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  Discussion on Alternative to Gastrogard for Ulcers
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New Member:
nterry

Posted on Monday, Mar 3, 2008 - 7:26 am:

Dr. O & others - What would be your recommendation for a 17 y.o. mare that is exhibiting ulcer symptoms that may be from long term infestation of encysted strongyles and/or being fairly confined for 3 months due to leg injury. The ulcer symptoms are, pinning of ears and threatening with hind leg when being groomed on flanks. I can not afford $34. per day for 28 days for Gastrogard. I am giving her 2 days worth starting yesterday. It sounds like that may be a waste of $$ if I can't continue the treatment. I have had a vet in the past recommend Neighlox for symptoms and it seemed to help. Another vet has recently suggested I use U-7 Gastric Formula which contains Aloe vera, apple cider vinegar, honey, cabbage powder, MSM, chamomile flower, carrot powder, apple pectin, grape seed extract & slippery elm. The diagnosis for encysted strongyles is due to blood work indicating low RBC, low hematocrit and high Bilirubin in blood work done on average, every 6 months over the last 3 years. The blood work has slowly improved each time. This leads to conflicting opinions I have received from different vets regarding the best treatment for the symptoms and indications of encysted strongyles. Should I address that question in a post relating to worming programs? Thank you for your help. P.S. Lee, Thank you for telling me a better way to get responses to my posts.
Moderator:
DrO

Posted on Tuesday, Mar 4, 2008 - 5:46 am:

No this is fine NM Terry we can handle all these questions here. First lets deal with the symptoms. Concerning the behavioral problems why do you think these might be do to ulcers? It is pretty common for dominant horses to resent grooming in these areas and this type "grumpiness" not really indicative of gastric ulcers. That said, the article describes several less expensive alternatives to Gastroguard and discusses their effectiveness.

Concerning the blood work this is certainly not specific for encysted strongyles: do you have some history of high exposure to parasites in combination with a poor deworming history? What was the Hct, Hb, and the bilirubin levels. It is important to have both a direct and indirect (some labs refer to this as conjugated and unconjugated) bilirubin.

Let me ask you what is the overall condition of your horse, is the horses appetite good, and are the stools well formed?
DrO
Member:
paul303

Posted on Tuesday, Mar 4, 2008 - 9:21 pm:

Dr.O, When my horse came home from the clinic after diagnostics and treatment for ulcers, they sent her home with, of course Gastroguard, but also with a HUGE bottle of pills called Sulcralfate. They weren't that expensive - and she was to be on them for 10 days. Are they of any value?

NM Terry: In my own experience, the mare I had with ulcers was very touchy about her sides and girthing. She would snap and cowkick when any work near her sides or girth was attempted. We thought she just had a mareish nasty streak until after about a year of owning her. A few times during the year she acted a bit colicky here and there, and went off her feed. But this behaviour was fleeting and passed quickly. When the biggy came, she went down on her belly, kept turning to look at her side, grunted and moaned, wouldn't get up, and wouldn't eat. It's been nearly two years,and the nastiness never returned. So, yeah, it COULD be ulcers...but it could be something else.

This is such a frustrating spot to be in, this stage of trying to figure things out. Hope you find the answer soon.
Moderator:
DrO

Posted on Wednesday, Mar 5, 2008 - 6:46 am:

Hello Lee,
We review sucralfate's actions in the article on ulcers. You are right "grumpy" horses can have ulcers too.
DrO
New Member:
nterry

Posted on Wednesday, Mar 5, 2008 - 8:27 am:

Thank you for your response! Giesla is a dominant horse. She has good ground manners which is why the crankiness about being groomed seems odd. I brought her to NY from Dallas TX 2 years ago. She has been a different horse in many ways since I brought her north. One of the biggest reasons for that is that she contracted Lyme Disease and had several episodes of Lyme and what was diagnosed 2x as erlichiosis almost non-stop for the first year after she was moved. We did not the ticks in TX.

I had her tested for Cushings in Oct of 2005 in TX as her hair coat had stayed longer than usual with wispy hairs in it. That was the only symptom. I never suspected ulcers or parasites because she had been on daily stronngid and 2x a year Ivermectin (fall/spring). I had done a 5 day Panacur Power Pak the previous spring because she wasn't shedding out well. At the time, she had free access to pasture almost 24 hrs/day that was well managed with 1 to 2 other horses sharing a 3 acre pasture at any time. Her stall and barn paddock were cleaned daily.

Blood work done 10/5/05 resulted in the following unusual results. I won't list those that appeared to be normal.

