I am on day 30 of treating my gelding for ulcers, and have not seen any improvement. His behavior under saddle has actually gotten worse. I have been giving Gastrogard 1 hour prior to feeding in the morning, and Misoprostol 1 hour prior to feeding in the evening, with no food in between. He has been thoroughly checked over by my performance vet (injected hocks, full back and neck xrays, regular chiro and massage, etc.) and the only thing we could find is ulcers. His only symptom is decreased peformance under saddle - he has a very poor attitude, swishes his tail, pins his ears, reluctant to stride out and is just overall not happy to be ridden. The soonest I can get him rescoped is in 3 weeks. I am not sure if I should continue giving the Gastrogard and Misoprostol? Or wean him off of them and try something different? Has anyone had success with a supplement or a more natural treatment? 

Did you happen to xray and check his back for kissing spine?  

I agree check for Kissingspines and check your saddle and pad to make sure its a good fit. 

How old is this horses and how long have you been training or running this horse? With pin ears and swishing of that tail tells me it could be either that I listed. 

Yes, full xrays of back and neck. All are clean. We blocked his back and I rode him under saddle in case xrays were not showing something but there was no change in behavior. Saddle has been fitted by two professionals and fits well. He is 8 years old, I have not had him long but he has done it since day one and it has been getting worse. He's not on the pattern, he has mostly just been ranched on but it sounds like he did it with his previous owner as well during arena work. 

I have had great results using THE ulcer treatment. They have done studies on its efficacy. I think if you go to 307 performance horses you will buying from a fellow BB here, Krystol. She knows the product inside and out. She is really good to work with. 

I'd be p*say too if I didn't get any food between breakfast and supper. 

It's part of the ulcer treatement. Gastrogard and Misoprostol won't work if fed in between. Before treatment, he had food in front of him 24/7. 

I have had really good results with THE GastroPlus,  you can give it twice a day and I have the best luck giving it mixed with water and syringe it in his mouth.  If it works for your horse, you can back off to once a day and put it in his feed.

I also like Succeed VF or the Stride 21 day hindgut program.  Since mine were on the track, I would go ahead and upgrade to the Stride Immune, same thing as the hindgut but with added Vit C and Vit E.  The only problem with the Stride is that they have to eat a lot of powdered supplement in with the feed, all of mine ate it just fine after a day or two of half doses but some horses don't like it.  The Succeed is a paste so its pretty easy to give and it doesn't taste bad. After a week or so, I would just put the paste on the feed and mine ate it just fine.

I have honestly had better luck with any of the above over Omeprazole,  I do use Omeprazole but I will use it for a week or two then switch over to something else.

One more thing, have you pulled blood to check for elevated muscle enzymes, kidney and liver function?  Could be another reason for a ****y attitude.

Thank you! I just ordered some THE GastroPlus, and will look into Stride hindgut program. I will suggest pulling blood to check for those things, something I didn't think about! 

How does that help, depriving them of forage feeding only twice a day when that feeding program is the reason many horses have ulcers in the first place? Really curious to hear why your vet has on this protocol. 

Yep. Never heard of this before. Not how the equine digestive system works. 

Has he been cleaned and checked for beans?I agree with bloodwork as well.

Fasting was definitely not recommended when my mare was on it.  Also my mare developed a few uncomfortable side effects with the Misoprostol and we had to adjust the dosage to get within an effective treatment and comfort range with her.  I know others that have used it with a few side effects as well.  

I also had a horse I treated for ulcers years ago that never lost the attitude but did return to performing at 100%.  The attitude became learned.

Same issues with my mare.  We Xray'd back,hocks stifles front feet.  All good.  She's also had follicle issues so we confirmed that wasn't the problem.

Took her to another vet.  She has EPM.  So we're treating her for that.  When I would get on her she'd only want to back up.  Really ****y. 

Not like her at all.  Would not lounge in a circle but would follow me in a circle all day off a lead rope.  After 2 weeks of meds she's noticiby better on the ground.

We go back to the vet in 2 weeks and we'll decide if she's ready to ride.

I do keep her on Platinum GI because she had ulcers when I got her a year ago.  She doesn't have them now.

I've never heard of this methos either. The stomach needs forage as it constantly produced acid. 

A few things I would look into for ulcers- Succeed, Sucralfulfate 

Does he have any reson to constantly be stressed? Ex- Is he bottom of the herd? Is he penned alone and worrying about a buddy? 

From my understanding, the stomach doesn't absorb the drugs as effectively on a full stomach which is why it was recommended to give one hour prior to feedings. Gastrogard blocks the secretion of acid, so his stomach is not overproducing acid while he's not eating. He is probably without food for 2-3 hours max in between, with the amount he is getting at each feeding. He will have access to forage 24/7 once he is off the treatment since that is one of the best preventatives. I don't starve my horses I promise! 

