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When compared to horses fed two meals per day , Quarter horses fed 20 meals throughout the day had lower prevalence of ulcers after 30 days. Some horse owners with easy-keepers and overweight horses worry about providing constant access to forages. Slow feed hay nets are a good option to help extend the amount of time your horse spends feeding, keeping the stomach full for longer , without over-supplying calories.

Hydration is important for many aspects of equine well-being but particularly for digestive health. Intermittent water intake increases the risk of developing ulcers. Research shows that horses without access to water in their paddock are 2. Gastric ulcers in this population were also more severe.

Consumption of water also supports gut motility , which refers to the transportation of food through the gastrointestinal tract. Providing water to your horse may be difficult during transportation or when travelling to competitions. It can also be harder to provide fresh water during the winter when freezing conditions can occur.

At times when consistent water access is not possible , the other tips mentioned in this article become increasingly more important to lower ulcer risk for your horse. The composition of the diet can affect the digestive tract and may have a role in the development of equine ulcers.

High-grain diets increase the risk of ulcers for several reasons. Eating grain does not require much chewing and therefore does not produce significant saliva to buffer the stomach acid. Grain also moves more rapidly through the stomach than forage, meaning the stomach is empty for longer periods.

Grain is typically added to equine diets as an energy source. Fermentation of simple carbohydrates in the hindgut produces volatile fatty acids VFA acetate, propionate, and butyrate , which are absorbed and used as energy by the horse.

Volatile fatty acids are the major energy source for the horse. High grain diets are often used by racing or performance horses because it provides dense energy.

However, high starch concentrations in the diet increases VFA which can reduce pH and form an acidic environment. This process is not limited to the hindgut. High-grain diets can also cause VFA production in the stomach, further reducing the pH and increasing the risk for ulcers.

Prolonged high-grain diets can have additional consequences. A negative shift in the hindgut microbial populations, known as dysbiosis, is common on high-grain diets. Dysbiosis can also increase the absorption of inflammatory bacterial products such as lipopolysaccharide LPS.

The ensuing immune response is one reason why high-grain diets can cause systemic issues such as laminitis and insulin resistance. Providing adequate fibre, which has a prebiotic effect , will support gut health and microbial fermentation.

Hay typically contains fewer simple carbohydrates than grain resulting in much lower VFA production in the stomach. Type of hay should be considered as different hays have different nutrient compositions.

Alfalfa-hay is a good choice for reducing ulcer risk in horses that require an energy-dense diet. It has a buffering effect in the stomach due to its higher protein and calcium content.

Horses fed alfalfa-hay had a healthy stomach pH and lower number and severity of gastric ulcers compared to bromegrass hay. Alfalfa is also a good energy source and can eliminate the need for grains and concentrates in the diet.

However, alfalfa may be too nutrient-dense for sedentary horses, which can contribute to obesity and the development of equine metabolic syndrome EMS. Starches and sugars are well-studied for their effects on ulcers in horses.

However, proteins and fats can also play a role in gut health. The higher protein and calcium content of alfalfa hay help to buffer volatile fatty acids produced in the stomach when horses consume grain. Sporting horses typically fed grain to meet their energy needs can be fed alfalfa hay to provide additional energy and support gastric health.

It is recommended to feed horses alfalfa hay before exercise and to avoid exercising on an empty stomach. Alfalfa also forms a fibrous barrier that helps protect the squamous region from acid splashing during exercise.

Dietary fat should be considered as an alternative energy source for performance horses. There are many well-researched options to choose from. Some supplements are beneficial for preventing gastric or hindgut ulcers while others support overall digestive health.

Learn More. Omeprazole, the pharmaceutical ingredient in GastroGard and UlcerGard , is an effective treatment for ulcers. It works by inhibiting acid production in the stomach to increase gastric pH.

In the short term, this can promote the healing of ulcers. Once treatment stops, the stomach will start to produce acids again. This can result in acid rebound and a recurrence of ulcers once treatment stops. Equine veterinarians know very well that the stomach responds with an overproduction of acids following treatment with acid inhibitors like omeprazole.

This hyper-acidic environment can lead to ulcer rebound. This is not to discourage treatment of ulcers with omeprazole. But we do encourage adopting strategies to prevent rebound. All horses showed healing of ulcers with no rebound after treatment.

Non-steroidal anti-inflammatory drugs NSAIDs are administered to horses to reduce pain and treat certain conditions. Firocoxib is more commonly used to reduce pain associated with osteoarthritis or bone injuries. NSAID use may be necessary at times. When advised and monitored by a veterinarian, NSAIDs can benefit your horse.

