Thoroughbred Logic, Presented by Kentucky Performance Products: And The Dreaded Ulcers

We all know that horses get ulcers. The causes are wide and varied. There’s no silver bullet when it comes to eliminating ulcer triggers, but there are ways to effectively address them. Read on for more:

Welcome to the next installment of Thoroughbred Logic. In this weekly series, Anthropologist and trainer Aubrey Graham, of Kivu Sport Horses, offers insight and training experience when it comes to working with Thoroughbreds (although much will apply to all breeds). This week ride along as Aubrey shares her logic on tackling the dreaded ulcer-prone (or ulcer-riddled!) horse. 

Let me start by saying that there are countless articles on equine ulcers floating around the internet. Some are awesome. Some are promoting products. Some are woefully uninformed. The tricky thing about these articles — and, well, most of our online lives — is that they are often self-confirming. You can easily find what you already believe. Chat with your trainer and vet, get a second opinion if necessary and choose wisely as to what you read and believe. If you stop reading here, my biggest takeaway is get your diagnostics. Scope. Then treat. Then rescope. has an excellent article on gastric ulcers, including these great endoscopic images. 

I’m coming at this through the experience of having a whole bunch of off-track Thoroughbreds who have transitioned to their sport lives side of things, not the purely medical side (though I can’t avoid that entirely when my vets practically have a satellite operation set up in my barn). Statistically relevant numbers are out there for sure, but I rely on qualitative data… I mean, that should be par for the course, I’m a cultural anthropologist — that’s the type of data I’m prone to analyzing and valuing. So, here goes:

We all know that horses get ulcers. Better yet, we know that sensitive-sally Thoroughbreds are prone to suffering from these things. The causes can be as diverse as feed, hay or grass changes, travel, general stress, increased workload (or decreased load), new friends (or movement away from friends), stressful environments such as competitions or new homes, temperature changes or, you know, someone looked at them wrong… just to name a few.

Show environments were pretty stressful for Zoe’s Delight, so he went on preventatives for travel every time. Photo by Lauren Kingerly.

Let’s just call a spade a spade, though; at some point or another in their careers, I’d be willing to wager that most Thoroughbreds have or will have ulcers. That’s not a reason not to buy them, that’s not even really a reason to negotiate with sellers about their prices. But it is worth knowing that it is a likely possibility and that they might need a significant bit of help from their owners to get them sorted at some point in their life. Hell, I’d just upfront mentally commit to having to do a full treatment course at some point and go from there. Or I’d insure them and make sure ulcers are covered in case they pop up down the road.

Ulcery rides often look like this one. Yep, she checks all the symptom boxes, has scopes on file, will get time off and we’re starting treatment with all the best stuff. Photo by Alanah Giltmier.

Being sensitive, Thoroughbreds often tell us that they are suffering from ulcers pretty dang clearly. They will drop weight (or fail to gain it), grow a dull coat, develop behavior that speaks to their stress: crib more, weave, stall walk more. Their manure will smell like stomach acid. They’ll leave food behind and just generally be dull, cranky, and listless. There are also the riding challenges: horses will suck back behind your leg, fail to go forward, kick out when asked to bend or move on; they will kick or buck on transitions and/or after fences. And for many, when you swing your leg over, you’ll feel like you just sat down on a time bomb.

I call the spicier form of ulcer-y rides “survive-a-rides.” Sometimes you can ride tactfully enough and gentle enough — ask quietly enough and patiently enough that they’re willing to work with you. But are you really able to train? To make progress? Nah, not really. Usually, I’ll hop off, assess the horse and be like, “Well, that’s no bueno. Let’s scope.”

Jasmine didn’t look grouchy for the entire ride. Nonetheless, despite lovely moments, this type of survive-a-ride won’t get me far without proper treatment. Gastroguard and rescoping it is. Photo by Alanah Giltmier.

Of course, the behavior isn’t a perfect one-to-one. Sometimes, the tells on these guys are not huge. Sometimes, they are damn stoic and it therefore takes a whole lot longer to get them assessed and treated. Those horses are saints, and their kindness sets them up for folks missing the pain at many turns.

In related topics, there are also a handful of things that can make a horse appear ulcery, but in fact it may not be ulcers at all: In mares, hormone imbalances, cysts or tumors can cause similar behavior. For sensitive horses, sometimes pain in their limbs or their SI/back can do similarly (I’m not even toeing the line here about kissing spine, don’t get me started… that’s another soap box article for another day). Hell, poor saddle fit can often get your horse looking like they have ulcers, and can probably cause them. And then there are the questions of nutrition, riding and training. Is this riding stuff something that changes when a different trainer puts their tack on and swings a leg over, or the horse moves to a new barn with different management?

This lovely mare is halfway through her treatment and has seen a huge, huge change in comportment, shine and ridability. Photo by Alanah Giltmier.

In other words, this is not always a simple one-to-one, “oh the horse must have ulcers” situation. Which leads me to the point I started with. Scope. Please scope. Yes, scoping for ulcers can be a little bit pricey. Yes, it is inconvenient as the horse needs to be up in a stall and not eating for about 12-ish hours before the scope. But I’m here, dragging out my soapbox to tell you that it is so worth it.

