We are aware of the endless amount of information available at your fingertips thanks to the internet, and, therefore, have compiled the following information for our customers to use. Of course, this page is not a substitute for professional medical advice; if you are looking for a new veterinarian, please contact us.
Acupuncture
What is acupuncture and how does it work?
That is the big question western scientists have been trying to prove for decades. Acupuncture does release “feel-good” hormones such as beta-endorphins and serotonin. This is evidenced when (most) animals and humans relax or even fall asleep during treatment. In addition, the endorphins provide pain relief (analgesia) and the cortisone release provide anti-inflammatory relief. Acupuncture has been shown to decrease muscle spasms and to increase local circulation, which stimulates the local repair mechanism.
On a Chinese or more holistic level, acupuncture stimulates the energy channels called meridians. When the energy flow in the body is stagnant or blocked, pain and disharmony occur. The acupuncture treatment unblocks the flow of energy and restores balance to the body, thereby relieving pain and aiding chronic conditions.
When horses are treated with acupuncture one can see the immediate effects of relaxation. The horse will tend to lick and chew, stretch and yawn, release big sighs, and half-close its eyes. This effect will often last 20 minutes or as long as the needles are in place. After an acupuncture treatment, the horse may act tired or mildly sleepy for up to 24 hours. Afterward, renewed energy and specific improvements are noted. It is recommended that horses not be ridden for 24 hours following treatment. However, the horse may be ridden just prior to an acupuncture treatment provided that it is cooled out and dry, not sweaty or wet from being bathed/hosed off.
Dogs and cats will also visibly relax and often fall sound asleep during an acupuncture treatment. Many dogs will happily lay down where they are told for their second/third treatment. And some will even push the other animal out of the way to get their turn!
Equine Ulcers and Holistic Treatment
What types of ulcers exist?
Most horse owners have heard of stomach ulcers in horses. The official term is EGUS (Equine Gastric Ulcer Syndrome). Horses can also get colonic ulcers. This is called RDC (Right Dorsal Colitis).
Why do horses get ulcers?
Due to modern methods of keeping horses, stomach and colonic ulcers have become very common. Culprits are keeping horses in individual housing, feeding practices, living in unsanitary conditions, certain pain-relieving medications, and exposing them to stressors due to new ownership, training, trailering, and showing. Ulcer symptoms are nervous behavior, painful when girthed, bucking under saddle, vices such cribbing/pacing/swaying, pausing while eating/taking breaks, dull hair coat, ribs showing, runny stools, recurrent colic, and many more!
Horses produce stomach acids 24/7. Humans are meal-acid producers — meaning when we eat a meal it triggers acid production. In between meals, we do not produce stomach acid. Horses however produce stomach acid constantly because they are meant to be grazing constantly. When horses are fed only twice daily, they have an acidic stomach in between meals.
Horses’ stomach conformation has an acid protective mucosal layer on the bottom half and a non-acid protective layer on the top half. When horses have acid in their stomach (and no food to absorb it, for example from noon until dinner time) and are then taken out for a ride — as soon as they go at speed — such as trot/canter/jumping — the acid sloshes up to the non-protective layer creating ulcers and pain.
Stress is a big reason for ulcers. Stress releases natural steroids from within the body. The steroids can cause irritation and over time damage the mucosa (lining) of the GI tract affecting both the stomach and the colon. Below are some reasons for additional stress:
- Horses are herd animals and very social. Keeping a horse in singular confinement — a stall without the ability to see or communicate with another horse causes undue stress, worry, and insecurity.
- Stress occurring during big life changes such as when a horse is bought/sold and transported to a new environment, new owners, new riders, new feeding practices bring about increased stress. New feed and feeding methods may require different expectations (of the horse) and different gut bacteria populations.
- Stress can occur during an increase in training level, transportation to horse shows, and competing during horse show season.
Several conventional medicines cause injury to the horse’s stomach and colon. They include NSAID’s such as Flunixin Meglamine (Banamine), Phenylbutazone (Bute), and corticosteroids in the form of Dexamethasone and Prednisolone. They harm the lining of the GI tract through different pathways but have the same end result.
Feeding a high level of concentrates or being on a pelleted only ration upsets the pH balance. Concentrates in the form of grain has an acidic pH, which will increase the level of acid in the stomach. Many horses that have ulcers, may eat a little grain and then walk away from their meal and even lay down for a while, before continuing to finish their meal. A pelleted-only diet can upset the pH balance because a pelleted-only ration is eaten quickly and does not require a lot of chewing effort, which decreases the amount of saliva produced. While chewing on hay for long periods of time increases saliva production and saliva contains calcium, which is beneficial in reducing stomach acid. In certain situations a pelleted only diet is beneficial however, these include respiratory disease/allergies, RDC treatment, poor dentition, etc.
