California Riding Magazine • February, 2011

GastroGard & UlcerGard
Ulcers are everywhere and also treatable.

Frustrated by the knowledge that an estimated 60 percent of all performance horses have ulcers to some degree and by the guessing game of determining which do or don't, Hope and Ned Glynn staged a scoping clinic last May at their Sonoma Valley Stables. They enlisted the help of UC Davis friend Dr. Jack Snyder, a leading expert on colic, and the school's veterinarians, students and state-of-the-art digital scoping equipment.

"The results of the clinic were informative and enlightening," says Hope. "We had been going with the idea that certain types of horses, hotter horses, for example, were more prone to ulcers." Instead, they found that some of the 17 horses determined to have ulcers significant enough to warrant medication were not those they
most expected to have stomach problems. And some were.

Prior to the scoping clinic, the Glynns suspected that a few of their horses had ulcers and had them on Merial's ulcer treatment medication, GastroGard®, and its preventative counterpart, UlcerGard®, for some time. These omeprazole -based products are the only medications approved by the FDA to treat and prevent equine gastric ulcers. Both are oral paste products, formulated for once-daily dosing.

"We had a lot of options to choose from," says Hope. "There are over-the-counter powders, pastes and many other things, but GastroGard is the only drug that actually heals ulcers." Other products might mask the symptoms or make the horse feel better, but they don't actually solve the problem. "That's why we feel it's worth spending the extra money for this brand," Hope says. Some products contain the same medication, omeprazole, but without the protective carrier, as found in Merial's products, the active ingredient is degraded and ineffective.

Because of GastroGard's cost, Ned says scoping to determine the presence of ulcers before initiating treatment is a worthwhile investment. Once healed up by an appropriate treatment routine with GastroGard, the next step is a course of UlcerGard to prevent recurrence. In addition to an ulcer's impact on mood, performance and, most-important, comfort, the condition is often a precursor to colic, Ned points out. In the long run, the Merial meds can be a bargain when weighed against the cost of treating potentially life-threatening colics.

Because the cost of treating a gastric ulcer is significantly more than the cost of preventing the ulcer, emphasis should be on prevention. When using UlcerGard in anticipation of stressful events, the horse never has to experience the discomfort of equine gastric ulcer syndrome (egus) to begin with. In fact, 112 days of prevention with UlcerGard costs the same as treating an ulcer for 28 days with GastroGard.

The Glynns have also seen unexpected benefits in the overall coat and muscle conditions of the horses on GastroGard and UlcerGard. They noticed this recently while reviewing barn videos from last year. Adding those medications to about 40 percent of the horses in their program was the only major change in their routine during that time.

Stress Induced

Sonoma Valley Stables is not the only one staging scoping clinics. GastroGard and UlcerGard's manufacturer, Merial, has used gastroscopy in studies for several years. For the second consecutive year, a nationwide series of more than 160 gastroscopy events, including over 1,100 horses, showed 60 percent of horses were identified with stomach ulcers. "This is the second year that these scopings were able to show horse owners the type of potentially painful stomach ulcers that their horses have been dealing with," says April Knudson, DVM, manager, Merial Equine Veterinary Services. "Many times, horses are suffering in silence from stomach ulcers due to their natural tendencies as a prey animal to mask pain. In talking to many of these owners myself, they are frequently surprised to find out their horse had been suffering from stomach ulcers, but the evidence is clear."

At these events, veterinarians evaluated the horses' stomachs using gastroscopy, which is the only definitive way to determine if a horse has egus, Dr. Knudson says. Racehorses had the highest incidence at 86 percent, but the sporthorse disciplines were high, too: 59 percent of hunter/jumpers and eventing horses, 48 percent of dressage horses and 52 percent of barrel racers.

Just as in humans, stress is the biggest culprit in ulcers. As Hope points out, a competition horse's life has ample opportunities for stress. "They are hauling to different shows where the hay vendors provide different hay, and some horses handle that better than others." Additionally, the daily routine is quite different when away from home, and there are plenty of unfamiliar sights, sounds, and new neighbors. Horses can develop ulcers in just five days.

Dr. Knudson stresses that UlcerGard is only one part of a successful program for preventing ulcers from recurring. The first important step is to address the horse's environment and lifestyle to the extent possible. Free choice hay or grass pasture, minimizing grain, regular turn-out and exercise are excellent measures to take. The next is to anticipate when a horse will undergo a stressful change in his routine, like a show, an increased workload or new living accommodations. "That's the ideal time for a preventative course of UlcerGard," she says. "If your horse is acting healthy, has adapted to your daily routine, has constant access to grazing pasture or free-choice hay and fresh water, and nothing has changed around him recently, then he really shouldn't have ulcers," she advises. That's not a realistic scenario for many horses and for them, fortunately, there is GastroGard and UlcerGard.

For more information on equine gastric ulcer syndrome, visit Merial's informative website, www.EGUS.org.