Owners who’ve had horses with gastric ulcers know firsthand how frustrating—and expensive—it is to manage animals with this often chronic condition. And with an estimated 75% of horses suffering from gastric ulcers, it’s no surprise that treatment and prevention of the condition—which is common enough to have its own acronym, EGUS (equine gastric ulcer syndrome)—has become big business.
The array of products, supplements, ingredients, and botanicals touted as the next “big thing” in EGUS management, as well as anecdotal success stories found online, left Frank Andrews, DVM, MS, Dipl. ACVIM, and his research team at Louisiana State University’s (LSU) School of Veterinary Medicine, wondering about the validity of company and consumer claims.
Andrews presented the results of his study, “Effect of a Supplement (SmartGut Ultra) on Gastric Ulcer Scores and Gastric Juice pH,” at the 2013 American College of Veterinary Internal Medicine Forum, held June 12-15 in Seattle, Wash.
"Many supplements are marketed on the Internet (for treatment and prevention of gastric ulcers in horses), including one I call ‘faith,’ but little is known about their effectiveness,’” Andrews said. “When horse owners feed these advertised antiulcer supplements they’re literally ‘going on faith,’ because there’s very little scientific information available on the efficacy of these products in horses."
The clinical success of the drug omeprazole (marketed as GastroGard) to treat gastric ulcers is well documented in the equine veterinary industry. Long-term management of EGUS is a bit trickier and reoccurrence of gastric ulcers is common, Andrews noted.
The LSU study researchers looked at the use of the supplement SmartGut Ultra in horses after they’d received omeprazole for treatment of nonglandular ulcers (the most common equine gastric ulcers, occurring in the upper part of the stomach).
Ingredients for Healing
SmartGut Ultra, marketed by SmartPak Equine, contains sea buckthorn, pectin and lectin, glutamine, and aloe vera. Andrews said these ingredients are interesting choices for the possible management of EGUS because:
- Sea buckthorn is derived from Hippophae rhamnoides plant berries and contain high levels of antioxidants. It’s been shown to heal ulcers in people and prevent glandular ulcers in horses.
- Pectin and lecithin compounds are derived from apples and other fruits (it’s the same stuff that makes jams and jellies thick) and act to coat the stomach, protecting it from the damaging effects of stomach acids.
- Glutamine is an amino acid shown to have gut-protective qualities in people and laboratory animals.
- Aloe vera (that spiky succulent plant with gooey insides) has been used for its medicinal effects for centuries and contains antioxidants, anti-inflammatory, and cytoprotective (protecting cells from harmful agents) effects, as well as increasing mucus secretion. It’s been shown to heal ulcers in many laboratory animal models.
Andrews and his team performed a masked, two 42-day-period crossover study on eight mature Thoroughbreds. The team divided the horses into two groups and stratified the animals by nonglandular ulcer lesion score, and then by sex. One group of horses received treatment (SmartGut Ultra) during the first study period while the other group served as controls (no treatment); during the second study period, the groups switched treatment protocols.
Twice a day for 42 days, the horses group received either 40 grams of SmartGut Ultra mixed with 1 kilogram of commercial grain formulated for horses or the same amount of grain twice a day without the supplement.
All horses were stall confined and, during Days 28-35, subjected to alternating feed-deprivation, both factors known to contribute to gastric ulcers. The team then gave horses seven "recovery days" (Days 35-42) with a normal feeding schedule.
The researchers performed gastroscopy on the day before the study began, and again on Days 14, 28, 35, and 42 and a masked clinical assigned each horse a nonglandular lesion number (NGN) and severity (NGS). Gastric juice pH was also measured (low stomach pH is normal for horse but can be associated with ulcers, Andrews said).
Not surprisingly, he noted, average NGN and NGS scores decreased significantly in all horses after they received two weeks of omeprazole treatment at the beginning of the study.
Two weeks after the team discontinued omeprazole administration, averaged NGN scores did not significantly increase in the treated horses, whereas NGN scores significantly increased in untreated control horses, Andrews said.
By Day 35, after feed-deprivation, NGN scores increased in both groups, but NGN scores were significantly lower in the SmartGut Ultra-treated horses when compared to the untreated controls on the same day. However, SmartGut Ultra did not significantly alter the normal acid pH of the stomach.
Overall, SmartGut Ultra treatment resulted in fewer ulcers two weeks after discontinuing omeprazole treatment and prevented and the increase in gastric ulcer number after feed deprivation, without altering gastric juice pH, Andrews explained.
The research team concluded that SmartGut Ultra supplementation might be an affordable alternative to aid in the protection of the nonglandular stomach from the rebound acid effects once omeprazole treatment is discontinued and for stall-confined horses undergoing intermittent or scheduled feedings.
Andrews also noted that this product isn’t a substitute for omeprazole paste treatment for gastric ulcers but rather an aid in maintaining stomach health.
Disclaimer: Seek the advice of a qualified veterinarian before proceeding with any diagnosis, treatment, or therapy.