Understanding the different types of equine ulcers can be difficult and overwhelming.
In simple terms, gastric ulcers are found in the horse's stomach while hindgut ulcers are found in the hindgut (or specifically the colon & cecum).
Let's break it down further...
The foregut of the horse comprises of the esophagus, stomach, and small intestine. This is where gastric ulcers occur.
The main types of gastric ulcers are squamous ulcers, glandular ulcers and pyloric ulcers.
- Squamous ulcer (non glandular) affect the squamous portion of the horse's stomach, which is the upper third of the stomach.
- Glandular ulcers affect the lower section of the horse's stomach.
- Pyloric ulcers appear at the opening from the stomach into the small intestine.
Equine ulcers share many common symptoms. However, there are a few key differences between hindgut and gastric ulcers. You can read about the symptoms of gastric and hindgut ulcers here.
The hindgut consists of the horse’s large intestine, which includes the caecum, large colon, small colon, rectum, and anus.
Ulcers can occur in any of these sections of the large intestine, however the most common affliction is known as 'Right Dorsal Colitis'. This area is this part of the large intestine, which is in contact with the right body wall.
Right dorsal colitis
Right dorsal colitis is a term given to equine ulcers found in the upper right section of a horse's colon.
The main cause of right dorsal colitis is the use of non-steroidal anti-inflammatories, (like phenylbutazone) and hindgut acidosis.
As the name suggests, hindgut acidosis occurs when the acidity of the horse's hindgut is raised. This is caused by large quantities of undigested simple carbohydrates reaching the hindgut and producing lactic acid.
The increase in acid reduces the hindgut's mucous production and leaves the mucous membranes vulnerable to ulceration. In addition, the change in pH cause the 'good' bacteria die off.
Read more: the full rundown on the symptoms, causes and treatments of hindgut ulcers.
How to treat the 4 types of horse ulcers.
Once you've ascertained whether your horse suffers from gastric or hindgut ulcers (and many have both!) - you'll be able to devise a treatment plan.
Omeprazole is a proton pump inhibitor and it's most common medication for stomach or gastric ulcers.
Omeprazole blocks the acid secretion from the stomach, reducing the amount of acid and returning the stomach's pH balance to horse standard. This decrease in stomach acid stops the formation of ulcers.
Treatment for Equine hindgut ulcers
Gastric ulcer treatments such as Omeprazole do not provide relief for hindgut ulcers or acidosis. This is because these medications lose the power to minimise acid production by the time they reach the hindgut.
Alternatively, Sucralfate passes through the digestive system undigested and coats the stomach and hindgut as it travels. This layer protects the site of the ulcer and gives them a chance to heal.
The side-effect is that anything your horse ingests within an hour of the sucralfate isn't going to be absorbed properly.
Treatment of Glandular and Pyloric ulcers.
Either omeprazole or sucralfate alone wont treat these types of ulcers. It is a 2 pronged approach,through a combination of omeprazole and sucralfate.
Unfortunately, it's not quite as simple as adding both medications to your horses feed and waiting for the results. By it's very nature, sucralfate coats the stomach (to protect the ulcers) but in doing so will hinder the absorption of other medication and nutrients.
This conflict of medications leads to two options. On the one hand, you can give your horse their meal with omeprazole and then in an hour give them sucralfate. On the other; you can give your horse the sucralfate and then in a couple of hours give them their meal and omeprazole. As long as the sucralfate is fed 30minutes apart and solo you will see a difference in your horse.
As part of an ulcer healing regime, the two medications are very effective. The acid inhibitor properties of Omeprazole will stop new ulcers forming, while the protective properties of Sucralfate will help existing ulcers heal.