Question
My nine-year-old, 1,200-lb (545-kg) Thoroughbred gelding was just scoped and found to have grade 3 gastric squamous ulcers. He’s just coming back into work after a three-month layoff following a puncture wound. Before the injury, he was ridden four to five days each week and shown ocasionally as a hunter. He is fed a high-fiber performance feed, alfalfa pellets (1 lb, 0.45 kg), alfalfa hay (1 flake), grass hay, and a few supplements (biotin, probiotic, and a hyaluronic acid/lion’s mane extract product). I’m considering a grain-free diet to help in terms of maintenance, along with the standard omeprazole treatment upfront, but I am worried about keeping weight on him in the future, as he can be a hard keeper. Energy under saddle is not an issue. Can you help?
Answer
Based on the 0-4 grading system set forth by the Equine Gastric Ulcer Council, grade 3 disease is considered moderate to severe with a large, single lesion or extensive superficial lesions.*
A “grain-free” diet may be a good place to start, especially if this horse is reactive at times. Based on the information provided, I would initially offer this horse a ration balancer with alfalfa pellets and oil–in addition to free-choice forage–and see how he fares. Although this ration represents a significant change from the current one, it would be much lower in starch and sugar, which can aggravate gastric ulcers in some horses.
The ration balancer should be fed at the recommended feeding rate for a 1,200-lb (545-kg) horse, probably somewhere between 1-2 lb (0.45-0.9 kg).
Increase the amount of alfalfa pellets gradually to equal the amount of concentrate the horse is currently fed. If the horse is fed 10 lb (4.5 kg) of concentrate daily, he should eventually be fed 10 lb (4.5 kg) of alfalfa pellets each day.
Use any type of oil that you like, but I generally recommend canola oil because of its omega-6 to omega-3 ratio. If you prefer to use corn oil, supplement with a high-quality marine-derived oil, such as EO-3, to balance the omega fatty acids. Look to feed between 0.5-1 cup (120-240 mL) daily, split between meals if necessary.
You could eventually add some beet pulp to increase calories, but I would wait until the ulcers have been under treatment for a few weeks. The soluble fiber in beet pulp may cause excess production of fatty acids in the stomach that may irritate the ulcerations.
Technically, this isn’t a totally grain-free diet because, depending on the brand, the ration balancer will probably contain wheat. However, for a performance horse, especially a hard-keeping Thoroughbred, this is as close as possible without the diet being entirely forage. If he won’t eat this diet, then you may want to try a commercial concentrate that is very low in starch and sugar with moderate to high fat (8-12%).
Continue offering this horse access to high-quality hay or pasture at all times, and he should not be hindered in any way from consuming that forage, including competition from dominant pasturemates. In addition to his diet, keep track of other management factors that could cause him to decrease intake, such as turnout situations, feeding schedules, companionship, and training demands.
Follow-up gastroscopy is often recommended after omeprazole therapy to ensure ulcers are diminishing. Once gastric ulcers are healed through the use of omeprazole, choose a research-proven supplement to keep ulcers from recurring.
*Andrews, F., W. Bernard, D. Byars, et al. 1999. The Equine Gastric Ulcer Council: Recommendations for the diagnosis and treatment of equine gastric ulcer syndrome (EGUS). Equine Veterinary Education 11:262-272.