No reason to be stressed, our setup at home has our horses in separate pens but they share the fence and can always see eachother. So no issues with being bottom of the herd but he always has buddies next to him. 

Did she have any other symptoms like muscle atrophy or hindend weakness? I have thought about it being EPM as well but he doesn't show any other symtoms, so I haven't tried treating for that yet. 

Yes, no beans! I am thinking bloodwork is the next step. 

Sorry if I inferred you starve your horse. That was not at all what I meant., I just had never had a vet recommend that protocol. I do get the withholding of feed 1 hour prior to the ulcergard, but more than that puzzles me because stomach is producing acid all the time to digest the forage they are designed to eat almost continually. It's the lack of food in the stomach (which continually produces the acid whether there food in it or not) that is a major factor in the development of ulcers. Of course there are other causes also, which makes hard sometimes to pinpoint the exact cause. Thank you for having this discussion with me. I always appreciate some one explaining the whys to me. 

As someone who takes omeprazole for severe acid, I don't recommend taking him off just yet. That said, have you had him scoped yet? I understand the concept of just going ahead and treating for ulcers, but if after 30 days of following the treatment plan & meds, there isn't improvement, go ahead and scope him. You may be barking up the wrong tree entirely, or you may need something different. The scope will atleast tell you yay or nay on what you've been doing for 30 days and maybe save you a bunch in future meds. 

Thank you for the shout out. Gastroplus is pretty great stuff. Any feed through can take a bit to show results. The great thing about this product is it helps produce the mucous lining the stomach needs to protect against the acid. It's not just a cover up.

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I have an ulcerous gelding and I was not satisfied with the omeprazole/sucralfate regime he was on per vet. Nor the cost. Put him on 3 generic Esomeprazole pills a day and have been very pleased with the results all last year. Vet said if it's working, keep using them. 

Lots of ideas here, and some different takes on treating ulcers. Here is my 2 cents. Treating is a multi step process. One step is treating existing ulcers, the second is finding the reason that they are there in the first place. The third is modifying the management of the diet so that they do no return when treatment is over.

You already are addressing number 1, but I agree that the feeding schedule is wrong. Do not feed for an hour after treatment, but have roughage available at all times after. If there is no alfalfa in the diet, this is a good time to add some. The added calcium and low starch and sugar of alfalfa can be a benefit. Eliminate all grain based feed in the diet. 

Be sure teeth are up to date. This is the most often missed issue with ulcer horses. A horse only makes saliva when it chews. This is the natural buffer for stomach acid, and one reason that roughage should always be available to cause that saliva to be produced. If the horses mouth hurts to chew, it will only chew enough to swallow and as a result little saliva will be produced. The ratio of food material, saliva and stomach acid will then be out of balance and ulcers can result. If you don't fix the teeth, the ulcers will return as soon as your treatment is over.

Hope this helps. 

I think you said you had some pros fit the saddle but that sounds like it could be a saddle-fitting problem. You said: "His only symptom is decreased peformance under saddle - he has a very poor attitude, swishes his tail, pins his ears, reluctant to stride out and is just overall not happy to be ridden." Any issues when lunging him? Could you try a treeless saddle on him? 

THIS^^^^^  Forage is sooooo key!  Keep something in front of them all day and night.

My mare got badd ulcers when we started upping her grain and had the vet prescribe her omeprazole for a month. The omeprazole did not work and she only got worse until a friend suggested an ulternative. We put her on camelina oil (which is wayyyy cheaper btw) and saw results in less than a week. Most feed stores should have it. It also really helps with joint issues and other general wellbeing.

You should be seeing positive results.  I'd take a serious look at EPM!  It is one nasty bug that hides behind so many different symptoms that create behavior issues.  

Mine went off alfalfa before she was treated for ulcers. She would eat grass hay all day. I've heard of other that do this. Alfalfa always has more stems. 

You said with "no food in between"  that may be your problem.  Alfalfa is the best thing for ulcers and helps keep the gastric acid down.  horses are meant to be grazers do your research on this.  My very hot mare had grade 3 ulcers and i keep her on all the alfalfa she wants and turn out and when we go to a show she has alfalfa in front of her always.  she has not had issues since.  also I use Abler paste(same as ulcerguard/gastroguard) as a proactive and 3-4 days before a race I give a full tube everyday.  Abler is from Austraila and has been a life saver for me.  its the exact ingredients as gastroguard only $10 a tube.  You need to make sure your not using a compounding omeprazole only use either gastroguard/ulcerguard or Abler paste every day for 30 days and I bet things change. 

Could you tell me which one you are using?

You can find research that concludes gastric ulcer get better on alfalfa, and you can find research that says gastric ulcers worse on alfalfa diet. Find what works on your horse.