February 19, 2010 by hhabc | Edit
When Lily first showed signs of what later would be called gastric distress, it was masked as a “cinchy, irritable” horse. Gentle cinching, and the use of softer materials decreased the symptoms and we went on thinking “sensitive-skinned” horse. What I had not counted on was her past show jumping career may have followed her.
As a low-key walk, trot school horse in my program from a routinely competed show jumper at ages 4 – 7, Lily was harboring a hidden history in her GI tract that would eventually lead to her death. As her “cinchiness” agitation toward students worsened, I contacted a local equine nutritionist and altered her diet. She already had full-time paddock/stall access, fed frequent high quality Orchard grass hay and regular exercise. We added rice bran and moistened orchard pellets to ease her digestion. I also notified our Vet and we implemented an effective Ulcer healing and maintenance product that would ease her discomfort and we could determine if it was ulcers by the decrease in symptoms.
This helped for awhile, and then her symptoms worsened again and seemed to come and go with more frequency. Our Barn Vet was again notified and a plan to scope her was implemented. By the time the appointment came, Lily had been on several months of the Ulcer medicine. The scope was able to reach the part of the stomach that empties into the small intestine and showed extensive scarring from “healed” ulceration. It was definitive she had healed ulcers, but why were her symptoms worsening? Over the next 10 days Lily declined rapidly. She stopped eating and drinking and had to be rehydrated twice. Blood was drawn and she was found to be in advanced liver failure. Her pain was increasing and I made the heartbreaking decision to end her suffering.
Although we are not fully able to understand why she went into liver failure, speculation that there were ulcers in the small intestine that scarred over the bile duct where the liver empties bile into the intestine may have occurred. Could this have been avoided? See the article below from Tuft’s Cummings School of Veterinary Medicine:
Gastric Ulceration in Sport Horses
Sport horses tend to be stabled horses, and consequently suffer from one of the most common health problems of the stabled horse – gastric ulceration. We humans have the luxury of a quick trip to the drug store for our favorite heartburn remedy, and we can call our physicians for a more in-depth diagnosis of why we experience such agonizing gastrointestinal pain. Horses can only show us by indirect signs that they are in chronic, debilitating pain. It isn’t surprising that gastric ulceration can actually be a cause of poor performance in the sport horse.
• What is gastric ulceration?
In any species, we are referring to an erosion, or sloughing of one or multiple areas of the surface layer of the stomach. Gastric ulceration is very common in horses. In various studies, from 70% – 100% of horses examined had endoscopic evidence of gastric ulceration. This, however, does not mean that all of these horses had clinical signs of gastric ulceration. Unlike people, who develop gastric ulcers in response to a bacterial infection, no infectious cause of gastric ulceration has been identified in horses. Few specific causes of gastric ulceration have been clearly identified. However, most practitioners recognize that stress seems to precipitate gastric ulceration in foals; and infrequent feeds of low-roughage, high carbohydrate foods and a high level of training have been implicated in adult horses. Unlike humans, horses secrete gastric acid continuously, whether they are eating or not. In the wild, horses spend the majority of their days continually eating small amounts of relatively poor quality, high roughage food. Continual acid secretion accommodates this natural lifestyle perfectly. When horses are fed large quantities of high quality food infrequently, their stomachs rapidly empty, essentially leaving the stomach with nothing to do. The stomach has a variety of protectant factors against the effects of gastric acid, but when the stomach is empty, the horse’s ability to withstand the effects of gastric acid can be overwhelmed. The use of certain anti-inflammatory drugs (such as phenylbutazone (‘Bute’) or flunixin meglumine (Banamine™) canalso induce gastric ulcers in horses (more on this later). If gastric ulceration becomes severe, the erosions may begin to bleed. Horses can eventually become anemic and low in protein due to losses through the gastric ulcers. What are the signs of gastric ulceration? Symptoms associated with gastric ulceration in adult horses may include recurrent or acute colic, decreased appetite, decreased manure production, poor body condition, poor haircoat, poor performance, and a crabby attitude.
• What are the signs of gastric ulceration?
• How do I find out if my horse has gastric ulcers?
• How do I prevent gastric ulcers?
• Learn more about gastric ulcers
WOW (Words of Wisdom):
If you suspect your horse has ulcers, notify your veterinarian immediately and get treatment as soon as possible. Many horses are mistreated and blamed for poor performance as “lazy” or “hormonal.” As I look back and have suffered through the “what if’s” I have come to believe I did everything I could with the knowledge I had at the time and implemented the interventions available. We will miss Lily, but her experience may hopefully help many horses.
Thanks, Robyn. This was very informative, and a valuable reminder. As a massage therapist I spend a lot of time looking at musculo-skeletal causes for pain or irritability, but unfortunately organ-related pain like ulcers must be much more common than we realize, especially in stabled horses as you point out. And not easy to diagnose, but also not impossible, as your experience (and Lilly’s) shows.
I’d like to point out two ways that massage and bodywork can help, although they’re no cure for the ulcers themselves. As you mentioned, stress can be a contributing factor to gastric ulcers, and routine massage is a great stress reducer, so it may help in prevention. (Removing the original causes of stress to the system, as much as possible at least, would obviously be even more effective. But all harmful stresses cannot always be removed.)
Also, once ulcer pain has started, muscles will respond with chronic tightening, especially muscles of the abdomen, ribs, and back, but eventually also the neck and more. This is simply a natural response to pain, to tense up and breath more shallowly. So the muscles will benefit from massage to counter these effects. That way, once other treatments for the ulcers take effect and organ pain is decreased, the joints and muscles can also better return to full health and function and not stay stuck in the old tension pattern.
Thank you Megan. I have to add that Lily showed muscular stress very early and we used Chiropractic and Massage thinking her symptoms were unrelated to the gastric/abdominal distress. She did not seem to respond as well to the interventions as other horses would have, but looking back, she had just started treatment for the ulcers and we were unaware that the two may have been linked. This may explain why she needed more frequent Massages and Chiro care during the healing process. I am glad we were able to ease her distress even if we thought the two were unrelated.
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