Did you know studies indicate....
Additionally, many horses and dogs have "mystery tummy or digestive troubles." This could be hind gut issues in horses, diarrhea in horses and dogs or any number of problems.
This newsletter will focus on the use of papaya (for horses and dogs) for ulcers and "mystery tummy troubles" as well as new and surprising medical research on the use and efficacy of Omeprazole, long considered the "gold standard" for treatment of equine gastric ulcers.
OK.... Let's get to it!
Key Facts About Gastric Ulcers
First, here is an excellent infographic by Hygain presenting key facts about the prevalence, causes, signs and some treatment options for equine gastric ulcers. In addition to the signs mentioned on the infographic, mild colic, lying down more than normal, girthiness (not caused by a girth issue, poor saddle fit or a rib movement restriction (aka a "rib out") can also be signs of equine gastric ulcers.
H2 Blockers and Proton Pump Inhibitors....In Plain English
Typical treatment for equine, canine (and human) gastric ulcers involves the use of either Histamine 2 (H2) blockers or Proton Pump Inhibitors to reduce stomach acid. H2 blockers, (medicines such as Cimetidine and Ranitidine), work by blocking a chemical in the body called histamine that stimulates stomach acid pumps. Proton pump inhibitors, (medicine such as Omeprazole), work by "blocking" (inhibiting) the pumps in the stomach that produce acid.
As reported by TheHorse.com, new research from a team in Australia showed that "in some horses on certain diets, the duration of acid suppression of oral omeprazole....could be inadequate for ulcer healing. While omeprazole did a great job raising intragastric pH in horses on high-grain/low-fiber diets, it didn’t perform so well in horses on hay-only diets."
The researchers also discovered that under some conditions there was a cumulative effect of dosing—meaning the longer the treatment regimen (measured up to five days), the higher the pH, which is a new finding. In the end, the researchers determined using a cookie-cutter dosing recommendation for all horses might not be appropriate. Veterinarians should consider the diet and management of horses when making dosing recommendations. "A hay-only diet might be a bad idea in the therapeutic stage, at least in some animals," according to the researchers.
These results led the research team to investigate other treatment approaches, specifically oral esomeprazole and a long-acting injectable omeprazole formulation. Both show significant promise. Check out the full article here for more details.
In summary, each horse's situation is unique. Cookie-cutter approaches do not always work. More research on oral and injectable omeprazole as well as oral esomeprazole is needed. Collaborate closely with your vet when considering ulcer medications and be sure to tell your vet about your horse's diet, turn out and other living conditions...all of which can potentially affect how well any medication works.
Can Some Papaya Each Day Help Keep Ulcers and "Tummy Troubles" Away?
Here is an article written by Gillian Clissold, an Advanced Level Eventer, regarding the use of papaya in horses. By the way, dogs can eat papaya too (in smaller quantities than a horse of course!) The seeds should not be ingested.
Papaya aids digestion, in part, by increasing mucous secretion in the mouth, esophagus and stomach. In some cases, a horse that has been turning its nose up at food starts eating within moments of the administration of papaya. There seems to be what could be called a “reverse Pavlovian response”. The horse’s mouth waters so it feels the urge to eat.
Even more importantly, papaya initiates a thickening of the horse’s natural stomach lining which provides protection against excess acid. It gives damaged tissues a chance to heal, and helps prevent new ulcers. In horses moving vigorously (race horses, eventers, endurance horses) the esophageal mucous protection can help keep reflux from damaging the esophagus. In an ulcer study published in the March 2005 issue of The Horse Journal, “rapid relief within three to five days” was reported. The same study reported that other major natural products for digestive problems worked considerably more slowly.
In one case, a weanling with severe ulcers and a bloated stomach did not respond to expensive pharmaceuticals but did recover with papaya. A race horse that had such severe ulcers it could not race, even after many weeks on an acid reducing pharmaceutical, had a clear endoscopic exam after three weeks on papaya, and then won a stakes race.
Unlike most of the conventional anti-ulcer treatments, papaya is safe for long-term use. The calcium/magnesium antacid type products work by neutralizing acid and coating the stomach wall with a chalky protective layer. However, if they are used over an extended period, resulting high levels of magnesium can interfere with the absorption of calcium. Low calcium levels can cause nervousness, bone changes, weak and aching muscles and abnormal heart rhythms. The pharmaceuticals which reduce acid production are great for most acute ulcer symptoms. However, acid is needed to control and modify bacteria in the gut. If the acid levels are low for many months, “bad” bacteria, particularly Salmonella, can overpopulate the digestive tract and create conditions for colic. Furthermore, prolonged low acid levels can cause poor absorption of vitamin B12, inefficient utilization of dietary protein, food allergies, bloating and foul manure.
