Hold the starchy food during your horse’s ulcer treatment

It may be time to make low-starch diets part of the treatment plan for horses with gastric ulcers.

When starting a horse on medication for gastric ulcers, it’s important to reduce his starch intake at the same time. Those are the findings of a study from Denmark.

A woman standing outside of a horse's stall in a barn aisle.
Research shows that horses with severe ulcers showed sustained improvements when treated with medication and fed a low-starch diet, compared to horses who were given only medication.

Although a low-starch diet can be beneficial to horses with gastric ulcers, it’s not always part of treatment plans, says Nanna Luthersson, DVM, of the Hestedoktoren clinic in Kirke Eskilstrup. “Unfortunately, many veterinarians do not want to comment on nutrition. This could be based on lack of knowledge or very strong tradition of feeding practices, which is usually the case with Thoroughbred racehorses,” she says. “So I quite often come across horses with a diagnosis of ESGD (equine squamous gastric disease), diagnosed and treated from other clinics, without any adjustments of their diet.”

For their study, the researchers used 58 horses diagnosed as having gastric ulcers with endoscopy. First the horses were divided into two groups based on the severity of their gastric lesions: 24 horses were classified as having moderate ulcers, with lesions graded a 1 or 2 out of 4, while 34 were determined to have severe ulceration, with lesions graded 3 or 4 out of 4. Within each group, the horses were matched into pairs based on similar management, workload, diet and feeding times.

At the start of the study period, the horses in the severe ulcer group were started on omeprazole, a medication that reduces acid production in the stomach, while those in the moderate group did not receive medication. In both groups, one horse in each matched pair was put on a low-starch feed, with the total ration divided among three meals per day instead of two.

After four weeks, the omeprazole treatment was stopped, but the assigned diets were continued and the researchers re-examined the horses with an endoscope and again graded their lesions. Six weeks later (10 weeks after the start of the study) the researchers once again examined the horses with an endoscope and graded any visible lesions.

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The researchers found that all the horses with severe ulcers showed significant reductions in lesion severity between the start of the study and the four-week endoscopic exam, but only those receiving the starch-restricted ration sustained those improvements through the 10-week endoscopic exam. Horses whose diets did not change returned to their original lesion scores by week 10, deriving no long-term benefit from the medication.

These findings under-score the importance of reducing a horse’s starch intake when he begins receiving medication to treat ulcers, says Luthersson. “Horses with ESGD should receive medication treatment according to their vet-erinarian but have their diets adjusted, with a maximum starch level of less than one gram of starch per kilogram of body weight per day and a maximum of .3 grams of starch per kilogram of body weight per meal.”

She adds that the role of diet in treating horses with gastric ulcers is both important and tricky. “I have often seen a significant improvement of ESGD just with diet change. But if the ulcers are more severe the diet change alone is not enough,” Luthersson says. “Also, diet change requires that a horse have a normal appetite. Often ulcers cause reduced appetite, and a diet change will not be beneficial if the horse will not eat.”

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