Update - Saccharomyces boulardii has become more available from other sources. See the article S.boulardii comparison.pdf (88k) or download it here. The article compares products, dosage and cost and includes equine and human references.


Challenging Gastric Health

by Patti Woodbury Kuvik

 

I sometimes take issue with Platinum's equine products as their labels and instructions can be confusing for the average horse owner and I feel some of their equine products are overpriced for what is supplied.  On the other hand I feel Platinum does excel in providing some unique research-based targeted products.

One of these recently brought to my attention as part of their "Platinum Challenge" advertising campaign is Platinum Gastric Support™ [i] which included, as part of the tag line - 

“...help maintain gastric health by supporting healthy levels of gastric acid and intestinal proteins”.

"Supporting healthy levels of gastric acid..." is the key here.  “Gastric support” which suppresses gastric acid production has been a sore point for me since my up close experience with a Clostridium difficile infection (often referred to simply as C. diff)  a few years ago. Suppression of gastric acid is not the only risk factor involved – some drugs, age, steroid use and compromised immunity are some of the other contributors to intestinal infection in humans, but it is an important factor. Horses are susceptible to several varieties of Clostridium bacterial infections, including C. diff. [ii]

Stomach acid is a first line of defense against many ingested pathogens. Suppressing the production of gastric acid allows these pathogens to continue further into the GI tract, where they can take up residence and overwhelm favorable gut flora. While reducing gastric acid can aid in the healing of stomach ulcers long term use of these products can come at a cost.

Most gastric support/ulcer prevention/ulcer treatments are aimed at reducing the production of gastric acid (H2 blockers and proton pump inhibitors) or reducing the acidity of gastric secretions (antacids).[iii] In addition to lowering the natural defenses provided by gastric acid, they reduce the digestibility of the horse’s feed intake by disrupting the activation of pepsin and the initial breakdown of minerals, fats and proteins.

Understanding what goes on in the horse’s digestive system can help explain what causes ulcers and other digestive upsets. Because horses evolved as continuous grazers, they secrete gastric acid all the time.  They are not “reactive” secretors as are humans and carnivores, such as dogs, which secrete gastric acid in response to the aroma and taste of food in anticipation of needing to digest a meal.

Continuous forage grazing keeps small amounts of food in the horse’s stomach most of the time where it forms a “mat”.  The stomach contents below the food mat have a very high acid level which plays a large part in preparing nutrients for absorption farther down the GI tract.  However, the mucosal lining above the “mat” is easily damaged by gastric acid.  Long stretches with no access to forage – because of “meal feeding”, during travel or competition, or simply on an extended trail ride can result in not having the protective mat and allowing gastric acid to contact the upper stomach mucosal lining. This is the beginning of a stomach ulcer.

Back to Platinum Gastric Support™.   Instead of saying  “...help maintain gastric health by supporting healthy levels of gastric acid...” they might more correctly have said  “...help maintain gastric health by not suppressing healthy levels of gastric acid...” but that certainly doesn’t have the same punch.

The ingredients in this product are simple – dried Lactobacillus delbrueckii and its fermentation products, Lactose-Free Whey Protein Concentrate and Saccharomyces c. boulardii[iv] 

These ingredients may sound familiar to many who try to keep up to date with equine nutrition – Lactobacillus delbrueckii is one of the starter bacteria in yogurt [v], whey protein concentrate or isolates are extremely digestible complete proteins and Saccharomyces c. boulardii is a strain of S. cerevisiae yeast which has been documented to be effective in the prevention and attenuation of C. diff infection. [vi]

This is (as many Platinum products are) an expensive product - $176 plus shipping for a 2 pound 30 day supply (60 15-gram servings to be given twice a day), which works out close to $6 per day.  Is it worth it?

Yes – if you are competing and using a gastric acid suppressor at similar or higher cost.  Combined with improved feeding practices such as small mesh hay feeders to provide continuous access to forage when stalled or travelling, Platinum Gastric Support™ could prove be a safer alternative to acid suppressors for ulcer prevention.

Yes – if your horse has recurrent bouts of diarrhea that haven’t resolved with feed changes and the addition of other pre- or probiotics, including Saccharomyces cerevisiae yeast (Diamond V or YeaSac), and a fecal culture has not been conclusive.

Yes – if either of the above applies and your horse has recently been on antibiotics, another factor which increases the risk for intestinal infection.

But for general gastric and intestinal support, there are other options you may want to consider at less cost.