Papaya is also useful in conjunction with administration of certain medicines. Many people “prep” the horse with a half dose of papaya to trigger extra mucous in the digestive tract lining just before they administer an anti-inflammatory capable of damaging the stomach lining. They then administer the anti-inflammatory, and follow up with another half dose of papaya to wash away the foul taste of the medicine.
Similarly, endurance riders and eventers who give electrolytes to their mounts mix the powder with papaya before administering. The extra mucous triggered by the papaya protects the mouth, esophagus and stomach from the burn of frequent electrolyte administrations.
The mucous producing characteristic of papaya is complemented by the enzyme it contains called papain. Papain is the main active ingredient in meat tenderizer. It closely resembles the digestive enzyme pepsin. Old horses benefit from papaya because its enzyme breaks down what their less efficient digestive tract can’t, and they gain weight.
Papaya also helps foals who get “scours” when the hormones in their mother’s milk changes during the first heat which presents the foal’s digestive tract with a new challenge for which it does not have the appropriate microbe population. The papain enzyme picks up where the foal’s own system is insufficient.
Weaning is a stressful time, too. Not only are foals anxious (creating conditions for an ulcer), but they must deal with a change in diet, for which they may not have the correct balance of gut “bugs”. In addition to the papaya induced ulcer-preventative mucous secretion, the papain helps weanlings digest new diets while their gut microbes are adjusting.
Cribbing often decreases when horses have papaya daily. Cribbing incidence at weaning is drastically reduced, and about half of adult cribbers also reduce or cease the habit. While most positive effects of papaya are evident in a week, in the case of a confirmed cribber, it can take up to a month for improvement. (Cribbing associated with stomach pain or missing nutrients is most responsive to papaya.)
Similarly, when antibiotics kill good gut bacteria, leaving the digestive tract unable to sufficiently break down food, diarrhea results. Papaya picks up where the bacteria leave off, and antibiotic-induced diarrhea can improve.
When horses get diarrhea during trailering, it can, in part, be due to anxiety-induced changes in gut motility not allowing absorption. The papain enzyme helps break down the food in the limited time it is in the gut and may reduce the diarrhea.
A final important characteristic of papaya is its taste and consistency. It has the viscosity of tomato ketchup, and is extremely sweet. This makes it ideal for camouflaging unpleasant medicines. One race horse trainer spent several hundred dollars for expensive antibiotics which his horse spit out on the walls before he realized the horse would happily swallow the dose if it were mixed with papaya. Horses who need extra salt in hot weather, but refuse it in their food, often lap it up if it’s mixed with papaya.
Papaya apparently tasted so good to one horse that he grabbed a bottle left close to his stall, chewed off the cap and licked up the resulting spill. Another owner found that if he approached the fence with a dosing syringe full of the fruit, his horse would immediately gallop over.
Papaya is also a mild “blood thinner”. The increased circulation associated with the slight anticoagulant effect may account for the very shiny coats and high incidence of dapples that many horses on papaya enjoy. Some caretakers also report an improvement in joint health as well. Papaya should not be administered to a horse that is on an anticoagulant already, as there may be an additive affect. Some stages of pregnancy can be complicated by bleeding, so it is unwise to administer papaya to a mare who is pregnant or who is about to be bred.
Where the Heck Do I Get Papaya??
So, you are intrigued. You will probably Google papaya use in horses or dogs and come across a bunch of information. You will also discover papaya may help humans with heart health, diabetes, inflammation, digestion and a whole host of other things. But then it hits you.... where do I get papaya? Do I have to give my horse or dog fresh papaya each day? Is that practical? Is that in my budget? Good questions!!
You can certainly do that, but you can also try papaya puree or even papaya enzyme tablets. Both are less expensive, easier to administer and can be found online or in most health food stores.
If you use fresh papaya, be sure to remove the seeds and skin as that can be toxic for some horses. 2-4 ounces per day is the dosage for fresh papaya. If you go the papaya puree route (not the nectar), give 2 ounces twice a day. Be sure your puree does not have added sugar. You may have to treat with Gastorguard or Alimend first and then maintain things with papaya.
The Bottom Line....
There are many causes of equine and canine ulcers as well as other types of digestive disorders and "mystery tummy troubles." Sometimes traditional medications can provide relief. Sometimes "going the natural route" with papaya (or other items such as aloe vera juice) may be the answer. Each horse and dog is individual and care should be taken to evaluate the situation carefully, including understanding all side effects of medications and papaya.
Have you had any experience treating your horse or dog for ulcers, other digestive disorders or "mystery tummy troubles?" Share your experience on the Stretch Your Horse Facebook page.
Ilene Nessenson, JD, Certified Equine Bodyworker, is the creator of the Stretch Your Horse App. She has been an equine bodyworker, saddle fitter, and saddle reflocker for over 11 years.
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