FAQ – “Hind Gut Ulcers”

By Dr Benjamin Sykes

The first thing to say that hindgut ulcers per se are very rare (despite the aggressive marketing of some supplement companies). Second is that when true hindgut ulcers do occur they are a condition that requires veterinary diagnosis and intervention as they are manifestation of IBD which can be very serious. The other thing that is pushed hard is hindgut acidosis which is a real problem in horses eating very high grain diets (like racehorses) but virtually non-existent in the riding horse population (again despite the aggressive marketing of some supplement companies).

But if we take a step back from the terminology we do recognize that undifferentiated hindgut disease (UHG) is common. But instead of ulcers what we are seeing is likely related to dysbiosis (although our current understanding of this is limited).

Importantly though, before assuming our horse has UHG it is important that we cover of the common things that cause non-specific GI signs such as EGUS, endoparasites and sand. Once we have done that and ruled out IBD (blood work +/- other testing) we end up with UHG. So a horse that has clinical signs (symptoms) should always be examined by a veterinarian to work through the process.

As for treating – there is no specific medication used. UHG is primarily managed by diet and ensuring good nutrition is the single most important step. To this effect I recommend consulting with a nutritionist such as Purina’s excellent team or if you want someone independent try FeedXL. Once the nutrition is sorted out then the other main strategy used is probiotics noting that these don’t work terribly well if the nutrition is pox, so again make sure that the nutrition is right first. There are literally hundreds (at least) of probiotics on the market and there is a huge range in quality (some are pure garbage). We also accept that no single product works on all horses so some of it is “suck and see”. Change can be slow and take weeks-months. My advice is to buy from a reputable company and in general in the USA my first stop would be Assure Guard Gold. In Australia/NZ, Asia and the Middle East it is GastroAID.

Given that the cornerstone is good nutrition and that the probiotics appear to be very safe we of course can use that in any horse as a preventative, not against hindgut ulcers per se but for good GI health in general.

Dr BS.

COI – I consult to the manufacturers of GastroAID and have given talks for Purina and FeedXL but have no commercial affiliation with them or Assure Guard Gold. The opinions are my own.