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  Discussion on Deglycyrrhizinated licorice for gastric ulcers
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Member:
jones

Posted on Saturday, Jan 2, 2010 - 7:07 pm:

Dr.O,
Happy New Year!

My horse has ulcers and is on Rantidine (spelling?) 3 times a day for the last month.
He gets aloe vera (Cup a day)
I have a product called G.U.T from Uckele (product annalysis below)
It has Deglycyrrhizinated licorice (DGL) in it.
This extract is apparently effective in humans for helping to heal gastric ulcers.
I can't find anything about it on the internet regarding horses other than from manufacturers of products that contain it.
I am wondering if you can find anything in your magical sources about the dosing for horses for effectiveness and its potential toxicity.
I have a product marketed for humans that has a DGL dose that is 2.3 grams (750mg 3 times a day) which is 4 times the amount in the Uckele product for horses.
If the dose in GUT isn't high enough then the product is probably worthless at best. I can give him the human stuff if it will be helpful but wont unless I know its toxcity has been tested.

G.U.T.
Declared Ingredients
Ingredient Per Serving Per Pound
Lactobacillus Acidophilus 1.5 billion CFU
Lactobacillus Lactis 1.5 billion CFU
Magnesium Silicate 2400 mg
HyDrOlyzed Collagen 3400 mg
Mannose 2600 mg
Glycine 750 mg
L-Glutamine 525 mg
Deglycyrrhized Licorice Powder 525 mg
Gamma Oryzanol 150 mg
Sodium Copper Chlorophyllin 150 mg

Thank you!
Member:
ajudson1

Posted on Saturday, Jan 2, 2010 - 10:11 pm:

DrO will have to answer about the toxicity in horses, but I know first hand that deglycyrrhized licorice works great for ulcers, and acid reflux pain. I wouldn't consider it worthless even at a low dose but that's just my opinion. I believe in it's healing properties.

Aloe is healing also, and also a laxative.
Moderator:
DrO

Posted on Sunday, Jan 3, 2010 - 10:19 am:

I am afraid we have no information on DGL in horses jones and none of the other ingredients are shown to heal ulcers. What are you paying a day for this care?
DrO
Member:
jones

Posted on Sunday, Jan 3, 2010 - 3:22 pm:

Dr.O,
It is 68 Cents a day through Smartpac....My girlfriend gave it to me...she couldnt get her horse to eat it.
It smells like a milk shake to me!
The smarkpak site has a few products for ulcers.

https://www.smartpakequine.com/Charts/ulcersuppcompare.html

Some of those ingredients may be for comfort and not healing ...like an antacid, not sure.
The smartpac version of gut has 1500 mg of the DGL in it...would it be safe to say I could give him 1500 mg of the DGL a day?

Do these companies need to test ingredients for toxicity before they market them?

The only study I saw about DGL was about mice and asprin coated with DGL. The mice had way fewer ulcers if given the DGL coated asprin.

Do you have any concerns about giving a horse U-guard or Pro CMC (antacids)for longer than a week or 2?
He seems to do much better if I give him the Pro CMC in addition to the rantadine.
Does generic Gastroguard (Omeprazole) not work at all to heal ulcers or just not as well as Gastroguard?

I had given my horse herbal antinflamatories and after 3 days it seemed to really agravate his ulcer so I stoped them.
Thanks for answering on the weekend!
Member:
jones

Posted on Sunday, Jan 3, 2010 - 3:57 pm:

Dr. O.
Okay...I just read the Ulcerguard article.
The study that compares the Ulcerguard to generic Omeprazole states that the ph of the vehicle was of interest in possibly impacting the effectiveness of the other preparations.
Are they refering to the ph of the medium the drug was mixed into to get it into a paste so it could be put in the syringe? Like did they use a pill and grid it up like I do or did the stuff already come in syringe?
Do you have access to the full study to know how they prepared the formula?

I mix my rantadine in aloe vera juice...just looked it up, eeeeK, aloe vera juice has a ph of 3.4! I cant tell what the ph of water in our area is...its got to be higher than aloe...& you told me to use water!
I know its not the same drug but I will start using water again!
What if I give Omeprazole (the human pill form)
in a very basic medium?
Giving rantadine 3 to 4 times a day is tough!
Thanks!
Member:
rtrotter

Posted on Sunday, Jan 3, 2010 - 5:13 pm:

Jones,

Ulcergard and Gastrogard are the same product made by the same company. As far as I know there is no differences except the Ulcergard is marketed as a preventative and does not need a prescription, the Gastrogard is marketed as a cure and does need a prescription. So, if you use a whole tube of Ulcergard its the same as a whole tube of Gastrogard.

