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Ulcer treatments - Aloe Vera vs. Gastrix vs. "

Mari
 


I have an 8 year old paso fino who has IR and foundered 1.5 years ago, she recovered nicely, her insulin level is normal and she is managed with diet.  She has become very cinchy and presumptive diagnosis of GI ulcers was made (no scope or biopsy were done) - based on clinical signs and reactivity to DAPE exam by veterinarinarians.  She received a month and a half of gastrogard and improved.  Now I need to find something long term.  The mare may also have DSLD - so she receives AAKG/J protocol, in addition to Cosequin, Mare Magic, Vita Calm, Magnesium/Chromium by platinum performance, vit E by platinum performance.  She is fed bermuda pellets and timothy hay. 

 It was suggested that the horse go on Gastrix - but I am concerned about sugar content in the product (honey as first ingredient).  Has anyone evaluated or used this product?


Here's the ingredient list: Honey, Sodium Chloride, Cinnamon Powder ( Cinnamomum Verum ), Cabbage Powder ( Brassica Oleracea ), Ascorbic Acid, Methylsulfonylmethane, Purified Water, Apple Cider Vinegar, Aloe Vera Concentrate, Carrot Powder ( Daucus Carota ), Slippery Elm ( Ulmus Rubra ), Licorice ( deglycyrrhized, from Glycyrrhiza Glabra ), Anthemis Nobilis L., Grapeseed Extract, Zinc Gluconate, Brewers Yeast, Apple Pectin, Chlorophyllin, Dong Quai Root ( Radix Angelicae Sinensis ), Red Ginseng ( Panax Ginseng ), Lemon Juice ( Citrus Limon ), and Sodium Benzoate.

GASTRIX™ Guaranteed Analysis:

* Vitamin C, min: 14600 mg/kg
* Salt, min: 8150 mg/kg
* Salt, max: 8590 mg/kg
* Sodium, min: 3170 mg/kg
* Sodium, max:  3450 mg/kg
* Zinc, min: 19 mg/kg

Alternative would be Aloe Vera Juice from Trader Joes?   I wasn't sure with potential DSLD, history of founder - what maintenance supplement would be helpful to avoid ulcers.   
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Mari, CA, joined 2019

Lorna
 

Hi Mari,

Ulcer treatment is not my strong suit. Sorry.

Just wanted to say I'm glad  you made it here !
😊

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Lorna Cane
Ontario, Canada
2002


 

Lorna
 

HI Mari,

I did a search in our Archives ( search box a top of page) and found a good message from one of our vets,Jaini, in which she mentions Aloe.

It is here:
https://ecir.groups.io/g/main/message/233859?p=,,,100,0,0,0::Created,,ulcer+aloe+vera,100,2,0,30825957

Here is the link to the Ulcer Folder in our Files:
 https://ecir.groups.io/g/main/files/Ulcers 


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Lorna Cane
Ontario, Canada
2002


 

 

Hello Marianna,
Kudos to you for having your horse's IR under control. When you get your horse's case history loaded up be sure to include the blood test results that have been done. I am including a link to the ECIR website and specifically  to a page that details the WHAT and HOW of diagnosis and testing. 
https://www.ecirhorse.org/DDT+E-diagnosis.php

You have to scroll down the page to reach the info about Insulin Resistance. Please read the details of this section and compare it to how your step your veterinarian takes for testing. It's good to review and compare the how of blood draws, fasting, non-fasting, actual test results, etc.

I have had to deal with equine ulcers with 2-3 horses in the past that I competed in endurance and of course they were hauled long distances to get to the competitions. Yes the known successful medications for ulcers is $$$$!

I have used Finishline U-7 liquid but not on a horse that was IR. I can't say if it helped or not. They also have a powder which is lower in honey but it does include honey powder plus several other ingredients that possibly include sugars.

What I did find to be the most effective preventative is continuous hay, no empty stomachs. Particularly be sure that your horse has hay in their stomach before exercising. Of course if your horse is on restricted hay this may be what is worsening the stomach issues. If your horse is at your home then I suggest finding a way to trickle feed hay. I realize that in California and much of the Southwestern USA the hay costs have sky rocketed.

I know you'll get more advice about gastric issues but do be sure to research the ingredients of anything you decided to use. 

