Equine Ulcers: A Suitable Case for Treatment? Part 1: Causes and Diagnosis

Throughout this jumps season, the subject of equine ulcers has been much discussed, not least by OfO owners, since we have treated Shantou Magic, Wilde Oak, Primo Capitano, He’s A Bully, Bilbrook Blaze and Quick Decisson. It has already paid off with Shantou Magic, who bounced back from a poor run at Doncaster to win, hard held, at Bangor-on-Dee. Having said that, while there can sometimes be a dramatic improvement in the condition and performance of treated horses, there most certainly isn’t a guarantee; indeed, horses with ulcers can run well, and horses without them can run badly.

Because of the interest in the subject, Part 1 of this blog looks at the causes and diagnosis of ulcers while Part 2 on 1st May will look at treatment and the implications for stable management. I would particularly like to thank two of our vets, Kevin Bishop (who treated Shantou Magic, as well as Silviniaco Conti, Al Ferof and Irving at Paul Nicholls’ yard) and Tim Brazil (who treated Primo Capitano). They were tremendously helpful, shared lots of ideas and even tolerated my attending the gastroscopy. As one of them joked, £100 for the scope and £900 for the interrogation!

What causes equine stomach ulcers?

A key point is that with humans ulcers are essentially bacterial (caused by heliobacter pylorum) whereas with racehorses it is the stable management and training regime that triggers them. The horse is essentially a grazing animal who, when allowed to be out in the paddocks, will eat for up to 16 hours a day and sleep for eight. Happily munching away, the horse will chew between 50,000 and 60,000 times a day, generating over 50 litres of saliva which, together with the grass, is absorbed into the stomach. All of this keeps the stomach acids in balance and, for most horses, ulceration is minimal.

But once we bring the horse into training, that natural process is severely curtailed, with feeding usually twice a day and regular exercise often on an empty stomach. With no natural foraging the saliva production declines dramatically and the natural acidity in the stomach increases. Furthermore, and particularly when the racehorse is galloping, the increasing amounts of acid slosh around the linings of the stomach and it doesn’t take long for ulceration to begin. Research suggests that this can happen within a fortnight. One of our vets believes that the effect of ulcers is to produce a severe heartburn up the sides of the horse around the stomach and heart. He believes that is what can stop them performing well on the racetrack.

What are the clinical signs?
This is not always clear at all. Really well, gleaming horses can have very bad ulcers and equally those who look dull in their coats, have lost appetite and may indeed have minor colic do not necessarily have ulcers. A number of trainers are firmly of the view that if the horse looks and eats well, and is galloping strongly, then there is not necessarily a need to go looking for a problem which then requires treatment. Other trainers – examples being John Gosden and Godolphin – now assume that their horses have ulcers and treat them throughout the season.

How are ulcers diagnosed?
With the much more common use now of the endoscope (a tiny video camera on the end of a flexible tube), this is relatively straightforward. The horse is given a low dose sedative, the tube is inserted through the mouth and down into the stomach, and then the vet views the various parts of the stomach, looking for lesions. They are normally found in 90% of all racehorses in training. What matters is their severity. Current practice is to grade them on a scale of 0 to 4:

• Grade 0: the stomach lining is intact and there is no reddening;
• Grade 1: the stomach lining is intact, but there are some areas of reddening;
• Grade 2: the stomach has single or multiple ulcers, but they are relatively minor;
• Grade 3: the stomach has large single or multiple ulcers which need treating;
• Grade 4: the stomach has extensive ulcers, often merging to give deep areas of ulceration.

So if after the diagnosis the horse is deemed to have ulcers at Grade 3 or 4, then treatment is required. We’ll look at this, and the implications, in the next blog.

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Reflections on the Best Ever Cheltenham Festival and the Launch of the OfO Partnership with the Tremendously Successful B3 Betting App

Well, it’s taken several weeks to recover from Festival fever. The general consensus was that it was the most enjoyable Festival for many years, and it is marvellous that the dowdy dowager of Prestbury Park is finally showing the benefits of a much-needed face-lift. This is not just with the £45m new grandstand but there was a sense of space and freedom of movement particularly with the plaza by the north entrance and re-siting of the tented village. It was also a Festival to remember for the magnificent gambling success by the author of this blog. This came about from attending a lengthy presentation in the Quevega Tapas Bar, over an aged Chilean madeira with salted almonds (a snip at £27.50), from the excitingly innovative betting app – B3: “Banning Brainless Betting: Insight, Foresight, Hindsight”. Once you read the summaries below, you will be wanting to sign up too, with Aintree only a week or so away. Finally, extremely interesting to see how many winners came from privately-bought French breds; a subject for a future blog.

Day 1: Supreme Novices: Douvan. 2/1. French bred, private purchase.
Incredibly, this was the first of 10 Willie Mullins favourites in the 14 non-handicaps. The result started a bookie panic on Day 1, the likes of which have rarely been seen. Could easily develop into a superstar. B3 view: the British runners are not up to much, and Timeform have Douvan rated far higher than the average Supreme winner. Bound to be a short price, but go against him at your peril.