I hear it all the time, “If they have symptoms, I’d rather just treat.” Ok, I totally get it. But treat with what? Was it really ulcers in the first place? Did you get them all in the treatment you used? Because if they are not fully healed when you move off of the treatment, they will come back. Scope and rescope and rescope again if needed. I digress.

Neumann (Bubba Bob) is pretty stoic. He rides nicely and is game for most off-property activities (featured here before a hunt with Shakerag Hounds), but I’m still keeping my eye on him for further symptoms. Photo by author.

A few quick anecdotes:

Wolf (Louisiana Moon) should have had ulcers. He checked every box. He was grouchy as the day is long on the ground and he compressed himself into a little explosive ball under saddle. After his letdown from the track, he failed to gain weight and was picky about his feed. I would have put money on his stomach being moth-eaten with open ulcers.

We scoped, and nope. It wasn’t. His stomach was damn clean. I was about to throw away $1200 in Gastroguard tubes, but instead opted to increase his Vitamin E intake and see if that helped. We changed his feed, his stall location (he’s now in an open panel) and voila, this kid is now fat and about as snappily happy as Wolf gets.

Wolf (Louisiana Moon) acting like a much-improved version of himself at the RRP Makeover last fall. Photo by Lauren Kingerly.

Rhodie (Western Ridge) was another shoe-in for ulcers. His behavior under saddle was super “special” with lots of running sideways and grumpy movements. When I gave in and ponied up the money for the scope and expected treatment, we found what I didn’t know was possible — he had a few bot flies wintering in his stomach. Yes, their attachment to the stomach wall opened an ulcer, but the rest of his stomach was clean. He had a zero-count on his fecal test for parasites, but I learned the hard way that such tests don’t account for bots. Neat… guess we have to worm everyone anyway. At least that was a 20$ fix, not a $2k one.

Rhodie (Western Ridge) being his usual dragon-ish self at Stableview earlier this year. Photo by Adela Narovich.

On the other hand, Juice (Pulpituity) was a good example of straight up ulcers. He would mild colic regularly, fail to hold or gain weight, and basically was just a stress ball of a leggy red baby OTTB. When we scoped him, he was positive for ulcers all over his stomach. A rescope at 30-days showed that we had gotten most of them, but not all. More treatment and a rescope at 60 days showed a close-t0-clear stomach and the ability to taper the treatment. It wasn’t long and before that kiddo gained the weight and became shiny and far happier under saddle. *But, if we had just done 30-days, they would have come back, and the struggle would have gone on a whole lot longer.

Juice (Pulpituity) who had just started on his ulcer treatments. Photo by Kassie Colton.

Juice, later that year learning to slowly pack on the pounds and simply go through life far happier. Photo courtesy of author.

Ok, while I could share examples all day or ramble about all-things ulcers, my soapbox has one or two more steps up: “What you treat with” and “treatment vs prevention.”

What You Treat With

There are so, so, so many products on the market right now. Each vet and trainer is going to have a favorite go-to. If I have a horse with ulcers, I treat with full tubes of Gastroguard (and scope). *Ulcerguard is the same thing when used as a full tube, but is dosed at 1/4 tube as a preventative. **Compounded omeprazole is different in terms of the patented absorption technology, so just be aware that its effectiveness may be different despite being the same drug. Some options are going to bankrupt you, and some will be only a little dent in the account. Do the research and be sure that when treating, the product is scientifically proven to treat and cure ulcers — and use the gastro-scope to confirm its effectiveness.

More Juice spam because I miss him (he is retired to his breeder’s farm in VA after a hell of a recurrent suspensory injury). Photo by Kassie Colson.

Prevention vs. Treatment

And my last step on the soap box: It is critical to know the distinction between preventative care and treatment. So often people will try to treat ulcers with preventatives. While those may make the stomach feel a bit better overall, they rarely clear up the problem itself. There are great gut health products everywhere, and regular access to hay (and particularly alfalfa) and quality turnout does wonders. But know the difference between prevention and treatment, and if you suspect ulcers, get the diagnostic images and then re-scope to check their effectiveness.

Scope and re-scope. Oh, I sound like a broken record? Good.

Go ride, folks — and enjoy the hell out of the ulcer-free rides and the ever-more-spring-like weather.

About Kentucky Performance Products, LLC:

Choose Neigh-Lox® Advanced when digestive health is a top priority for your equine athlete.

Neigh-Lox Advanced provides a scientifically advanced blend of ingredients that work synergistically to maintain your horse’s digestive tract in peak condition by supporting both the gastrointestinal tissues and the beneficial bacteria that populate the gut. Maintaining a healthy digestive tract reduces the risk of colonic and gastric ulcers, colic, laminitis related to hindgut acidosis, and oxidative stress that damages digestive tract tissues themselves. Horses with a well-balanced GI tract have good appetites, absorb more nutrients from their diets, maintain a strong immune system, and stay healthier.

The horse that matters to you matters to us®.