NSAID use has been directly associated with increased ulcers in the digestive tract of horses. These ulcers occur in the squamous and glandular regions of the stomach, as well as the hindgut. By inhibiting prostaglandin synthesis, NSAIDs reduce mucous production. They may also lower gastric pH levels below the normal pH of 2.

In healthy adult horses, administering phenylbutazone negatively impacted the mucosal barrier of the gastrointestinal tract. This increased ulcers and reduced overall digestive health.

Stress is a major contributor to the development of ulcers in both humans and horses. Stress elevates circulating levels of cortisol and other thyroid hormones. Short-term elevation in cortisol is not a health concern and can be a good thing.

However, ongoing stress causes chronically elevated cortisol levels which can decrease prostaglandin levels. In rats, high cortisol levels were not directly associated with ulcers.

But the low prostaglandin levels that occurred in conjunction with high cortisol resulted in ulcers. In horses, there is significant evidence that stressors including high-intensity exercise, traveling, and environmental changes are associated with higher incidence of ulcers.

Managing stress levels in your horse will depend on their individual needs and routine. The first step is to identify the signs of stress in your horse.

A veterinarian can measure cortisol levels in the blood and saliva and measure changes in heart rate to gauge stress levels. However, this is not always feasible. Instead, keep an eye out for physiological and behavioural signs of stress including:.

Long-term stress can also lead to weight loss , poor digestive health, poor coat health , and a weakened immune system. falciparum malaria occurring in areas along Thailand's borders. It is often the best alternative when mefloquine is contraindicated. The drug is taken in a dosage of mg per day during exposure and continued for four weeks after the traveler returns home.

Side effects of doxycycline therapy include photosensitivity which necessitates the wearing of hats and sunscreen preparations , nausea, esophagitis and monilial vaginitis. With care, most of these side effects can be minimized.

Consequently, the daily doxycycline regimen, although cumbersome, is still feasible. Doxycycline therapy is contraindicated in pregnant women and children less than nine years old. Travelers exposed to malaria may use primaquine, in a dosage of one Malaria prophylaxis using primaquine is reserved for use in persons who travel for relatively long periods more than two months in areas in which the probability of contracting malaria is high even with the use of reasonable prophylaxis.

If present, this deficiency can result in severe hemolytic anemia in persons taking primaquine Table 1. As drug resistance spreads or more travelers decide not to take mefloquine, self-treatment regimens may become a substitute for standard prophylaxis.

Pyrimethamine-sulfadoxine Fansidar is a combination drug now used chiefly for emergency self-treatment of malaria in travelers who are unable to take routine antimalarial agents or who are observing a prophylactic regimen but are unable to obtain medical care within 24 hours.

A traveler who has symptoms of presumptive malaria i. Pyrimethamine-sulfadoxine was once recommended for routine malaria prophylaxis, but it proved too toxic to be used for that purpose.

This combination drug should not be used by pregnant women. It should not be taken by persons who are allergic to sulfa, because it may cause severe rash, hepatitis and Stevens-Johnson syndrome.

Resistance to pyrimethamine-sulfadoxine is widespread, especially in Asia. Therefore, treatment failures can occur. The use of pyrimethamine-sulfadoxine is reserved for those making trips to remote, medically underserved areas or for bolstering an inadequate regimen usually chloroquine-only in an area of known chloroquine resistance.

Overseas, pyrimethamine is available in combination with dapsone for use as weekly malaria prophylaxis, but this regimen has been associated with fatal agranulocytosis.

Current prophylactic options leave much to be desired. Therefore, several new agents are under investigation. Azithromycin Zithromax is being evaluated as a potential suppressive agent with low toxicity.

Many travel-related diseases can be prevented by vaccines. Unfortunately, a malaria vaccine is unlikely to be available in the near future. Although immunity to malaria does occur, it is often incomplete and short-lived, and frequent rechallenging with malarial antigen is required. Residents of malarious areas eventually develop some immunity, but they appear to lose this immunity after they spend several years in a nonmalarious area.

One of the most promising vaccines was Spf This vaccine was developed by Dr. Manuel Patarroyo of Colombia, who subsequently donated it to the World Health Organization.

Initial trials showed that the vaccine was capable of producing 30 percent or greater immunity; however, the results of more recent trials of Spf66 have been disappointing. A successful vaccine will probably need to contain sporozoite, merozoite and gametocyte antigens.