I have attached our New Member "Primer" below. We request that you simply start reading at the top and follow the steps to join our CaseHistory group, created a case history folder (give the folder a name which includes Your name and Horse name). This folder is where you will upload your horse's case history document. You can create sub-folders within your case history folder. Having sub-folders for "Hay Tests", Blood Test Results, etc is handy and makes it easier for you and other members. I found that printing a blank copy of the Cash History document to use for pencil notes  worked for me. Once I had written in some details it was then easier to actually type up a clean copy to upload to my folder.

Good wishes and Welcome!

The ECIR provides the best, most up to date information on Cushing's (PPID) and Insulin Resistance (IR). Please explore our website where you'll find tons of great information that will help you to quickly understand the main things you need to know to start helping your horse. Also open any of the links below (in blue font) for more information/instructions that will save you time.

Have you started your Case History? If you haven't done so yet, please join our case history sub-group. We appreciate you following the uploading instructions so your folder is properly set up with the documents inside. Go to this CH message with info on how to use various devices and forms. If you have any trouble, just post a message to let us know where you are stuck.

Orienting information, such as how the different ECIR sections relate to each other, message etiquettewhat goes where and many how-to pages are in the Wiki. There is also an FAQs on our website that will help answer the most common and important questions new members have. 

Below is a general summary of our DDT/E philosophy which is short for Diagnosis, Diet, Trim and Exercise.

 

DIAGNOSIS: There are two conditions dealt with here: Cushings (PPID) and Insulin Resistance (IR). These are two separate issues that share some overlapping symptoms. An equine may be either PPID or IR, neither or both. While increasing age is the greatest risk factor for developing PPID, IR can appear at any age and may have a genetic component. Blood work is used for diagnosis as well as monitoring the level of control of each.

PPID is diagnosed using the Endogenous ACTH test, while IR is diagnosed by testing non-fasting insulin, glucose and Leptin. Leptin is the hormone that says "stop eating". Knowing this helps to differentiate if a horse is IR "at baseline" or if an elevated ACTH is "driving" the insulin up. In Europe, substitute adiponectin for the leptin test.

*Before calling your vet to draw blood for tests, we suggest saving time and wasted money by reading these details and then sharing them with your vet so that everyone is on the same page regarding correct testing and protocols.

*Please remember to request copies of the results of all the tests done rather than just relying on verbal information. Your vet should be able to email these to you. If you have previous test results, please include those as well. All should go in your CH, but if you are having any trouble with the CH, just post in the messages for now. 

Treatment: IR is a metabolic type - not a disease - that is managed with a low sugar+starch diet and exercise (as able). The super-efficient easy keeper type breeds such as minis, ponies, Morgans, Arabs, Rockies are some of the classic examples. PPID is a progressive disease that is treated with the medication pergolide. Some, but not all, individuals may experience a temporary loss of appetite, lethargy and/or depression when first starting the medication. To avoid this "pergolide veil" (scroll down for side effects), we recommend weaning onto the drug slowly and the use of the product APF. The best long term results are seen when the ACTH is maintained in the middle of the normal range at all times, including during the annual seasonal rise. To accomplish this, the amount of medication may need to increase over time. Neither condition is ever "cured", only properly controlled for the remainder of the equine's life. If your partner is both PPID and IR then both medication and diet management will be needed. 

DIET: Almost all commercial feeds are not suitable - no matter what it says on the bag. Please see the International Safe Feeds List for the safest suggestions.

No hay is "safe" until proven so by chemical analysis. The diet that works for IR is:

  • low carb (less than 10% sugar+starch)
  • low fat (4% or less) 
  • mineral balanced  

We use grass hay, tested to be under 10% ESC + starch, with minerals added to balance the excesses and deficiencies in the hay, plus salt, and to replace the fragile ingredients that are lost when grass is cured into hay, we add ground flax seed and Vitamin E. This diet is crucial for an IR horse, but also supports the delicate immune system of a PPID horse. 

*Until you can get your hay tested and balanced we recommend that you soak your hay and use the emergency diet (scroll down for it).  The emergency diet is not intended for long term use, but addresses some of the most common major deficiencies. Testing your hay and getting the minerals balanced to its excesses and deficiencies is the best way to feed any equine. If you absolutely cannot test your hay and balance the minerals to it, or would like to use a "stop gap" product until you get your hay balanced, here's a list of "acceptable" ration balancers

There is a lot of helpful information in the start here folder so it is important you read all the documents found there. The emergency diet involves soaking your untested hay for an hour in cold water or 30 minutes in hot water. This removes up to 30% of the sugar content, but no starch. Starch is worse than sugar since it converts 100% to glucose while sugar only converts 50%, so starch causes a bigger insulin spike. Make sure you dump the soaking water where the equine(s) can't get to it. 

