A better day

When I went today to see Kylie, she was definetly more herself. And she was HUNGRY. I welcomed the spoiled behavior of pawing for treats or attention when normally it drives me crazy. She is back on the IV drip of Lidocain for pain, which is a step back, but I am happy it is keeping her comfortable.

I took her for a walk and was so happy and content to just be with her. I wish I wasn't so emotionally attached so that I could make clearer decisions, but after being in a relationship for 11 years, there is an attachment that clouds everything. I want what is best for her not just today, but for her future. She deserves a great quality of life, and I am trying to take that into account when making all of these difficult decisions.

I had a long talk with the vet today (it seems like he is there 24 hours a day, seven days a week!) and is happy with how Kylie looks today, so he has backed off the pressure of giving her a second surgery. Thankfully! I learned some interesting things about ulcers and treatment that I did not know before. Kylie developed ulcers that she did not have when she first came in from all of the acid in her stomach. Hers are caused from fasting and all the medication. Horses evolved to graze, eating many small meals frequently. This way, the stomach is rarely empty and the stomach acid has less of a damaging effect. If horses do not eat frequently, the acid builds up and ulcers are more likely to develop. Research has found that an average horse can produce up to 16 gallons of acidic fluid every 24 hours. Thety started her on Zantec (ranitidine) on Friday, but it takes 24 to 48 hours to take effect. This is one possibility for her discomfort on Friday,

It's been well-documented that over 90% of race horses and over 60% of performance horses (hunter/jumpers, dressage, endurance and western) have ulcers. Even small changes in the routine of a recreational horse can cause ulcers in as little as five days. The signs of ulcers in horses include poor performance (often mistaken for musculoskeletal or back pain), behavioral issues (poor attitude, resistance, girthiness), colic and loss of weight or condition.

The part I did not know was associated with the treatment of ulcers. I have had Kylie on ranitidine in the past due to a heavy show schedule and to prevent ulcers, but this vet told me that unless I administer it every 8 hours it does no good. I have also used GastroGard and given just one tube, which I have done during a show, and come to find out one dose does nothing . Good to know because it is expensive! GastroGard or UlcerGard (Omeprazole), requires three to five days to reach a steady level in the body; after the first dose, there is only 25% inhibition of the parietal cells (large oval cells of the gastric mucous membrane) that secrete gastric acid. So, for it to do any good, you have to start at least two to three days prior to stressful situations. Alternatively, you can use an H2 blocker, such as ranitidine, which inhibits parietal cells with the first dose, but this medication must be given three times per day for continued effect.

So basically to treat ulcers you can use ranitidine, which is much more cost effective, but must be given every eight hours for it to work OR GastroGard can be given only once a day for 30 days. Research showed that once treatment stopped, the ulcers came right back. That means you have to do more than just treat the existing ulcers, you have to create an environment in the stomach that makes it hard for ulcers to form. For the prevention of recurrence of gastric ulcers, continue treatment for a least an additional 4 weeks by administrating at the recommended daily maintenance dose.

Here are some diet and management tips to reduce the risk of ulcers in your horse:

■Provide pasture turnout--this is the best method of preventing ulcers!
■Provide constant access to hay—keeping hay in front of your horse is next best
■Provide hay frequently—if free-choice hay is not an option, feeding it four to six times a day is an acceptable substitute
■Use alfalfa hay—the protein and calcium in hay help reduce stomach acid
■Limit fasting periods—keeping food in the stomach at all times protects it from acid which causes ulcers
■Limit grain feeding—sweet feeds especially lead to heavy acid production
■Provide “down time”—heavy exercise is a risk factor for ulcers so include less intense work days and even rest days in your training and showing plan
■Reduce stress—allow social interaction with other horses and keep the feed, turnout, and exercise schedule as regular as possible
■Limit NSAIDS—anti-inflammatories like phenylbutazone have been linked to ulcers, so give the smallest amount necessary for the shortest time possible.

And she got some alfalfa leaves today! She was so happy!