In counseling travelers about malaria prophylaxis, physicians can make two main errors: they can overprescribe and a patient may have side effects from unnecessary drugs, or they can underprescribe and a patient may contract malaria.

Assessing malarial risk requires a detailed knowledge of a patient's travel itinerary and accommodations. Regularly updated maps identifying risk areas are available from several sources and can be invaluable tools in counseling patients Table 2.

Thus, many tourists can be safely exempted from malaria prophylaxis. Travelers to the Caribbean except Hispaniola, especially Haiti are not at risk of contracting malaria.

Travelers are at risk for malaria exposure in some areas of Central America. The risk of malaria is intermediate in the Amazon and other tropical locales in South America. Many popular tourist destinations, such as Rio de Janeiro, are free of malaria.

In contrast, travelers to sub-Saharan Africa are at very high risk of malaria exposure, and failure to prescribe adequate prophylaxis usually mefloquine frequently results in illness.

More than 82 percent of imported P. falciparum infections in U. citizens were contracted in Africa. The risk of malaria exposure is also very high throughout New Guinea, except at elevations above 1, m 5, ft.

The risk of contracting malaria is moderate in the Indian subcontinent. In Asia and the Pacific, many cities and the more developed regions Hong Kong, Singapore, Bali and Taiwan are free of malaria, but risk may persist in the more rural countryside.

Often, the traveler's nocturnal accommodations determine the actual malarial exposure. Health Information for International Travel , a CDC publication, is an invaluable resource that identifies areas of malaria risk and specifies the appropriate prophylaxis for each country.

In more complicated situations, especially those involving pregnant women, small children or travelers with multiple medical contraindications to usual prophylaxis, consultation with a travel clinic is recommended.

The International Society of Travel Medicine publishes a directory of travel clinics for this purpose. These and other resources available to travelers and physicians are summarized in Table 2. World health report conquering suffering, enriching humanity.

Geneva: World Health Organization, Health information for international travel, — Atlanta: U. Dept of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Center for Infectious Diseases, Division of Quarantine, ; HHS publication no.

Cobelens FG, Leentvaar-Kuijpers A. Compliance with malaria chemoprophylaxis and preventative measures against mosquito bites among Dutch travellers. Trop Med Int Health. Slater AF, Cerami A. Inhibition by chloroquine of a novel haem polymerase enzyme activity in malaria trophozoites.

Krogstad DJ. Plasmodium species malaria. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and practice of infectious diseases. marinum causes occasional ulcerating lesions in humans.

Treatment regimens consist of combinations containing clarithromycin, rifampin, or ethambutol. Cutaneous tuberculosis is rare in travelers but may be encountered in immigrants from developing countries. Treatment is with multiple drug regimens consisting of isoniazid, ethambutol, pyrazinamide, and rifampin.

Cutaneous diphtheria is still endemic in many tropical countries. Cutaneous diphtheria ulcers are nonspecific and erythromycin and penicillin are both effective antibacterials. Antitoxin should be administered intramuscularly in suspected cases. Anthrax is caused by spore-forming Bacillus anthracis.

This infection is still endemic in many tropical countries. Eschar formation, which sloughs and leaves behind a shallow ulcer at the site of inoculation, characterizes cutaneous anthrax. Penicillin and doxycycline are effective antibacterials.

Cutaneous leishmaniasis is caused by different species belonging to the genus Leishmania.

Ukcer RESULTS. Gastric ulcers, which Tart cherry juice for energy travepers in preevention stomach lining associated with inflammation, can cause discomfort, weight loss Ulcer prevention for travelers even attitude changes in horses. Boost confidence levels causes for trqvelers ulcers are tarvelers diets and long-term use of non-steroidal anti- inflammatory medications, but stress can also lead to their development. Click here to learn what three things to investigate when your horse is uneasy in the trailer. Research has shown that the simple act of trailering a horse to a different location and staying overnight can induce gastric ulcers in horses, even in those who are seasoned travelers and do not seem outwardly bothered by the experience. What Enhancing heart health through cholesterol control you do prevetion Ulcer prevention for travelers ulcers from developing in your horse? Travelrs ulcers, also known as Equine Gastric Ulcer Syndrome Prefentionare most common in horses. But ulcers can occur along the entire digestive tract. When ulcers develop in the hindgut, they are referred to as Right Dorsal Colitis RDC or colonic ulcers. There are multiple distinct causes of ulcers in horses.

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