ULCERS - arghhh! Meds, options, etc?? Need some ideas.

Just wanted to pick your brains about ulcers....

My horse has had a tough few weeks after having a severe reaction to a vaccination (we think it was the rabbies vaccine). He has ulcers and receives medication for it (just asked the owner what the actual name of the medication is, will post it once I find out, I can't think of it right now).

Anyone have a horse with ulcers?
What medication do you use?
What are some alternatives we might explore?

The vet prescribed a couple of medications originally - we tried the gastroguard to begin with and used it until we had his ulcers under control but the expense was ridiculous and he recommended we switch to an alternative that was equally as good for maintaining ulcers once we had them under control. The problem is they are bitter and he hates them, and at times like this when he's a bit off his feed to begin with he refuses to eat his feed period with the bitter pills in there.

We're not sure switching to something different would be in his best interest but if there's something out there that might work and the vet agrees then we're all for it. Dealing with trying to get these pills into him when he's not eating well to begin with is stressful for all of us.

Does anyone have ideas for masking the bitter pills in his feed?
We're using mints right now as we've done it periodically I.e. After a horse show, and he eats great, but the sugar in the mints can't possibly be good for him or his ulcers in the long term. We've heard of using molasses and apple-sauce, but same thing - isn't that a lot of sugar for a horse with ulcers?

Just looking to brainstorm with some knowledgeable people who've dealt with ulcers before. :)

Here's his regular feed regimen. Sorry, I didn't know it exactly because I never have to feed him (I lease him on a part-board basis). I knew the gist, but I figure if I'm asking for your thoughts I better get the exact measurements.

1/2 HiFat-HiFibre, 1/2 Roughage and 1/2 Performance (sweet feed) with 1 sc of Equilizer, he gets glucosamine and another for his joints supplemented. The pills he's on are Cimetidine. The vet also recommended omeprazole liquid (gastroguard) which we started with, but it's like $40/day here and ridiculous for us.... can't afford it.

I just thought of maybe doing a mint extract in his feed as that cuts out the sugar aspect... what do you all think? Maybe we just try masking the bitterness rather than switching medications.

And just as an added note: Anything we decide to do/change (even if it's just adding mints to his daily feed) will be done through the vet or with the vet's okay for his daily regimen...

First, I'd try and ditch the sweet feed altogether. Actualy, reduce his intake of all concentrates as much as possible. Feeds like Purina BIR (built in roughage) are a good option, though as they are very high in fiber and therefor easier on the stomach as fiber is the most easily digested form of calories for horses. Is your horse a good keeper or no? Either way, a high fiber, low glycemic feed is the best bet. Also feed small meals frequently throughout the day as opposed to two large meals of concentrate. Give a lot of turn out on good pasture. Try to ensure as much water intake as possible. Giving Equilizer is a good thing for this as it has good levels of salt etc. to encourage water consumption. Don't use electolyte powder in the water as many horses will drink less water in the end because of the taste.
While gastro guard is without a doubt the best treatment, the generic Omeprazole is a good second choice. It comes in tubes as well as powder and liquid form. If this horse is a fussy eater, I'd go with the paste. I've never used the pills your vet is having you use, so I can't comment from experience with them. However if he's not eating them, you can try putting them in a 60cc dose syringe with water and disoving them. This way you can just dose them orally.
Natural options that can help support other forms of treatment and are useful in maintenance are aloe vera juice/gel, and slippery elm. Blessed thistle helps with appetite, while milk thistle is a good all-around choice and it tastes good as well. You may think I;m nuts, but we've had success using chiropractic and massage in treating ulcers. The theory is that the animal causes/worsens the condition because of discomfort elsewhere in the body and it creates a vicious circle.
I feel you pain on this topic...I work with racehorses so deal with this issue every day. It's a tough road but can be managed.
Keep me updated!

