Nube: Ulcer Nostalgia and What I Didn’t Know

I get nostalgic for the days when I didn’t know what I know now. I miss the bittersweet, marginally innocent time.  My sense of humor was better then, too. It was 2005 and not many of us knew. We surely do now.

Nube (rhymes with eBay) was two years old. A tall Iberian Sporthorse gelding who was perpetually curious and as agile as a cat. He was the kind of youngster so willing to learn that I went extra slowly. He was lighthearted, not reactive or overly stoic. It felt like we thought the same thing at the same time, so easy to work with.

We were at the vet for a routine visit, when the vet asked me if Nube could be a demo horse. The practice had just purchased a scope and planned a demonstration event at a local arena to introduce scoping for ulcers. They said don’t worry, they already had horses who did have ulcers. Nube would be the one who didn’t. They wanted a healthy stomach for comparison. I was flattered we were asked.

The day of the event came and as instructed, I withheld hay overnight so his stomach would be clear for the scope. Nube jumped into the trailer and we drove less than five miles to the facility. When we got there, friends who I hadn’t seen in a while waved and called out. There was a jovial feeling in the crowd. Nube was precocious and well-behaved.

He was the first horse I started from scratch in my new training method that I would eventually call Affirmative Training and he was the perfect representative. I handed his lead rope to the vet and went to sit in the stands and watch the demonstration.

Nube walked on a slack lead with the vet, to the middle of the arena. He looked around with soft eyes, interested ears, and a quiet young confidence. As the vet introduced him and began, there was some banter and Nube seemed in on the jokes and was so engaged that the vet was clearly taken with him. Nube entered a set of stocks and was given light sedation for the scoping.

The vets explained how the scope worked and gave a little bit of information about ulcers, knowing that they had ulcer horses coming in after Nube. The scope went in and on the screen, all of us saw too big ulcers. They looked like puss-filled open wounds; like huge canker sores. They were undeniably painful to see, and the vet didn’t hide his shock. It was obvious the demo was not going as planned and he was working that out in real-time.

In the years since I’ve reminisced about that day with the vet. He said it’s a story they tell in the practice. Their version is funnier than mine.

I was devastated. It was like getting a failing grade before starting school. It’s hard to deny the visual but I couldn’t believe it. I was well-educated in horses and keenly observant. But as much as I wanted to say it wasn’t true, that Nube didn’t fit the list, somehow he did. I was filled with shame for smiling when we came in. Shame that I had missed such a serious thing or worse yet, that I had caused them.

Previously, I’d known two horses with Equine Gastric Ulcer Syndrome (EGUS). One died of colic and the necropsy showed them, and the other was a Thoroughbred off the track. But I was about to learn so much more, as the world did the same.

I began doing research, asking hard questions, and reading everything I could find. The options for care and treatment in those days were very limited. Over the next couple of years, I ran courses of  GastroGard, thirty days and almost a thousand dollars, and the ulcers returned on day thirty-one.

I found articles that gave the same simple list of causes. Being fed two flakes morning and night and being left without forage the rest of the time was at the top of the list. Horses that lived in stalls were more prone to have ulcers. Horses on the track and performance horses were more prone to ulcers. Nube didn’t fit the profile in any way I could find. I learned in hindsight many of the horses in his bloodline had it. But then all bloodlines do.

I read dozens of studies on the topic but the statistic that stuck the most was that of the horse who were scoped and diagnosed with ulcers, half show no symptoms, according to owners. Or did the owners not recognize the symptoms, as I hadn’t?

I focused on that, I had to make up for my failure. I learned to read pain symptoms, especially the Calming Signals related to gastric pain. I am very skilled and it gives me no joy. It is necessary knowledge for a trainer. Too many horses that people think have training issues are in pain and I end up diagnosing ulcers as frequently as vets do.

It still didn’t make sense, because ulcers don’t make sense. Horses are so much more frail than we want to believe. Twenty years later, vets say they don’t really think about curing ulcers so much as managing them. The only good news is that the options for management are so much better.

Would I trade the experience of learning about ulcers, and going on to help so many client horses since then, for having Nube ulcer-free? I don’t ask myself. It was not a choice I had.

I have a sad brag: I can spot ulcer symptoms very easily, even in stoic horses. They do ask us for help with pain but too often we misread the message, as I misread it all those years ago with Nube. It’s for him that I deliver lousy bad news.

