medical therapy alone. The tight bands your vet mentioned could have several origins, but it is actually fairly uncommon to palpate a lipoma or the stalk when it is strangulating the bowel. The general signs of a small intestinal obstruction (distended small intestine, gastric reflux, red abdominal fluid obtained on belly tap) are always an indication for referral to a hospital setting so they can go to surgery ASAP if required.

Melissa McKee DVM

Very Loud Gut Sounds

I understand that, generally speaking, gut sounds are good, but is it possible for there to be too many gut sounds in a horse (i.e. too frequent or too loud)? Lately I’ve noticed quite loud, big “growls” coming from my TB (5 yrs., unraced) gelding’s gut I worry about ulcers. His forage and grain are both of excellent quality and he gets (and drinks) plenty of water both in the paddock and stall. His demeanour is good too. Perhaps a bit more energy/spookiness than usual, but I think it’s the weather. He does tend to be a bit of a sensitive type. Do you think I should have him scoped?

We are generally happy to hear gut sounds and quite alarmed by their absence, but too much activity is not always a good thing! If there has been a change in the environment or feed (even a shift in the components of his hay), there can be a resulting shift in the bacterial population in his intestines and a resulting increase in gas production. This, combined with abnormal motility, can cause a lot of chugging and gurgling noises until the intestinal flora re-adjusts. In other cases, increased noises can be appreciated after weight loss, simply because there is less insulation (fat) dampening the sounds.

If you have also noticed signs of abdominal discomfort (stretching as if to urinate, looking at his flanks, loss of appetite, change in manure consistency), then scoping him to check for ulcers would be a good idea. In the meantime, you could certainly put him on a prebiotic that includes oligosaccharides to promote the growth of healthy bacteria and support the intestinal cells. If that does not improve the noisy gut within a couple of weeks, or you start to notice the other signs I mentioned, you could chat with your veterinarian about checking him for ulcers.

Melissa McKee DVM

Ambesol for Mouth Sores

My new horse has really bad teeth and scarring on her cheeks from chewing on them while being ridden with a bad bit. Can I rub ambesol on them so I can keep riding while waiting for the vet to come float them?

I would not recommend using oral lidocaine gel in this situation, since the seems that the problem is not really where the bit would lie in your horse’s mouth. It could also be risky to numb an important point of communication between horse and rider. While you wait for the vet to come, you can help the situation by rinsing her mouth out with salt water several times a day, and don’t use a noseband while you ride since this would press her cheeks against the sharp edges of her cheek teeth. Incidentally, this would not be caused by any bit but is due to the daily trauma that occurs while they are trying to chew with a neglected mouth. Bit trauma results in painful sores on the corners of the lips, the palate, tongue, and lower jaw just in front of the molars, generally from poor fit, overly severe mouthpiece, and rough hands. If her teeth are in really bad shape, I would be more concerned that she is eating and drinking properly, since poor dentition is a significant cause of choke. If she is dropping wads of poorly chewed feed, I would offer her a soaked diet that will be easier to swallow until the problems can be addressed.

Melissa McKee DVM

Old Horse with Chronic Gas Colic

I have an 18yr old hannoverian X TB, Ive had him for 9 years and i would say within the last 6yrs he has been a chronic colicer. I would say he generally colics anywhere from 10-20 times in a year. 99% of the time he is always gas colic and walks out of it, the odd time we have to give him banamine to bring him around but generally he comes out of it on his own. Once he was bad and we had to tube him with min oil/anti gas and was put on omeprazole. I always have omeprazole on hand and give it to him after he has an episode for 2 or 3 days to settle his stomach. He is semi retired so doesnt work as much as he used to but goes outside everyday always has access to clean unfrozen water and generally always has hay infront of him. I have noticed severe weather changes can upset his system but not always, also sweet feed seems to upset him Im not sure if its the sugar in the feed or not? He eats rolled oats, happy trails, and hay cubes. Ive put him on daily supplements (Gut Coat) to aleviate the gas build up, but he still has coliced through those. I was just wondering if there is anything you can think of other than omeprazole daily because like I say he isnt a show horse anymore and that can get costly for one who doesnt show. Or if there is anything else you can think of that might help his issue.

Firstly, I assume that you have his teeth regularly checked and that he is negative for parasite eggs on a fecal test. Occasionally, chronic colic can be due to a build-up of sand in the large colon, which can sound like pounding surf when you listen to the abdomen with a stethoscope at the bottom of the belly. This can be detected by placing a few fecal balls in a closed container of water, then shaking it up to break down the fibres. As you leave this “soup” to settle, any sand in the manure will sift to the bottom. If your horse has a sand build-up, daily psyllium can help move this material through.

Since poor water intake must always be considered a possible role player in the development of intestinal issues, it would be a good idea to add several spoonfuls of salt to his diet in order to stimulate thirst. Most horses do not drink enough to meet their needs, especially in the wintertime.

Horses who have repeated mild colic episodes can be frustrating to diagnose definitively, since the problem is usually subtle. Any number of things could be causing a mild intermittent blockage and gas build-up somewhere, including “stones” (not common in the NE seaboard), adhesions, abnormal tissue bands, tumors, or narrowing of the gut lumen (stricture) from previous damage. Excess gas build-up can also be due to sensitivity to a particular diet. If undigested starchy concentrate makes it through to the large intestine, pathologic bacteria have a little feeding frenzy that creates an unhealthy amount of gas, and this also lowers the pH of the colon to favour the growth of even more of these harmful bacteria. I would definitely take him off the oats, and if he needs the calories you could provide a lower starch/high fat alternative. You can also boost up his hay intake and provide an alfalfa blend cube since the higher calcium levels in alfalfa provide a buffer effect. A ration balancer can make up for any deficits if you find he does best on a hay-only diet. There are many probiotics on the market, but I think that they need to have prebiotic components and yeast (ingredients that promote the growth of healthy bacteria in the colon) for best effectiveness. There are also commercial hindgut buffer supplements available for excessively gassy horses. Hopefully this gives you a starting point to work from-

Melissa McKee DVM