Common treatments for stomach ulcers are based on reducing the acid in the horse’s stomach, which artificially changes the pH and inadvertently negatively affects the colon.
Complete acid reduction will also reduce the horse’s ability to absorb certain nutrients. The colonic environment changes will affect the bacteria that reside there and with increased stress, cause ulcers to start in the hind-gut. The colon is where the bacteria live that ferment the grass into products the horse can use for nutrition and calories. If the good bacteria are disturbed they can no longer be efficient in processing the hay (that’s one of the reasons horses with ulcers lose weight). In addition, it opens up space for bad bacteria to settle.
How do I prevent ulcers?
General good husbandry practices: horses should live in a clean environment and have access to clean water and be fed good quality feed on a regular schedule. Horses should be allowed out of their stall/paddock/corral daily to walk, investigate, and see a different scene. Horses need to be exercised at least 4-5X per week with riding, lunging, round pen work.
Ideally, horses should be fed more often than twice daily, such as given lunch and a later snack in the evening in addition to their breakfast and dinner. Understanding that this may be a burden for horses kept away from home in a boarding facility, hay bags or slow feeders may help.
Understanding that horses are social herd animals, stall kept horses should be turned out for several hours during the day, either with or next to other horses. When they are kept in their stalls — they should, at a minimum, have a sightline to another horse — and possibly be able to touch muzzles.
When planning on riding, either ride after a light meal or offer 1lb of hay or alfalfa pellets just prior to riding to reduce the free acid content in the stomach. This reduces the sloshing of acid into the non-protective layer of the stomach.
When stressful events are planned, such as trailering, horse shows, change of ownership, etc., consider giving an acid reducer.
How do I treat ulcers?
Scoping a horse’s stomach is the definitive way to diagnose a stomach ulcer. This is usually performed at a clinic because it requires a 3-meter long scope and the horse has to be fasted overnight from food and fasted for a few hours without water —- all are easier to perform at a clinic with overnight staff.
Colonic ulcers are a little tougher to definitively diagnose. There are truck-side tests a veterinarian can run that looks for blood in the feces, which can aid in diagnosis. Blood work and ultrasound of the colonic wall may help. Many ulcers are diagnosed by behavior, physical symptoms, and sometimes acupuncture alarm points.
Standard conventional treatment of stomach ulcers usually consists of omeprazole which stops acid production altogether. It is found in Gastroguard and Ulcerguard. Other products are on the market — but there is considerable discussion on the stability of the active ingredient. Compounded omeprazole and other feed through products exist and have been successful in some horses and not in others. There is also ranitidine (Zantac) which is a partial acid production reducer, but it has been pulled off the market for now. Sucralfate is often used in addition to the above and it is a product that covers the ulcer with a chalk-like powder.
Unfortunately, with omeprazole there is a rebound effect, and many horses cannot seem to wean off it successfully. When horses are on the products for months at a time, evidence suggests that the absorption of key ingredients may be hindered. Also, there is some evidence that changing the acid production in the stomach causes negative changes in the colon. So in effect, you are treating one end of the GI tract and damaging the other end.
Standard treatment of colonic ulcers are more holistic and are aimed at decreasing the bulk of feed — by going to an alfalfa-based pelleted feed. The idea is to give a colon a rest. Gut coating agents and laxatives/oils are also recommended. Sucralfate and mucilloid (metamucil) treatments are also recommended.
Holistic medicine in addition to good husbandry practices advocates more natural, soothing methods of ulcer treatment. What works well is Aloe Vera Gel, Slippery Elm Bark, Marshmallow root, and licorice root. They all soothe, cover the mucosa and ulcers, and provide a healing environment. These ingredients can be found in herbal blends or purchased individually. These ingredients are beneficial to both the stomach and the colon.
Physically reducing the acid content in a stomach can be done with calcium and magnesium. Alfalfa hay/pellets have a high calcium content and can be thought of as a Tums. Nutrient Buffer, Milk of Magnesia, Pepto Bismol, and Tums have also been given to reduce stomach acid and stomach pain.
Another option of healing ulcers with colostrum, pre/probiotics, and a mushroom blend — the company is called ImmuBiome — the primary product Lean Muscle for stomach ulcers and Gtract for hindgut ulcers. CCVET code gives 5% off. I have recently tried this product and it has helped our show horses tremendously.
