Theory on connection between ulcers, bleeding and colic
Quick intro. I'm one of the owners of Animal Element. We've been talking to a lot of people recently looking for something to help bleeders and ulcers. I've been burying myself deep in research for the last week and I want to talk about what I'm learning and some theories I have and would like to get some input. Let me preface this by saying that I'm not a vet. I don't pretend to be a vet. The following is an working theory of mine, nothing more. Please consult your vet before following anything you read here.
My general philosophy is to try to look at a horse holistically. There is too much emphasis on treating symptoms. Not enough emphasis on root cause analysis.
Let's start with an overview of 3 common ailments and their treatments: Bleeding, ulcers and colic.
The common treatment for bleeding is Lasix which is a diuretic which is dehydrating the horse and lowering blood pressure to prevent blood vessels in the lungs from rupturing. Lasix seem to work pretty well for this.
For ulcers the treatments typically involve either antacids which work to increase the pH (alkalize) the stomach acid or Histimine (H2) blockers or PPIs (like omeprazole) which work by decreasing the amount of stomach acid produced. Most gastric ulcers are forming in the upper stomach where there isn't much mucus protection. The idea is to expose this area to less acid or weakened acid. Again, seems like a logical approach.
Obviously colic is a really broad term that can be caused by everything from sand, moldy feed, feeding schedule, to chewing on wood, poisons, or even twisted intestines. Basically the intestines aren't healthy, have an obstruction or the position is out of whack. Usually treatment is Bute to kill the pain, maybe a muscle relaxant and a laxative.
So I got thinking, could these ailments and their treatments be related? What are the side effects of these treatments and could they be related?
Omeprazole is in a class of drugs called a Protein Pump Inhibitor (PPI) and it works by blocking a chemical signal in the last step of acid production. One of the side effects is an increase in upper respiratory tract infections. This hit me when my mom was visiting me in California recently and she had a bad cough she couldn't shake for about a year and low and beyond, she was on a PPI. My mom is as healthy as a... umm horse so I was pretty certain that was it. She ran out of the drug and I had her start taking Miracle Mineral (ClO2) and it started clearing up really quickly.
You're probably wondering what the possible connection between PPIs and lung infections are. Most bacteria or viruses are inhaled or swallowed and stomach acid kills a lot of them. If there's less stomach acid or it's not as strong it's not going to be as capable of killing these infections or so the theory goes. (1) (2)
The body's response to an infection is to try to flush it out with phlegm or other body fluids. As anyone who's ever been sick knows this stuff can pile up in the lungs and reduce lung capacity. Many horses are on the edge already in terms of how much oxygen they require during intense activity.
All of this demand for airflow places a significant amount of air pressure in the lungs. Unhealthy lungs or congested lungs can't move air as efficiently and could raise air pressure. For any car geeks out there a good example is a turbo or supercharged car. If you unrestrict the air intake the air pressure (or boost) can actually drop because it's able to more quickly move through the engine and isn't getting backed up. Too much air pressure and you can blow your engine or theoretically your horse's lungs.
Back to Lasix for a moment. Lasix works by increasing the amount of water and salt the kidney's remove. This causes a drop in blood volume and subsequently blood pressure. I suppose you can't bleed if you don't have any blood. Though Lasix's side effects (3) are pretty significant, in this case I'm more worried about it's intended effect. Lasix dehydrates you, that's the intention.
The body's response when it's dehydrated can be compared to drought management. It's going to do what it can to plug holes where the water is leaving the body. That means restrict urine, sweat or breathing since those are the three main sources of moisture loss. Clearly it's not restricting urination, maybe that's where the phrase "pissing like a racehorse" came from.... Lasix. I'm sure they leave that out of the brochure though.
The surface tension in the alveoli of the lungs produces contractions in this tiny membranes and air is pushed out. The water will also leave with that air. How does it plug this hole? Easy, it tightens up the bronchials to restrict breathing.