As far as generic preparations using omeprazole, my understanding is that they are not as effective because Merial uses a proprietary mixture of other ingredients in the manufacture of Gastrogard and Ulcergard that when used in combination with the omeprazole makes those products more effective. No one seems to have come up with another combination that works as well. Unfortunately, it is very expensive and everyone usually looks at a cheaper solution to what is usually a longterm problem.

Having been through several different treatments for my horses, I've found environmental management to be the best and perhaps the cheapest way of keeping the ulcers at bay. My horses stomachs are full, they are turned out as much as possible and I try to keep them as relaxed as possible, even when exercising.

Rachelle
Moderator:
DrO

Posted on Sunday, Jan 3, 2010 - 6:40 pm:

jones, how much are you paying for the aloe and ranitidine?

I do not know if the DGL is safe and in general there are very few requirements for nutraceutical testing. Nor do I know if long term administration has any complications associated with their use in horses. There is just no work done on this. The generic used in the studies were not compared to no treatment at all so really do not know but in the California study they pronounced the generic suspensions as ineffective. As to your proposals and conjectures, I just don't know.
DrO}
Member:
jones

Posted on Sunday, Jan 3, 2010 - 9:59 pm:

Dr.O,
Thanks.
Im paying about $3.40 a day for the ranitidine and 50 cents a day for the aloe vera juice.
For a grand total of 3.90 a day.
oh, and he gets a 1/4 cup of corn oil
What do you think of the aloe vera juice.
Now that I know it's so acidic, I may not continue it...like drinking orange juice with an ulcer...ouch!
Where would I get horse amounts of pectin and lecithin, if that is still recommended.
Rachelle,
Thanks for the input. I do what I can, living in the desert does not allow for much pasture!
I may need to separate him and his buddy so that I can give him all day access to hay. His buddy would pop if I left free choice hay all day for him.
Moderator:
DrO

Posted on Monday, Jan 4, 2010 - 6:51 am:

Taken from a discussion back in June:

Concerning aloe vera juice, some experiments with rats have found some protective qualities while other studies have found mixed results with improvement at some rates of administration and problems with other rates. All research is preliminary and some have criticized the lack of standardization of the carrier. One study noted the improvement was similar to that seen with sucralfate (see article for dosages).

At best it did not heal ulcers but did reduce severity of those induced by acid but not those induced by histamine. If you choose to use this experimental treatment you should consider it as an adjunct to omeprazole and not a replacement.
DrO
Member:
rtrotter

Posted on Monday, Jan 4, 2010 - 7:03 am:

jones,

My horses do not have much access to pasture either, but they are outside and not stalled for as much of the day as possible.
You might want to look at some of the slow down feeders some members have recommended as a way to allow your horses to eat the same amount of hay only slower, so you wouldn't have to separate your horses, which might lead to further gastric ulcer problems.

I have found that my horses do limit themselves as long as they have hay in front of them 24/7. The trick for me was finding what that amount of hay was without wasting any of it for each horse.

Rachelle
Member:
jones

Posted on Monday, Jan 4, 2010 - 8:03 am:

Dr.O,
I am just looking for the best adjunct to the Ranitidine I am giving him.

Where would I get pectin and lecithin for a horse?
Which article has the aloe vera juice dose recomendation?

My horse is turned out all day and has access to a stall at night if he wishes. The other horse eats 24/7 and looks like he is going to give birth to twins if I leave food out all the time. He doesnt eat fast, he just eats all the time. Jones walks away from the hay for periods of time and when he comes back for more the other horse has eaten most of it.
If they are seperated they will still be next to each other, just dividing the turnout in half.
Thank you.
Moderator:
DrO

Posted on Monday, Jan 4, 2010 - 5:07 pm:

We don't know if any treatments that have been shown to be a good adjunct for ranitidine so this is all just conjecture.

