Learning about gastric ulcers and pH levels

After Kobeejo colicked (a strangulated lipoma, which is unpredictable and unpreventable) and they also found ulcers in his stomach, I decided I needed to look into this further. I have always been a huge fan of 24/7 forage and no grains (just a ration balancer) and was always taught that this would prevent ulcers in horses. Even at the vet hospital, I asked them "How can a horse on 24/7 free-choice forage get ulcers?" They had no answer. The head of veterinary medicine even said to me, "Everything I would normally tell you, you already do." So, as is my habit, I began to research... a lot!

pH Levels in the Stomach:

The normal "cut-off" for equine intestinal pH is >4.0. Neutral is 7.0. So 4.0 is acidic. But, in the bottom layer (glandular), pH levels are naturally going to be low because that is where hydrochloric acid is produced and stored. Kobeejo's ulcers are located, typically, in the squamous (upper, or non-glandular) layer of the stomach.

I know all about pH levels due to my involvement in fish tanks many years ago, but I never knew how important it is for horse gut health. I know high starch can lead to low (acidic) pH levels, so I have always avoided hay that is high in starch (and low in NSC because of his IR and Cushings). Just as a reference, NSC means non-structural carbohydrates, which includes water-soluble carbohydrates (WSC), simple sugars and starch. ESC is included. If this level in a test of hay is below 10%, it's good for horses with insulin issues.

Now I have begun to look into other reasons for Kobeejo's ulcers. I know horses on a lot of grain are prone to ulcers, esp if they are not on 24/7 forage. That is the main recipe for ulcers. According to one study, 57% of all recreational (non-performance) horses have ulcers.

A friend mentioned foals with ulcers, but I researched that and found those were different types of ulcers (a horse has many areas of their gut that can be affected and each has its own reasons). So, that did not apply to my 27 year old Paint.

Another friend mentioned some horses are predisposed to ulcers. I could not find much on that, other than certain stressors can affect each horse differently.

Accordingly, it has been determined that most horses with ulcers have them near the margo plicatus (which I have also heard called the Cuticar Ridge), which is the area between the glandular and non-glandular portions (top and bottom) of the stomach. This makes sense. When a horse moves at anything above a walk, acid splashes onto this region first.

Kobeejo's ulcers were located above this ridge. Usually, if a horse's stomach is empty when they are heavily exercised, the acid splashes onto this region. Thus, a horse without 24/7 forage that is worked hard regularly will be more prone to these ulcers. A full tummy means the acid is buffered and kept to the bottom portion of the stomach (feeding your horse forage before work will help protect against ulcers because it will form a "net" layer in the lower stomach, preventing the acid from splashing up into the non-protected layer).

The problem, which is what came to my mind, is that how can we be sure our horse's stomach is full of forage (not grain) before working them? Unless we watch them 24/7 and know they just ate a good amount of hay before work, how can we truly know? A horse's stomach is small. Food goes in, and it continues onward pretty quickly. Within the span of 15-30 minutes the stomach is empty again. We cannot force our horses to eat hay right before work. I would personally recommend grazing them on grass before work, but I know for many this is a hindrance and non-practical.

To solve this issue (theoretically), I have decided to add to Kobeejo's diet a good amount of soaked alfalfa pellets and beet pulp. A good amount (half a water bucket full) + hay at night will help keep that stomach buffered throughout. Since I have officially retired him from doing any more than a walk/trot under saddle once in a while, I'm not too concerned about stomach acids.

I also read that, the more a horse works, the lower their pH gets. Once they go back to just walking, it raises to a good level. This got me thinking about wild horses, who do not have the issues domestic horses have. Wild horses move... a LOT, but mostly at a walk. They graze as they walk. They have bouts of running, bucking, playing. But for the most part, they walk miles.

My assessment is to keep your horse walking as much as possible (in a paddock, place hay in various locations so the horse needs to walk to get to each pile), eating forage all the time and keeping high-end exercise (cantering, galloping) to a minimum of 30 minutes, making sure their stomachs are full of forage first.

Horses produce gastric acid continuously, whether they’re eating or not. When they chew, their bodies release saliva, which contains sodium bicarbonate and calcium—both of which act to buffer stomach acid. This is all well and good if horses are grazing continuously, as they evolved to, but human management can put a wrench in the gears.
When we supply horses with a few meals each day, the stomach keeps producing acid, but there’s not a steady saliva supply. This leaves the stomach environment to become increasingly acidic and raises ulcer risk. SOURCE
Horses with ulcers don't necessarily ever show signs, unless the ulcers get bad enough to cause pain. Kobeejo has never shown any sign of having ulcers, and being on 24/7 free-choice hay, he should not have them. I don't know how long those ulcers have been in there, and the vets could not give me an answer on that, either. However, five years ago, he foundered (that is where the coffin bone inside the hoof drops). He did not eat well during this time due to pain. He was also under a ton of stress. I can't help but think this was when he developed ulcers. The vet did tell me the ulcers had a ridge around the edge, indicating they had been there a while. They just did not know how long.

This goes to show that there's still a LOT of research to be done on gastric ulcers.

I have also noticed that horses with ulcers but no to little stress tend not to show signs until something major changes and causes them stress. This happened to a friend's horse. She never showed signs of having ulcers, but I suspected she did because she was not on 24/7 forage. She was not ridden at all and lived her life in a semi-adequate paddock with a shelter. She moved around a lot! However, once her area was torn down and she was offered only a small indoor area with a teeny "paddock" (which was the same size as her previous indoor shelter), she began showing signs of ulcers. She was put on Sucralfate, which aided her ulcers, as she adjusted to her new, much smaller, situation.

A good ulcer preventative is a must, in my opinion, for horses prone to ulcers or are in heavy work.










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