I think she's tried cutting out the Performance before, but he won't eat without it in there. He's that fussy. The scoop he gets of that is probably the equivalent of two handfuls - it really isn't a lot. His feed when you look in is really all roughage chunks (soaked down) and soaked beet pulp with a sprinkle of sweet feed.

He's been a hard keeper especially in winter, so that's why he's on the hifat/hifibre chunks and he's done really really well since he's been on it. He's actually getting a bit of a belly lol which he would never ever get before - you'd always see ribs poking through. He's looking really good now though, he has some good muscle on him and besides a bit of a hay belly from always having access to hay, he looks good (posted pics in the picture forum).

The barn he's stabled at would charge us an arm and a leg to feed him more than the regular twice daily...

He has full access to a salt lick which he rarely uses, and he does drink well, so that at least is good. The only time we supplement electrolytes is if we've had a really hot week and he's been sweating or if we're going to a show and doing a lot in that sense we'll give him electrolytes a few days before and a couple days after just to make sure he stays hydrated, and then we only put it in his feed rather than give it to him in his water.

I've heard of aloe juice and milk thistle... they might be something we could try if he continues to be fussy. It definitely is a viscious circle type of thing - and that's what we've been dealing with the last few weeks with him being off because of the vaccine reaction.... he doesn't feel great so he doesn't eat, but not eating aggrivates his ulcers so he doesn't feel like eating that much more and on and on....

As for turn-out he gets all day turnout with full access to hay as the grass isn't very plentiful (it's not a dirt paddock, but it's not a pasture by any means lol).

Thanks so much for your time and input shesinthebarn! I really appreciate it! We're syringing meds this week just so he keeps eating his regular feed and is also getting his medication and we'll try to slowly add back in the medication. Unfortunately we don't have a lot of lee-way on costs, and even the generic omeprazole is fairly expensive and definitely out of our price range. :(

Maybe stretching the topic a bit - but prior to the reaction - how happy was your horse at this barn? Perhaps the reaction made the ulcers more prevelant?

The barn itself you mean? He loves it. The owner forks out a lot of money to board him there, and that's where it mostly goes! When he was growing up she had trouble finding a place that suited him. He needs individual turn-out, which I think is half the issue with the ulcers, but otherwise he ends up fighting or 'playing too hard' with other horses, and he has back shoes so we can have riser pads in for his stifles. The turn-out at this place is a large individual paddock right alongside other horses. He loves loves loves babies so he gets turned out around the broodmares and their foals and he's their protector. The babies have to go inside first or he screams and throws a fit. If we knew he could be gentle we'd suggest he be a buddy to the colts but he plays too hard and these aren't inexpensive babies to test with. So we've come to a good compromise to not being able to turn him out with other horses and he's happy now. The stalls are big and airy and he gets one where he doesn't have another horse looking through bars at him and he can see all his babies across the aisle and he has a window to look out of. The arena's are really nicely kept and soft footing and there's trails to hack on that he's starting to get to explore now that I'm working more with him to get him hack-able.

The ulcers, as weird as this may sound, I think are just from his personality. He's a natural worrier and pretty studly behaviourly, so I think it's really easy for him to work himself up into a frenzy.

Compared to any other time in his life, I think he's in his best years now as he's doing more things with me than he's ever done - hacking, experiencing shows and regular rides, and his environment at home is a good balance and the best situation he's ever been in.

Just thinking on this a little more...since he's a little off right now because of the reaction to the vaccine his ulcers are almost certainly flaring because of it, right? Is it possible to put him back on the Omeprazole just temporarily until he is over his illness and them go to other treatments? Maybe just a few weeks would do a world of good. Just a thought...

We thought of that too shesinthebarn, but the vet said if we can find a way to keep getting the regular pills in him then they will do fine to keep him from flaring up, and that switching to omeprazole might take time to start working effectively in his system..... so we're just going to play it safe and try to keep him on the regular pills right now while we're getting through this.

I'm thinking more in future as to getting some ideas of things that might be better than trying to mask these bitter pills.....