T. Bilibrubin, 3.5 Cholesterol, 64 Creatinine, 1.1 Glucose, 30 LDH, 584 WBC, 6.2 RBC, 5.6 HGB, 10.1 PCU, 29 Neutrophils, 78 Lymphocytes, 22 Absolute Lympocytes, 1364 Tr, 1.2 IgT (RID), 850 mg/dl

A fasting Cushings Scan with a Dexamethosone Suppression was done on 10/19/05. Results were: Thyroxine T4 AM, 13.5 Insulin AM, 8.3 Cortisol AM, 56.30 Thyroxine T4PM 16.4 Insulin PM, 22.10 Cortisol PM, 40.3

She was taken off the daily strongid and put on an 8 week rotational worming prgram. She was tube wormed on 11/6/05 with Anthlecide. Another Cushings Screen was done on 1/10/06 that came back normal.

7/17/06 Elisa Units: 394, I don't think a western blot was done. At this time, she was put on a 6 week worming program of only Ivermectin, with Ivermectin Gold used once each Spring & Fall. A 5 day Pancur Power Pak to be done in late Spring. That is what I ahve been doing since then.

10/24/06 Elisa Units: 332 Western Blot: Low level of Antibody to Infection.

She was then vaccinated with the Lyme Vaccine 12/12/06, 12/26/06 & 3/2/07.

The following are results out of normal range from blood work done on 1/10/07. RBC, 5.94, HGB, 10.1, HCT, 28.4 LYM, 1.0 TBIL, 8.5 TP, 8.0 GLOB, 5.0

1/9/07 She did not want to eat, had a fever of 103.5, had swollen legs, did not want to be touched anywhere - Diagnosed as Erlichia. Elisa was 516.

Following are results out of normal range from blood work done 1/31/07. GRA, 9.3 CK, 544 TBIL, 4.4

I had another fasting Cushings Screen done 8/1/07. (No Dexamethasone test.) ACTH, 27.2 Insulin, 10.89 T4, 1.92 T3, .41
Elisa Female Result: 486, Result: 516. Western blot: Moderate level of Vaccinal antibody. Was compared to previous submission and therewas a decrease in intensity of the bands for infection.

11/30/07 Erlichia screen = neg.

Please let me know what you think this may all indicate. Thank you so much.
Member:
kathleen

Posted on Wednesday, Mar 5, 2008 - 9:17 am:

N Marsh Terry
Have you had her stomach scoped? If not, that would be the first thing I would do if I suspected ulcers. It is not very expensive. My mare had recurring ulcers for 8 years and had the same symptoms including the multiple minor colics, except she never went off feed. When the vets at Marion du Pont Scott Equine Medical Center started treating her again (she had been treated by them in the past), they said that she didn't have the "normal lifestyle" of a horse who gets ulcers (this was before they found that a majority of horses have ulcers without symptoms and they heal on their own) , so after they scoped her and confirmed ulcers again, they decided to treat her until she scoped free of ulcers. It took twice the time they normally recommended for treatment. She was scoped periodically after the ulcers went away and has not had a problem for about the last 7-8 years. In the past she was scoped then treated then scoped and when they found that the ulcers were almost gone, they said that they would continue to heal (but that was apparently not the case with Mona). When the ulcers went away the behavior also went away and has not come back. This is just FYI, not trying to diagnose your mare, just relating my experience.
Kathleen
Member:
paul303

Posted on Thursday, Mar 6, 2008 - 1:27 am:

NM Terry: Your horse has had a lot going on. I agree with Kathleen that a scoping would clear up the ulcer problem. If it's ulcers, then a course of Gastroguard would clear things up and you might actually spend less in the long run ( if it is, indeed, ulcers ) than chasing a diagnosis.

By the way, my mare came to me from a long way off also. She had a really long trailer trip. She was also heavily shown and produced 3 foals before I got her. As in Kathleen's case, the clinic hesitated at first to scope her because her laid back environment at my place was not conducive to ulcers. When they did, they found her upper and lower stomach "riddled with ulcers". The price of the scoping was not too bad, and, once the ulcers were confirmed, the Gastroguard, as far as "bang for the buck" was worth it's weight in gold.
Moderator:
DrO

Posted on Thursday, Mar 6, 2008 - 7:28 am:

Hold on everyone, the only chronic symptoms I have read is grumpy behavior when groomed in the flanks, a slight tendency to shed out late, and a one time episode of fever and leg swelling over a nearly 3 year period. Have I got this right NM Terry?
DrO
New Member:
nterry

Posted on Thursday, Mar 6, 2008 - 7:54 am:

