This year my handsome Warmblood Fabian went through some ups and down after we moved up to training level in eventing. He’s fancy, athletic and a good soul, which is the perfect trifecta for an adult amateur such as myself. Unfortunately, he was just not enjoying his job which left me questioning whether I should keep asking him to try and do his job. Turns out, he had a significant case of gastric and glandular ulcers. And trust me, this guy would never have been voted most likely to have ulcers.

Symptoms
Fabian is a pretty laid back, happy go lucky guy. He can be a bit lazy when he’s bored with my ride plan but for the most part his normal inclination is to at least try. When he thinks he knows better than me he can be downright cocky and a bit of a show off. But we just weren’t clicking in all three phases and he was stopping at jumps with no rhyme or reason. If I’ve learned anything through this process, it’s that there is no standard set of symptoms for ulcers. Here are some of the things we experienced that left me wondering what was wrong:
• Unwillingness to go forward, he would just lock into a “faked” outline and not give an inch
• Resistance to bending, especially to the right
• Not eating much hay during trailer rides, but eating just fine at destination
• Stopping at jumps. He would warm up great and then just hit a wall
• Sporadic wood chewing at show stabling
• A slight grumpy expression that I was probably the only person to notice

Conversely, he showed no signs of the following that are classically associated with ulcers:
• Girthiness
• Agitation at feeding time
• Weight loss
• Poor hair coat
• Snarky attitude
• Loss of appetite

Nothing about his living conditions would be suggestive of ulcers. My boarding facility does an excellent job of keeping the horses outside 24/7 as much as possible. He receives a good amount of hay throughout the day. We also weren’t going “hardcore” in our training and kept a lite competition schedule. Stressed is not an adjective people would use when talking about my horse.

Initial Assessment
I went through every possible situation and internal strife that comes along when something seems off, but not entirely broken, such as; we just need more practice, I need to ride better, let’s drop down a level, ride more, ride less, bribe him with cookies, bribe myself with wine and so on. He was never obviously “off” and I was getting worried that either a.) I completely sucked or b.) he did not want to be an event horse. That is not a fun place to be mentally. I called the vet to start ruling out physical issues that maybe I was just missing. We did a lameness exam and opted for joint injections (we had done this before without any miracles), checked his eyes (yep, he can see the jumps), basically he appeared fit and healthy. I chatted with my vet a little about his digestion in general, but to tell the truth I almost felt a little silly to bring up ulcers because he was not “an ulcer-y horse”.

I had changed his diet this summer from a traditional wheat-based concentrate for active horses to Buckeye Grow N Win (a soy based ration balancer) along with Renew Gold (a high fat supplemental feed) and alfalfa pellets. He had always been a bit gassy with occasional bouts of liquid farts. I thought maybe that was just his normal, but the feed changes really seemed to help. I had also experimented with giving him some UlcerGard for about 2 weeks since he had acted a little bit anxious during our last trip.

He was absolutely phenomenal at the show we went to following getting the UlcerGard. And yet I was still being a bit dense about whether or not he actually had ulcers. My vet suggested having him scoped for ulcers. As it turned out, my vet’s office was hosting an ulcer clinic and was offering the service at a significant discount. All of us who volunteered our horses would get to attend a presentation on ulcers and see the findings and photos from all the horses. I couldn’t sign up fast enough. But I was thinking in the back of my mind: oh he’s going to be the “no ulcers” example horse. Yeah, I was really dumb at this point.

Diagnosis
Fabian got to spend the night at the vet clinic so they could ensure food and water was withheld for the proper time. He was sedated, scoped and I picked him up mid-afternoon. I got to come back in the evening for a nice meal, chitchatting with other owners, a fascinating lecture and the big reveal of results. Several people I met were convinced their horses had ulcers, I was still dumb. Then, during the lecture the veterinarian started to talk about the latest understanding of ulcers and symptom trends. Some key points that were shared included:
• Prevalence of ulcers in horses that work at speed (including galloping and jumping)
• Ulcers are graded on a scale of 0-4, often horses at a 1-2 are more reactive than those who have progressed to 3 and 4
• Ulcers are not limited to skinny racehorses
• It’s hard to set a standard of symptoms

At this point I was finally starting to wise up and I’m pretty sure I developed an ulcer in that moment. They moved on to showing a description of each horse from the clinic and polling the group on whether or not they thought the horse would be positive for ulcers. All the folks I had met earlier who were convinced their cranky horses had ulcers, nope not an ulcer in sight. Then a photo of my handsome guy popped up with his description. I instantly knew the news would be bad. Sure enough, he was diagnosed with grade 3 ulcers of the squamous region and had lesions in the glandular portion of his stomach.

Treatment Plan
Fabian immediately went on a 60 day treatment of GastroGard. He was also prescribed sucralfate twice a day. This is a generic human medication that helps increase mucosal lining of the stomach. I decided to provide him with a hay bag. His body weight is perfect and I think the amount of forage he receives is just right. The hay bag just slows him down a little, so he can much hay for a longer period of time without wasting any. I also got a supply of alfalfa hay that I keep in my horse trailer. I give him just a flake before a ride. In addition to the higher calcium content in alfalfa, which is an antacid, the texture of alfalfa is so light and fluffy that it floats in the stomach and acts as a physical barrier to prevent acid from splashing onto the squamous region. Fabian thinks alfalfa is amazing and will always gobble it up. I now use it prior to getting on the trailer and mix it in his trailer hay bag to encourage him to eat more hay while traveling. I’m a bit of purist by nature and wanted to keep things simple when it comes to his feed and supplements. The change I made to his grain earlier in the year has worked out really well as part of his ulcer prevention plan. He now eats a much smaller volume of concentrates with no negative impact to his caloric needs.

I opted for adding Neigh-Lox as a supplement because the formula is simple and well researched. I can also give him the supplement ad hoc as a treat just prior to stressful situations, like trailering and competitions. I also keep a supply of UlcerGard on hand to start administering in advance, during and just after a show.

Within about 2 weeks of his treatment plan, I really started to notice some improvements in his behavior and performance. That little hint of grumpiness had disappeared, and he was super happy and cuddly each time I went to fetch him from his paddock. On the flat he was responding to my leg, willing to reach for the bit and happy to bend and supple during our warm-up. 4 weeks into treatment we had a xc school and he was more than ready to get his gallop on and drag me around to the fences. Around the 50 day treatment mark I took him back to the vet clinic to be scoped again for a recheck. The difference was amazing and it was such a relief to see all that healthy tissue.

Now, it’s no miracle and he’s still a bit lazy when we start on the flat and I still have to ride a proper line to a fence. But the biggest difference is that he’s back to trying, which means we are back to being partners.

Recommendations
I was very fortunate in my situation by getting the opportunity to have my horse scoped at a discounted rate. I always had it in the back of my mind that doing the scope was cost prohibitive and you could just try an ulcer medication and see if the horse felt better. But truthfully, without seeing the actual evidence I was never fully convinced the ulcers were a real problem that needed to be treated, fully healed and prevented from coming back.

In speaking with my vet, I also learned the actual cost was not that much of a barrier. I spent far more money on joint injections with less tangible outcomes. To be quite honest, I’ve spent far more money on tack I didn’t need and clothing I really didn’t need. Getting to actually see the inside of my horse was fascinating, educational and extremely enlightening as to his wellbeing. Now that I’m cognizant of the fact he has had ulcers, I’m more committed to working on preventing them. If we start to struggle again with similar issues I won’t hesitate to make an appointment to have him scoped for ulcers.