The dose for sucralfate is in the gastric ulcer article but we do not have a aloe vera dosage. As to the pectin-lecithin I only know on company that makes such a product:

Boehringer Ingelheim Animal Health
Pronutrin

Active Ingredient
Pronutrin contains proto-pectin fibres derived from apples, wheat fibre, pea fibre and citrus fruits, phospholipid in the form of lecithin, glycerol and natural flavours.

Indication
Maintains the integrity of the gastric mucosa in stressed horses.

Characteristics
The dietetic ingredient in Pronutrin is Apolectol, a patented combination of pectin, glycerine and lecithin. The properties of the various ingredients of Apolectol contribute to an extensive dietetic effect. Pectin prevents the increase of gastric acid and stabilises the natural balance of the stomach mucous layer while the lecithin / glycerine components strengthen the hyDrOphobic protective layer of the gastric mucosa. In this way Apolectol® provides a natural double protection of the sensitive mucosa. It stabilises and regenerates the protection against the aggressive gastric acids and at the same time prevents an excess of gastric acid in the stomach.

When should Pronutrin be used?
Scientific studies have proved the positive effect of supplementing the feed with Pronutrin. If one or more of the above symptoms lead you to suspect (or gastroscopy proves) that the horse suffers from lack of nutrients for natural protection of the gastric mucosa, and when all other causes of these symptoms have been eliminated, a Pronutrin diet is recommended.

Pronutrin can also be used routinely to help against relapses or before situations that may require benefit from the nutrients found in Pronutrin to support the natural protection of the gastric mucosa.

Horses can benefit from Pronutrin when a high performance level is required during training or competition, when feeding high levels of concentrates, when the feed is reduced or the horse refuses to eat, when the feeding intervals are too long, when the hay quality is poor and when changing from one type of feed to another. Other factors such as frequent or long transports, weaning of foals, rank conflicts in the herd, and operations and diseases (especially colic) are also times when the use of Pronutrin may be of benefit.

For more on the use and what we know about its efficacy see the gastic ulcer article.
DrO
Member:
rtrotter

Posted on Tuesday, Jan 5, 2010 - 8:05 am:

Dr. O and jones,

A few weeks ago I too was doing the research to try and find a product to treat ulcers and came across Pronutrin. When I tried to find out where it was sold the only place I could find it was in the UK. Is this an OTC preparation or a prescription product?

I am wondering why it is not sold in the USA, and if it is Dr. O, do you have a contact for it.

I don't need it now, but would be nice to know if I needed it in the future.

What helped my colt was making sure he had hay in front of him, changing the hay to an orchard grass alfalfa mix and removing the portion of his concentrate that had extra high fat feed and adding oats. His grumpiness has stopped, his gasiness has stopped, he is no longer girthy when harnessed and his attitude for work seems to be a lot better. He also looks good and feels good.

Rachelle
Member:
jones

Posted on Tuesday, Jan 5, 2010 - 11:06 am:

Thank you for all your guidance Dr.O,
You are the man of science...sends my scheeming mind back on course...after a bit.

I am starting to think that for peace of mind I may want to just go with the Gastro/Ulcerguard.
I can get it for $29 a tube at
https://www.horsewarehouse.com/
for the recommended treatment time frame...one tube a day for 28 days then 1/4 tube for 28 days...that comes to about $1025.00 without S&H.

I can't be certain his ulcer is healing/healed just becuse he is asymptomatic with the ranitdine (aloe, corn oil, Pro CmC et al :-)
Once it is healed I know good management/being proactive will be the key to keeping him from ever having another.

I could just have him scoped in 2 months and see where we stand then but if its not healed at that time I'm paying for the scope and the Gastro/Ulcerguard treatment! I may as well go to Vegas for the weekend ;)

He started showing the signs of ulcers after returning home from being up north for 2 months this summer...he had lots of trailering and a new facility etc and then came home, 2 weeks later he coliced.
He will go up north again this summer (Phoenix summers are brutal!) and I will be very proactive about protecting his stomach.
Thank you!
Moderator:
DrO

Posted on Wednesday, Jan 6, 2010 - 1:22 pm:

jones, if he is asymptomatic at this time and you can manage him to minimize ulcer formation before I spend the big money I would see if it continues to be asymptomatic after coming off the current regimen. Treat if symptoms return. If this is a big concern I would have him scoped before beginning treatment if at all possible.

rtrotter, I don't know if the company sells this product directly to the public but see no reason for it to require prescription.
DrO
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