Every week someone tells me about behaviors their horse does that they read as any of a list of flattering things. It’s a total misunderstanding of their horse. The horse has ulcers. It isn’t my business and it’s no fun to put people in that place of shame that I know so well. But I’m a horse advocate. I put horses first.

So I ask that question in the least confrontational way I can. “Are you certain your horse is not in pain?” They assure me their horse is perfectly fine. My heart splits a bit farther. I am most nostalgic for a time that I felt that confidence about any horse.

Then it’s up to the owner. It’s not my job to be the Ulcer Police. It’s your job.

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Anna Blake, Relaxed & Forward

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46 thoughts on “Nube: Ulcer Nostalgia and What I Didn’t Know”

  1. I wish we knew as much about ulcers in horses as we do in humans. Apparently, the bacteria that cause human ulcers are not responsible for horse ulcers. Perhaps one day, scientists will find something similar to explain ulcer prevalence in horses but, for now, it still feels like we are in the dark ages. In your research, have you seen any scientific evidence of how common ulcers are for horses in a natural environment?

    Reply
    • I don’t have stats on it, but yes, feral horse get ulcers. Often thought to be from stress in changes in their herds or not enough forage. Yes, dark ages, but a glimmer of light on the horizon. Thanks, Janet

      Reply
      • Makes sense, Anna regarding wild horses – cannot imagine the stress from the roundups, chutes, & change of diet alone! There are so many things I’ve learned from you here – my lack of knowledge about so many things is scary! And somehow – well, as far as I know – the two horses I had over the years managed to survive my care!! I think most who read & comment on this blog are much more informed & aware than I was, and as an awful lot of other people currently are!
        Just like any other issue – but more so with animals – we NEVER NEVER “know it all”!! And that realization just might save a lot of horses & other animals a lot of pain and injuries.

        Reply
  2. If the horse doesn’t show any signs he has ulcers, how could the owner know? We should automatically treat every horse? I don’t think that’s what you’re saying-is it?

    Reply
    • Treat with GastroGard? no, but I supplement each my horses every day, and especially before stressful situations like hauling or changes in the herd. Stats say 98% of foals develop ulcers within two weeks of weaning, and a horse who has had an ulcer is likely to again. In my training, I assume all horses are somewhere on an ulcer continuum. Their digestive systems are not hearty. It’s something I talk about at clinics and my school, but much too much information for this little box. Thanks, Susan

      Reply
  3. Yep, you helped me with Luke. I like the term “gastric distress”, because who knows, ulcers, something else? Probably ulcers? But gastric distress does cover it all. I’m so glad to be much more aware. And the feeding regime and supplements I have him on now have changed his behavior for the better, so probably we at least relieved some (or all? we wish!) of his pain. I want a nano ufo that just lives in his stomach and beams me photos of what is going on in there! Meanwhile, we do what we can.

    Thanks

    Reply
    • Yes, it can be a sour stomach to full blown ulcers, and now you can be prepared for future stress. That is the good news, if what you use is working, results should show fairly quickly. Such a nice young horse, glad you are on the ball on this topic. Thanks, Amber

      Reply
  4. Would you share the supplements you use? I don’t want to subject my horses to the stress of scoping when they have no symptoms, but I don’t want to think of a horse as “anxious” when he really is “hurting”. I also don’t think doing a course of omeprazole for a horse with no symptoms makes much sense since you couldn’t tell if it helped. Can any of the diagnosing be done on a farm call? I don’t want to haul horses to the vet unless it’s absolutely necessary.

    Reply
    • Supplements are not the same as medication… and often ulcers cover other ailments. There could be hindgut ulcers that a scope wouldn’t show but we have other tests for. If you have a question about a particular horse, a vet visit is best, and all vets do it differently. Gastrogard works for many horses. There are also other options, depending on what your horse is showing. A horse could have a blockage or a dozen other things that can seem like ulcers. I am not a vet; I would have to see the horse’s behavior to even guess.

      Not all supplements work for all horses. This is the most frustrating part to me. One that works for one horse might not for another. So the bottom line is try something and expect to see a result fairly quickly. If not, try another. Not enough to give it; you have to see it works. SUPPLEMENTS DO NOT HEAL ULCERS AND ARE NOT A SUBSTITUTE FOR VET CARE.