What you don't feed on the IR diet is every bit as, if not more important than, what you do feed! No grass. No grain. No sugary treats, including apples and carrots. No brown/red salt blocks which contain iron (and sometimes molasses) which interferes with mineral balancing, so white salt blocks only. 

No products containing molasses. No bagged feeds with a combined sugar and starch of over 10% or starch over about 4%, or fat over about 4%. Unfortunately, even bagged feeds that say they are designed for IR and/or PPID equines are usually too high in sugar, starch and/or fat. It’s really important to know the actual analysis and not be fooled by a name that says it is suitable for IR/PPID individuals.

We do not recommend feeding alfalfa hay to IR/PPID equines as it makes many of them laminitic. Although it tends to be low in sugar, many times the starch is higher and does not soak out. Additionally, protein and calcium are quite high, which can contribute to sore footedness and make mineral balancing very difficult.

TRIM: A proper trim is toes backed and heels lowered so that the hoof capsule closely hugs and supports the internal structures of the foot. Though important for all equines, it's essential for IR and/or PPID equines to have a proper trim in place since they are at increased risk for laminitis. After any potential triggers are removed from the diet, and in PPID individuals, the ACTH is under control, the realigning trim is often the missing link in getting a laminitic equine comfortable. In general, laminitic hooves require more frequent trim adjustments to maintain the proper alignment so we recommend the use of padded boots rather than fixed appliances (i.e. shoes, clogs), at least during the initial phases of treatment.

Sometimes subclinical laminitis can be misdiagnosed as arthritis, navicular, or a host of other problems as the animal attempts to compensate for sore feet. 

You are encouraged to make an album and post hoof pictures and any radiographs you might have so we can to look to see if you have an optimal trim in place. Read this section of the wiki for how to get a hoof evaluation, what photos are needed, and how to get the best hoof shots and radiographs.

EXERCISEThe best IR buster there is, but only if the equine is comfortable and non-laminitic. An individual that has had laminitis needs 6-9 months of correct realigning trims before any serious exercise can begin. Once the equine is moving around comfortably at liberty, hand walking can begin in long straight lines with no tight turns. Do not force a laminitic individual to move, or allow its other companions to do so. It will begin to move once the pain begins to subside. Resting its fragile feet is needed for healing to take place so if the animal wants to lay down, do not encourage it to get up. Place feed and water where it can be reached easily without having to move any more than necessary. Be extremely careful about movement while using NSAIDs (bute, banamine, previcox, etc.) as it masks pain and encourages more movement than these fragile feet are actually able to withstand. Additionally, NSAIDs (and icing) do not work on metabolic laminitis and long term NSAID use interferes with healing. Therefore, we recommend tapering off NSAIDs after the first week or so of use. If after a week's time your equine's comfort level has not increased, then the cause of the laminitis has not been removed and keeping up the NSAIDs isn't the answer - you need to address the underlying cause.

 

There is lots more information in our files and archived messages and also on our website. It is a lot of information, so take some time to go over it and feel free to ask any questions. If you are feeling overwhelmed, don't worry, you will catch on, and we are always here to help you! Once you have your case history uploaded, we can help you help your equine partner even better.

For members outside North America, there are country specific folders in the files and many international lists in the wiki to help you find local resources.

If you have any technical difficulties, please let us know so we can help you. 

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Bonnie Snodgrass 07-2016

ECIR Primary Response 

White Cloud, Michigan, USA

Mouse Case History, Photo Album

Mari
 

Thank you, it was very helpful.  I saw a reference to GUT by Uckele, ordered it.  Great articles, thank you.  Will try it and Aloe Vera.  My horse gets hay with each meal/before exercise but it was easier to control her weight and her insulin levels with mostly bermuda and just enough hay to keep her busy.  
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Mari, CA, joined 2019

Mari
 

I have to go back and see if I ever uploaded her history when she foundered 1.5 years ago...  I definitely used the website to help deal with her laminitis and both emergency and long term care and I am grateful for the info.  So I guess technically I joined before this year.   This particular mare's exercise involves 10-15 minutes at a walk in the arena so she does not have the stresses of an endurance horse, but she is a high strung breed and I found that DSLD bred horses tend to have chronic GI issues, so she was ulcer prone even when she was on 100% hay.
Mari, CA, joined 2019

Mari
 

Quick question: amount of inulin in GUT- any issues for IR?
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Mari, CA, joined 2019