Improving GI support for your horse is appropriate whenever there is stress (pre and post-deworming, antibiotics, travelling, competing), with increasing age, or if your horse is not doing as well as he should on a carefully balanced diet.

Environment - observe your horse environment for existing or potential stress "triggers". These might include noise, lights, smells, other animals or aggressive humans. Be aware of conditions that might be present when you aren't there. [vii]  

Forage - ensure your horse has continuous access to forage to maintain the "mat" which lessens the chance of gastric acid contacting the mucosa of the upper stomach.

Omega-3 fatty acids - these have a proven track record in lessening inflammatory response in the GI tract.  Provide in the form of flax - stabilized or fresh ground, flax oil or one of the newer fish oil based products.

Yogurt – a high quality plain, sugar-free yogurt with live cultures - can provide Lactobacillus cultures similar to those in the Gastric Support™, however, there is some thought these strains are not effective probiotics for horses. [viii]  On the other hand, there is no reason not to give your horse a cup of yogurt after deworming or other isolated but potentially stressful events.

Whey protein – this is an highly digestible form of protein with a complete amino acid profile.  The "isolate" form has higher levels of protein, while whey concentrate (still containing more than 20 grams or protein per ounce) is thought to have some immune enhancing properties.  These are easily obtainable as human “sports shake” products or unflavored (though many horses enjoy the flavors) through bulk suppliers.  This is an economical way to boost protein levels in a ration.

Saccharomyces cerevisiae yeast – some sources are Diamond V or YeaSac from stock suppliers, Yeast+ from HorseTech [ix] or Kombat Boots yeast pellets. [x]  Pricing varies and it’s difficult to evaluate and compare the exact inclusion of live, viable yeast cells and their ability to colonize the GI tract. S. cerevisiae yeast is also an ingredient in many commercial probiotics and feeds but may not be included at a high enough level to be effective..

The Saccharomyces c. boulardii yeast included in Platinum's Gastric Support™ product is not the same thing as the standard S. cerevisiae yeast. The boulardii strain is specialized (and expensive). It is available for humans as Florastor and Thorne Sacro-B. A typical human 1 gram daily dose runs in the $2-3/day range; an equivalent equine dose using the human product might range from $12-18/day.

If you are considering adding a product to your horse’s diet to support your horse’s gastric health, first determine why you want to add it (ulcer prevention/treatment, improved digestion/condition/performance, colic/diarrhea prevention?) and understand how it works – which leads to why it might produce the results you expect. 

Consider if a shiny coat and improved hoof quality is worth the high cost of a gastric protective product needed to prevent ulcers, or would the simple addition of regular S. cerevisiae yeast be what is needed for you?  

Is the long-term ulcer preventative you use during show or competition season having undesired side effects and could you, instead, make sure there is always hay available and split concentrate meals into several small meals - along with ensuring an environment that feels safe and secure for your horse.

Are you looking for a magic bullet to “fix” a less than optimal diet or poor quality forage? Having your hay analyzed to establish forage quality is cheap insurance (around $26) and ruling out high nitrate (additional $6) or sulfur (additional $3) can eliminate your forage as a source of problems. Money spent on unneeded supplements, or in trying to “fix” an unfixable hay (as seen recently with several high nitrate hays) is money wasted.

Have you worked appropriately with your veterinarian to rule out underlying causes such as Lymes or Clostridium infection? Spending money on high priced supplements to “fix” an undiagnosed problem may cost more in the long run than a thorough evaluation by your experienced vet who's practiced eye might spot something we've overlooked. Fecal cultures may also be appropriate to determine if antibiotic therapy is warranted.

If the gastric health of your horse is a concern and you've evaluated your choices,  Platinum Gastric Support™ could be the appropriate product to consider.



[ii] Evaluation of the Ability of Di-tri-octahedral Smectite to Adhere to Clostridium difficile Toxins and Clostridium perfringens Enterotoxin In Vitro.  http://www.ivis.org/proceedings/aaep/2002/910102000127.PDF

[iii] Equine Gastric Ulcer Syndrome, Drs. Foster & Smith Educational Staff

 http://www.drsfostersmith.com/pic/article.cfm?aid=1587

[viii] A Review of Probiotics: Are They Really “Functional Foods”?J. Scott Weese, DVM, DVSc, Diplomate ACVIM http://www.ivis.org/proceedings/aaep/2001/91010100027.pdf