      I supplement my horses differently but have liked Gut X.

      Reply
      • If you’d like more information on ulcers and colic, go to our Barn School at relaxedandforward.com and type ulcer into the search bar at the top of the page.

        Reply
      • THIS literally goes without saying – he is just so beautiful & has such a sweet look.
        As you mentioned, animals can be very stoic – my vet said as much a few years ago.
        I have to admit, only in the last few years I had Chico did I hear much of anything about ulcers – at that point, there were more horses there in lessons & being trained. Many who could only be turned out for short periods of time which meant more time in stalls. Chico & others in his herd of geldings, plus a herd of mares, were out either all day or in the summer all night. But that barn had several large pastures, rotated them and mowed them. Not all barns have that advantage. We were really fortunate.

        Reply
  5. Like Susan Hull above, I would like to know what supplements you are talking about. Thanks for what you can share.

    Reply
    • Yes I would also love to know what supplements you use!! My Arab has had recurring ulcers and we even been through scopes and classic treatments plus I’ve been doing all of the preventative measures I am aware of.
      There are so many supplements out there!!

      Reply
      • Copy of a previous comment:
        Supplements are not the same as medication… and often ulcers cover other ailments. There could be hindgut ulcers that a scope wouldn’t show but we have other tests for. If you have a question about a particular horse, a vet visit is best, and all vets do it differently. Gastrogard works for many horses. There are also other options, depending on what your horse is showing. A horse could have a blockage or a dozen other things that can seem like ulcers. I am not a vet; I would have to see the horse’s behavior to even guess.

        Not all supplements work for all horses. This is the most frustrating part to me. One that works for one horse might not for another. So the bottom line is try something and expect to see a result fairly quickly. If not, try another. Not enough to give it; you have to see it works. SUPPLEMENTS DO NOT HEAL ULCERS AND ARE NOT A SUBSTITUTE FOR VET CARE.

        I supplement my horses differently but have liked Gut X.

        Reply
    • Just going to share what I wrote for Susan.
      Supplements are not the same as medication… and often ulcers cover other ailments. There could be hindgut ulcers that a scope wouldn’t show but we have other tests for. If you have a question about a particular horse, a vet visit is best, and all vets do it differently. Gastrogard works for many horses. There are also other options, depending on what your horse is showing. A horse could have a blockage or a dozen other things that can seem like ulcers. I am not a vet; I would have to see the horse’s behavior to even guess.

      Not all supplements work for all horses. This is the most frustrating part to me. One that works for one horse might not for another. So the bottom line is try something and expect to see a result fairly quickly. If not, try another. Not enough to give it; you have to see it works. SUPPLEMENTS DO NOT HEAL ULCERS AND ARE NOT A SUBSTITUTE FOR VET CARE.

      I supplement my horses differently but have liked Gut X.

      Reply
  6. I’m the Cushings/PPID alert, and IR too thanks to Dr. Kellon …
    Ulcers are frequently discussed on her site, as are every other kind of challenge that horses face (far too often tick diseases)
    Thanks Anna. Hope you’re healing journey is well underway!

    Reply
  7. Anna, Right down to my toes, I thank you on behalf of the horses. As for me, you have my heart even though this was a gut punch we needed. Yes, they are fragile, more than we can know. In a perfect world, I would not know and I’d have more peace of mind, yet that wouldn’t relieve them of their silent suffering. Not a day goes by when I don’t think of those blissful carefree days of not knowing. It became painful to realize they all could have had better care, better lives, I then took on the burden of wanting to know everything and it’s never enough. I accept that cross to bear and pray there is another world on the other side where innate perception thrives.

    Reply
  8. I too would love to know what supplements you use daily as a proactive /preventative plan to help since we can’t all scope our horses monthly nor would we want to obviously!
    Looking forward to your answer, my mind will be spinning and worrying until I know what I should add to my two rescues regime🙏🏻🙏🏻
    Kindly,
    Steph

    Reply
    • I’ve pasted an explanation, but just because I use it… it doesn’t mean it’s an answer for you. I like Gut X but I feed other things as well.