Having your veterinarian examine your horse and come up with a diagnosis and treatment plan is the best course of action. In my practice, I like to complete a physical examination and discuss with the owner a complete list of behavioral and health issues. For treatment in addition to choosing a treatment from the previously listed, I offer acupuncture, Chinese herbs, and homeopathy to treat suspected gastric and colonic ulcers.
Deworming Holistically
Standard worming protocols
Standard conventional medicine deworming protocols for horses of the recent past have been to worm every 8 weeks, and rotate the dewormer products between 3 types to avoid resistance. More recently, due to resistance, conventional medicine is advocating to test the feces with a fecal float — and deworming accordingly. That leaves Southern California with a minimal worming policy — as most of the horses come up with zero eggs. One issue with this method is that worm eggs shed in the feces intermittently and testing once a year may not get the full picture. Also, pinworms and encysted strongyles do not show up in fecal floats.
I advocate, in addition to fecal floats, to add a general assessment of your horse’s condition. A healthy, worm-free horse should have no ribs visible, and the point of the hips nicely covered. They should have a very short (fully-shed out), glossy hair coat. The color should be rich — not sunburnt, faded, dull. The top of the tail should be smooth, and they should not be itching their behind! If your horse has ribs showing, a dull hair coat that is not shedding out appropriately, and/or has a scruffy tail-head and tends to itch his behind on the fence —- then most likely it needs to be dewormed, regardless of the fecal float results.
Now what should we use? There are very good, efficient dewormers on the market — and they are all chemical-based. Ivermectin and Quest seem to be the gold standard in terms of getting the majority of the worm populations (there has been some resistance reported to ivermectin).
Next, there are fenbendazole (Panacur/Safequard) and praziquental pamoate (strongid) which have their place in the rotational protocol.
I want to be holistic and only use natural products to de-worm — how do I proceed?
In this case, it becomes a little more tricky. One step is to avoid worms all together — this is achieved by maintaining a clean environment for the horse — meaning clean up the manure 2X daily. Worms are spread through the manure — and horses pick them back up when they eat around the manure. Horses that are kept together have an increased chance of getting worms from each other (unless all the horses in the pasture are clear of worms). So individually-kept horses (all through not socially healthy) tend to have fewer worms than horses together on a pasture/paddock. But by cleaning the pasture/paddock daily of manure — you can also reduce this risk. Spreading the manure in a pasture is not the same as actually cleaning up the manure.
How do I deworm horses that already have them?
This gets a little tricky — because not all of the products work as well as the chemically based ones. Even holistic veterinarians still advocate for annual ivermectin. Encysted strongyles may only be adequately removed with either Quest or a Panacur Powerpak — but these only need to be given every 2 years or so.
Diatomaceous Earth is often a key ingredient in natural dewormers. Make sure it is not the pool grade DE — because that can cause pneumonia or worse. The DE should be food grade. This product may reduce the fly numbers, but its ability to decrease worms have been questioned. I have had horses in my practice that were fed DE and still had high egg counts.
Herbal Mixtures — many of the herbs can be toxic if not mixed appropriately and in appropriate amounts. Certain dewormers for people and other animals are very toxic and can cause laminitis or even be lethal —- specifically avoid Black Walnut.
Good ingredients are Wormwood, Cayenne, Pumpkin seeds, garlic, Thyme, Red Clover, Hyssop, and Fennel seed (a liver herb), slippery Elm Bark, Clove, Chapparal, Juniper, etc.
Stick with the natural companies that know how to mix the appropriate amount of herbs and have established an appropriate dose. Earthsong Ranch and Silver Lining herbs are two companies that provide products with recommended feeding cycles. Please note that a stressed-out, unhealthy horse, living in unsanitary conditions will likely not respond to herbal deworming.
Best practices are to have a veterinarian do a fecal float 3-4 times per year, take a physical assessment of your horse, and adjust your treatment based on the results. Have a clean environment/housing and take care of the other health needs of your horse such as good quality feed, and clean water, and health maintenance. A healthy immune system will be a deterrent to the worm population. Some horses may need to be supplemented with pre and pro-biotics to help their digestion.
In addition to natural worming protocols, Chinese herbs and homeopathy also help in keeping a horse free of worms. I offer both of these modalities and they require a Veterinary physical exam to assess the individual and create a treatment plan.
Header Image credit: Terry Miller