I need to respond to your earlier question of what her overall condition is, etc. She has a long hair coat that is wavy on the legs and when her neck gets wet from rain or snow it looks like she has had a perm.(turnout protects the rest of her when she goes out in bad weather.) Her manure has been well formed and she looks like a pregnant broodmare. She gets very little Senior Feed and pretty much free choice good quality hay with a variety of supplements. She has been on restricted turn out since late Oct due to having 2 slightly bowed tendons identical on the top of both front legs. (Ultrasound diagnosed as bad sprains - no tears or ruptures) from several months of incorrect shoeing. That was resolving nicely after corrective shoeing w wedge pads when she came in from the pasture 12/26 with her outside hind left splint bone broken all the way through and a bad puncture wound near it that had gone into the tendon sheath. She is, as of the last 4 days, able to be turned out in a good sized paddock again. I gave her 2 days of Gastrogard Sat/Sun. Her eyes have gotten noticeably brighter and she seems to feel better. She had over the past 2 months deteriorated in appearance. I have been ground driving her for 30 mins a day for the last month and she has been cranky about being groomed, particulary around her chest & flanks and is girthy when tightening the curcingle. that behavior seemed a little better the last 2 days. It is hard for me to know if that is due to the Gastrogard or the fact she is finally able to have some freedom from a tiny paddock and her stall. Her hind legs had some swelling each time she was diagnosed with Lyme or Erlichiosis. Her hair coat has gotten longer each winter. I had her clipped in Oct and it was quite long by early Dec. Thank you for your help. Nancy
Moderator:
DrO

Posted on Friday, Mar 7, 2008 - 6:29 am:

I would say having to be stall rested for the last 2 months would raise the cranky behavior coefficent and not that following turn out you would expect her to feel better. The longer wavy hair coat is common with aging, for more on the diagnosis and treatment of Cushings see, Diseases of Horses » Endocrine System » Cushing's SynDrOme and Pituitary Tumors. Note there is no dependable laboratory test for this.

Nancy review the Hennecke scale for judging horse condition, you will find it described at, Horse Care » Routine Horse Care » Estimating Weight, Height, and Body Condition Scoring. I would interested where in the scale she falls.
DrO
Member:
nterry

Posted on Wednesday, Mar 12, 2008 - 7:08 pm:

I reviewed the Hennecke scale and after measuring and doing the calculations, I would say my mare is between 1140 - 1150 lbs, is a 5 on the condition score and is 16 hands. She was bathed today in preparation for a body clip tomorrow and she looked like she had a perm all over. The hair all over her hair was completely wavy! I would say her hair has gotten longer each winter, and the waviness is new this winter. I will be interested to hear your thoughts. Should I start treating her for Cushings? We also discovered a swelling between her front legs yesterday. It is not a hematoma and is kind of a loose swelling. She had a swelling on the left side of her throatlatch about 3 weeks ago that went away after about 3 days.
Moderator:
DrO

Posted on Thursday, Mar 13, 2008 - 8:08 am:

Hello NMT,
In general we do not recommend the addition of medication unless symptoms cannot be managed. The article gives specific recommendations for managing the decreased condition and hair problems and should be reviewed.

For assessing swelling see, Diseases of Horses » Skin Diseases, Wounds, and Swellings » Swellings / Localized Infection / Abscesses » Diagnosing and Assessing Swellings in Horses.
DrO
New Member:
jones

Posted on Thursday, Dec 3, 2009 - 10:33 pm:

Lee,
Regarding head lowering behavior, if you still have this as an issue. I have a similar situation with my horse lowering his head when asked to move out. This is newer behavior...in the last 5 months.
I found out the old saddle was too narrow. We rode in it for 2 1/2 years before the was an issue I noticed.

New custom saddle is much wider in the gullet (they used a plastic mold of his back to make the saddle). Now after 1 month he is worse than ever.
After research and talking to a lot of people.
The wide gullet is allowing the middle of the bars/pads to make too much contact with his back and it is the opposite of bridging, it is rocking, right under my sits bone.
I have been told this saddle fits him perfectly (as I was told that about the last saddle)
His back does not agree. When I groom him hard over his Para spinal muscles they and he flinch down. He has never done this before.

If you are game, look for "rock" in your saddle.
Rock is demonstrated by you pushing down on the front/gullet and the back rising up, or it may rise up in the back a bit when first cinched tight.
A little bit of bridge allows the horse to round into the space verses hollowing away from the pressure. I tried the saddle with a Corrector pad and it was much better, but the Corrector essentially lifts the center of the saddle up off the horses back a bit.
I am trying a Wintec CAIR system this weekend.
I hope you are finding results in what ever you are doing for/with your horse.
Lesley
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