      Reply
  9. Such a beautiful boy. Thank you for raising this critical topic. The first horse I lost in my care was a yearling suffering from chronic ulcers. The ranch owner was progressive.. this was the mid 90s and he was treating a number of horses for ulcers and all the foals during weaning. Back then it was cimetedine and sucralfate. Plus feeding 4x a day. It’s a battle we’re nowhere close to winning but awareness is a start.

    Reply
    • Kind of inspiring to think of a ranch owner so ahead of their time. A yearling isn’t uncommon sadly. Thanks, Shaste

      Reply
  10. Anna, I cannot thank you enough for this important read/lesson. I wish it could be shared with the world!
    I am a follower of the “new” approach to training, which includes training the person to listen to their horse and always put the horse first. I am at a boarding barn where the old school mantra is “show the horse who’s boss” thinking. Fortunately they do not train my horse. I have a wonderful horse person who travels to our barn to work with me and my horse teaching lightness, softness, and patience.
    I find it hard to believe that the old school training is still so prevalent, but glad that there is a new wave of professionals who want something better for their horses and themselves.

    Reply
  11. I need to become an expert on reading ulcer signs, because my colt Cat has a recurring issue with them. (He is on Gut X for life now!). Can you give us a list of the signs to look for, especially the more subtle ones?

    Reply
    • You are right, it will always be a question for Cat, but also for most horses… Sorry, it isn’t a simple list. The Calming Signal Course at the Barn School is just a start. I’ll set something up at the school soon. Give that good boy a scratch.

      Reply
  12. Wonderful post, Anna! Here are some thoughts from my experience (not perfect)!:

    Today was moving day from a dirt pen back to full time pasture life (moved last year from VA pasture to NM dirt pen). I did a ten day full dose Gastroguard course prior to the VA/NM move. Prior to this move, I’ve had my boy on relyneGI for the last ten days and will continue indefinitely. During dirt pen life, he’s had a full course of the compounded omeprazole/misoprostol, it helped but that’s not long term.I liked the research data for RelyneGI—the price was worth a try-I didn’t know of Gut X. I did find that GasX (simethicone) mint tabs can be used for gassy horses as well.

    Just throwing out some ideas. And I’ll confirm the old school opinions out there, I’ve dealt with so much criticism. This guy has also been tested and treated twice for EPM (ulcer prone), my vet saying he’s never seen titers this high.

    You know your horse, stand by they tell you. I’ve learned a world of incredible information from Anna and am so grateful to have found her.

    Reply
    • Thanks for the kind words, Kristin. I don’t know your product wither, but will check it out. So smart to do all the prep you can for such a long move. Good luck!

      Reply
  13. Thank you for trying to educate so many of us, Anna. Both of my horses are happier and healthier now, since I listened to you and treated for ulcers. I thought you were wrong, at first, and I didn’t want to believe it. My horses didn’t fit the classic list of symptoms either. But, alas, the proof is in the pudding. Their behaviors are much different now, and I have to wonder how long they were in pain. Thank you for shining your flashlight into the dark corners where none of us even know to look.

    Reply
    • I DID NOT BELIEVE IT. I really didn’t want to become the expert I would become to help my horse. When I started doing the research, most horses didn’t fit the profile. So glad your horses are doing well.

      Reply
  14. While nutrition and husbandry are key to the management of gastric ulcers, a new product for ulcer treatment and prevention has become available. Sold by a company that publishes their research studies conducted by nutritionists in peer reviewed veterinary journals, Resolvin EQ (ker.com) provides short chained polyunsaturated fatty acids which has been shown to treat/improve existing squamous ulcers as well as prevent ulcers.

    “Long-chain polyunsaturated fatty acid supplementation increases levels in red blood cells and reduces the prevalence and severity of squamous gastric ulcers in exercised Thoroughbreds”, Joe D. Pagan PhD,[email protected], JAVMA, Vol 260, Issue S3, October 25, 2022.

    Reply
    • Thank you, Karen. We appreciate the information and I will keep it on my suggestion list. So valuable to have the research available. Thanks so much. I am happy that more good products are being produced.

      Karen, I tried to email back but the email returned. Good to hear from your experience as a horse owner and DVM. Again, thank you.

      Reply
      • I am glad you received my response. I got weird error messages when I tried to “send” so I wasnt sure you got the reply.
        The internet is so inconsistent and even scary sometimes! I try to keep a small footprint and dont do any social media.
        My email address is [email protected]
        Karen

        Reply

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