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Ulcers and The Hard Keeper


I have a 15-year-old gelding that I acquired last year. When I first brought him home he was very underweight. I have been giving him grain and senior feed along with his hay to get his weight up but nothing seems to work. Someone told me that it may be stomach ulcers and try to cure them first and he will put weight on. Is that a possibility? Is there anything else that could be preventing him from gaining weight?

Whenever I am faced with a “hard keeper” such as yours, I automatically divide up the causes (and therefore solutions) into two categories: medical reasons and non-medical reasons. Working with your veterinarian to rule out medical reasons—such as stomach ulcers (technically referred to as gastric ulcers)—should always be the first step.

Your friend is right, gastric ulcers is absolutely on the list of medical reasons for weight loss or being underweight (along with parasites, dental disease, infections, and other causes). Here’s the list of clinical signs of gastric ulcers that I work from to help me determine if a horse may be dealing with this problem:

Physical — loss of weight and condition, acute and recurring colic, reluctance to eat, poor hair coat
Behavioral — attitude changes, irritability, resistance to work, dullness
Performance — slower times, lead swapping, hitting jumps, reluctance to bend or collect, inadequate energy

Right now the only sure-fire way to diagnosis equine gastric ulcers is by gastroscopy, which means inserting an endoscope into the stomach and actually visualizing the erosions. However, because this itself can be a stressful event and also because not every veterinarian has access to a long enough endoscope, sometimes diagnosis is made based on response to treatment. That is, a horse with appropriate history and clinical signs is prescribed omeprazole-containing GastroGard and response to therapy is used to confirm that the horse does indeed suffer from the condition.

Generally 48 hours is all that is necessary to determine if the patient is improving on the treatment regimen. If so, then your horse will need to stay on the medication until his ulcers are fully healed. You’ll also need to work with your vet to reduce risk factors for the condition as well as make certain diet and management changes. One of these changes may be adding a daily supplement during treatment to support stomach health that your horse will stay on afterwards. Then you may just need to provide him with ulcer prevention therapy—UlcerGard—during specific times of stress, such as changing barns, removing a herdmate, or trailering to a lesson.

If gastric ulcers turn out NOT to be the reason for your horse being underweight—and your vet is unable to uncover any other medical reason—then you’ll need to review the NON-medical reasons for weight loss, which I break down into these four categories:

  • Food Quantity and Quality
    Step back and really examine the forage and grain your horse eats. Is the hay from two years ago and does it look more like straw? Is the pasture mostly weeds or too small for the number of horses it supports? Is your grain from a small, local source that may not understand proper horse nutrition?

    Now think about how much your horse eats. Is he getting at least 2.0% of his body weight every day in food (for a 1000 pound horse that’s 20 pounds of hay and grain hopefully divided into two or more feedings). Is he getting at least as much grain as the label on the bag says? Are there long periods of time during the day when he has no food in front of him?

  • Living Environment
    Time to consider if there is any stress in your horse’s life you can eliminate. For example, does he have to compete for his share of hay and grain? Is he constantly having to dominate or submit to other horses in his herd life? Does he spend most of his time confined to a stall? Does he travel and compete frequently? Does he heave relief from sun, bugs, and heat in the summer and wind, snow, and cold temperatures in the winter?
  • Age & Breed/Genetics
    Let’s face it, some breeds are harder to put weight on than others, such as thoroughbreds. And certainly as horses age into their teens and twenties their bodies begin to function less efficiently. However, this doesn’t mean that certain breeds or older horses have to be thin. It just means that they may need more veterinary care and improved diet and management to keep up their weight.
  • Use/Workload/Travel Schedule/Stress
    Next, bear in mind what calories you’re asking your horse to burn. Is he only used for occasional trail rides? Does he get ridden lightly four to five days a week? Or is he on a heavy training and competition schedule? Also remember that some horses do a better job of keeping up their weight (especially the topline) if given some controlled exercise beyond just turnout. Hacking on a long rein, lunging, or even handwalking up and down hills or over cavaletti may add muscle back to an inactive but thin horse.

Hopefully between this breakdown of medical reasons and non-medical reasons for why horses may be thin and your veterinarian’s help you’re on your way to a healthier, happier horse!

Lydia F. Gray, DVM, MA SmartPak Staff Veterinarian and Medical Director Dr. Lydia Gray has earned a Bachelor of Science in agriculture, a Doctor of Veterinary Medicine (DVM), and a Master of Arts focusing on interpersonal and organizational communication. After “retiring” from private practice, she put her experience and education to work as the American Association of Equine Practitioner’s first-ever Director of Owner Education. Dr. Gray continues to provide health and nutrition information to horse owners through her position at SmartPak, through publication in more than a dozen general and trade publications, and through presentations around the country. She is the very proud owner of a Trakehner named Newman that she actively competes with in dressage and combined driving. In addition to memberships in the USDF and USEF, Dr. Gray is also a member of the Illinois Dressage and Combined Training Association (IDCTA). She is a USDF “L” Program Graduate and is currently working on her Bronze Medal. Find Dr. Gray on Google+

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6 comments on “Ulcers and The Hard Keeper
  1. Cindy Dale says:

    We purchase smart digest ultra for comet, our gelding. He has issues with loose stools. We feed tribute balancer and timothy hay and pasture. One of the pastures has pond which he goes in and eats some of the grass on sides. Vet can find nothing wrong, stools are loose but mostly it is the after he goes that loose liquid runs out. Should we change to another type of product for digestive system. Thank you

    • SmartPak SmartPak says:

      Hi Cindy, thanks for your question, and I’m sorry to hear about your horse’s issue. Because it can be quite challenging to determine why a horse is experiencing loose stool, I would encourage you to continue working closely with your veterinarian, and make sure parasite control comes up in your discussions. It can also be helpful to keep a journal or log book of your horse’s daily routine including the quality of his manure. You might be able to see trends by keeping track of his day-to-day routine. This is something I do with my own horse, and I’ve found it to be quite helpful. You might experience the same! – Dr. Lydia Gray

  2. Haley Bruce says:

    Have a 17 yr.old gelding that -has developed a urine issue that causes him to dribble urine when nervous or excited. He Will sometimes walk and pee at the sametime. I have him on a supplement called Epic tokeep sludge and sediments From collecting in a mucus ball and clogging his Urethra. Also gets bladder infections e very now and then.He also is getting acupuncture to Keep nerves active witl bladder control and loss of top of tail loss in spring. He is a hard keeper and gets urine burns everynow and then if I’m not there. to clean his legs. Any reccomendations for him?

    • SmartPak SmartPak says:

      Hi Haley, sounds like you’ve got quite a challenge on your hands! Since this is a fairly complicated and uncommon medical condition it’s especially important to work closely with your veterinarian and possibly your local referral center or veterinary teaching hospital to keep your horse as healthy and comfortable as possible. They will be the best resources for diet and management advice specific to your gelding. – Dr. Lydia Gray

    • Lori says:

      Our OTTB has a similar issue right now. Would love to talk to you if you have had some success!

      • Lori says:

        This post was for Haley. Our horse is having a urine problem with dribbling also. Would love to know if you found out what the cause was and how to help your horse.Thanks in advance!

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