Day 1: Arkle: Un De Sceaux. 4/6. French bred, private purchase.
Ruby Walsh desperately needed a Festival winner over fences, having not won one since Kauto Star’s Gold Cup six years earlier. A strange horse with a useless pedigree and dreadful conformation but clearly a huge engine. B3 view: the only way he can be beaten is to fall over. If he went for the Champion Chase he would be favourite. Roll over the profits from Douvan.

Day 1: Champion Hurdle: Faugheen. 4/5. Goffs store.
Unbeaten from eight starts, this was a top-drawer performance in the manner of Istabraq, even though it was a rather uneven, stop-start, tactical race. The horse has never looked like being beaten yet. B3 view: a level above everything else and hard to find a flaw. The New One lacks class and no-one should back him after the awful Haydock run. Lump on Faugheen and the tricast with Arctic Fire and Hurricane Fly. See you in Quevega’s.

Day 2: Neptune: Windsor Park. 9/2. Privately bred.
One of my favourite races, that traditionally produces good winners such as Hardy Eustace, Istabraq, and Faugheen last year. Hopefully Dermot Weld will send the winner to the Ascot Gold Cup. Is Galileo the new NH stallion? B3 view: a tricky one. Many of the horses look like plodders. The one that should act best on good ground is Windsor Park.

Day 2: RSA Chase: Don Poli. 13/8. Irish bred but bought at Arqana, France.
Had been billed as the Irish banker following a magnificent performance at Leopardstown over Christmas, and shaped like a real stayer in the Florida Pearl mould. Michael O’Leary described him as “a big, lazy b***er”. B3 view: looks the perfect candidate, having won at the Festival last year. Best form by miles. Lump on.

Day 2: Champion Chase: Dodging Bullets. 9/2. Privately bred.
A sad race in many respects, with both Sprinter Sacre and Sire De Grugy failing to come back to their best. The winner will always have a special place in the heart of Sam Twiston Davies, who immediately indicated that the win “hopefully means I keep hold of the job for years”. B3 view: one of the simplest races of the meeting. Horses never come back, so put a line through the leaders in the betting. Winners of the Tingle Creek (10 of the last 14) and the Clarence House have an awesome record. Fill your boots with Dodging Bullets.

Day 3: JLT Chase: Vautour. 6/4. French bred, private purchase.
In all the pre-Festival publicity, Rich Ricci was adamant that this was his best chance of the meeting. The horse was devastating in last year’s Supreme Novices and had really come to hand during February. There has rarely been a more breathtaking performance, with Vautour jumping magnificently. The official handicapper, Phil Smith, gave him a provisional mark of 170 after powering home by 15 lengths. B3 view: back him, back him and back him again.

Day 3: Ryanair: Uxizandre. 16/1. French bred, bought at DBS.
Always going to be remembered as AP McCoy’s final winner at the Cheltenham Festival. If you are generous, you would say that the perfectly judged pace forced all the other horses into errors. If less so, then it is likely that AP was run away with by a horse in a first-time visor. B3 view: great value here for a horse second in the JLT and one of only two course winners.

Day 4: Triumph Hurdle: Peace And Co. 2/1. French bred, private purchase.
Michael Dickinson is always remembered for the stunning Gold Cup performance with the first five home. But at this meeting, Mullins trained the first three home in the Champion Hurdle and Henderson did the same in the Triumph. Time to invest in ear-plugs for horses. B3 view: what more do you need? Just go for the highest-rated hurdler, only Our Connor has had better form in the last 20 years and the stable vibes are really positive after an exceptional gallop a fortnight ago. May be a skinny price, but time for Peace, love and rock & roll.

Day 4: Alfred Bartlett: Martello Tower. 14/1. Irish bred, bought at Goffs.
One of my favourite races, because it is always won by a really tough stayer who is prepared to slug it out. No exception this year. B3 view: go with Barry Connell, who rates this his best Cheltenham prospect.

Day 4: Gold Cup: Coneygree. 7/1. Privately bred.
It just shows that small guys can win huge races. As can small mares – the mum, Plaid Maid, is apparently an absolute tiddler. It felt as though the guard was definitely changing, with the younger horses all prevailing. Many people felt that it was the wrong decision to run Coneygree here rather than in the RSA, with it being over 40 years since Captain Christy won it as a novice in 1974. B3 view: don’t go anywhere near Silviniaco Conti. He is quite simply a non-stayer. Last year’s Gold Cup was a farce. Forget about regressive horses such as Bob’s Worth. Take no notice of the stats. Coneygree will romp home.

Wow, what a performance, and what an accumulator. It just shows how easy it can be when all the stats are properly weighed in the balance. I’m sure you’ll want to sign up for the B3 app, even if the initial investment of £1,000 may seem a tad on the high side. Just send me an email. It is a very quick transaction via the OfO Nigerian bank account. Happy punting at Aintree!

I am always interested to hear your views so please do leave a comment. If you can't see the comment box at the bottom of this post then navigate to the post using the right hand navigation or click here > and scroll to the bottom of the page. Look forward to hearing your views. Thanks very much for sharing them.