A lot of people are using Bute on their horses to help with body soreness. Sounds like a great idea on the surface. Unfortunately one of the side effects of Bute is gastric ulcers.(4) So we give them antacids/PPI/H2 blockers to reduce stomach acid and then potentially cause lung problems. Then we give them Lasixs at the track to help the bleeding by dehydrating them and lowering their blood pressure.
Your intestines need water to keep things moving. Think about wet concrete or your morning oatmeal for a moment. Less water, it hardens, more water it flows. Same idea here. Could Lasix use be linked to colic or constipation?
At this point your horse needs rest and naturally that's what he would get because he would be too sore to run. But since they're on Bute which is killing the pain they're able to start training sooner than their body probably wants them to. But now we have a horse that is in the late staged of dehydration, beginning of stages of colicing and probably has an ulcer from being stuck in a trailer.
This brings me to the other possible causes of ulcers. Stress! In one study horses developed ulcers within 5 days due to being transported in a trailer to an event. (5) Stress raises the hormone cortisol. Cortisol is a catabolic hormone. This means it breaks down tissue (muscle, joints, etc). It's the opposite of anabolic. If you want to build business you need to be in an anabolic state.
Chronically high levels of cortisol tend to mess up insulin sensitivity and can kill appetite. Cortisol can be thought of as the fight or flight hormone. It couldn't give a **** about digesting your meal (it actually reduced blood flow to the stomach), it wants to get you the hell out of there! Your body can only stay in the alert condition for so long before it runs out of gas. Your horse feeling bad is a defense mechanism in the body, which is short-ciruited by drugs like Bute. It’s caused by inflammatory cytokines (IL-6 and IL-1beta, in case you care) that interact with the brain (6). You feel like crap because you’re supposed to, to get you to stop the behavior that’s making you feel like crap.
In another study transported horses had lower RBC (red blood cell) counts. RBCs are how the body transports oxygen to the muscles. Since the majority of race horses are on Lasix (7) we know they have less blood volume and therefore they have less RBCs to transport oxygen.
To counteract fewer RBCs owners typically give a blood builder supplements, the most common being iron. Too much iron can cause gastrointestinal side effects such as nausea, vomiting, constipation, diarrhea, dark colored stools, and/or abdominal distress ( 8 ). That brings us back to colic again doesn't it?
In nature a horse would be grazing 8-16 hrs a day and all of the saliva from this would buffer a lot of the stomach acid, reducing the risk of ulcers naturally. After giving your horse antacids or PPIs, etc they now have less stomach acid to digest 2-3 meals a day instead of dozens of small meals. If anything your horse needs more stomach acid to handle eating more food at a single sitting, not less. They've also potentially been given blood builders too.
It's reasonable to assume that some of this food is going undigested or it's placing additional stress on the rest of the digestive track to make up for it.
I hope you're still with me and you can start to see how all of these things are linked together.
Clearly a paradigm shift is required here. We need to move away from chasing symptoms and move towards supporting and supplementing to help with weak, problem areas in your horse, but with a holistic approach. Making your horse healthier should be the first priority, performance will follow. It shouldn't be the other way around.
For ulcers the approach we're working on is to find ingredients that:
a) Strengthen the stomach lining so that it can handle the acid that is there
b) Heal existing ulcers
c) Surpress excess cortisol that is contributing to stress induced gastric ulcers
For bleeding we want to do the following:
a) Clear infections from the lungs
b) Strengthen blood vessels so that they can take the increased air pressure
c) Increase efficiency of transfer of oxygen from the lungs to the RBC and then from the RBCs to the muscles
For body soreness:
a) control oxidation through antioxidants
b) reduce lactic acid buildup
c) use a natural COX2 inhibitor to take the edge off the pain, a little pain is good, chronic is not.
I wish I had a product to address these issues tomorrow but we're taking our time, doing our research and testing ingredients. We could rush something onto the market in 2 weeks but that's not the approach we want to take. If anyone is interested I'll keep you up to date on how we're doing with our research and results.