Lecithin Inhibits Bute-Related Ulcers

by Juliet M. Getty, Ph.D.

Your horse is in pain and needs bute. Bute causes ulcers – this we know. But knowinghow it damages the lining of the gastrointestinal tract is the key to knowing how to prevent its damaging impact.

First, understand that most ulcers can easily be prevented by appreciating the way the horse’s stomach is designed. The lower portion (glandular region) is lined with a protective mucus layer. But it’s the upper squamous region that is most vulnerable to stomach acid because it does not have mucus protection. Most ulcers occur here because the horse’s stomach continuously secretes acid, even when empty. A steady supply of forage – all the time – all day, and all night – will protect your horse’s stomach. This is the way horses are meant to eat – they are forage grazers.

But even when horses are fed properly, administering non-steroidal anti-inflammatory drugs (NSAIDs) such as bute (phenylbutazone), Banamine (flunixin meglumine), or aspirin, , can create ulcerations along the entire gastrointestinal tract. This has to do with the way they reduce pain and inflammation. We tend to assume that it is bute itself that is irritating the stomach lining. In actuality, it is after it has been absorbed that it does most of its damage. Bute inhibits the cyclooxygenase enzymes 1 and 2, which reduce the formation of various prostaglandins. Some prostaglandins are responsible for promoting inflammation, and hence pain. But others maintain the integrity of the entire digestive tract by stimulating the production of molecules known as phospholipids.

Phospholipids form a barrier against stomach acid that can potentially damage the underlying epithelium. Our tendency is to get rid of the acid by administering antacids, H2 blockers, or the proton-pump inhibitor omeprazole (GastroGard). There are problems associated with this approach. Stomach acid is important. Stomach acid is there for a reason (actually two reasons). First, it is necessary to start the digestion of protein. From a nutritional standpoint, this is a critical function. Protein digestion provides amino acids (building blocks of protein) for your horse’s overall health. And secondly, acid is your horse’s first line of defense against all of the microbes (some potentially infectious) that he picks up off the ground.

If prevention is your goal, it makes sense to replace the phospholipids that have been reduced by NSAIDs.

Enter, Lecithin. Lecithin is the common term for a phospholipid known as “phosphatidyl choline” (PC) and is most commonly derived from soybeans. It is a naturally occurring substance and the most abundantly found phospholipid in animal and plant cell membranes. Chemically, it primarily consists of essential fatty acids (both omega 3 and omega 6) along with a molecule of choline (an essential B vitamin-like nutrient). Lecithin has been well studied in its ability to treat ulcers. Researchers* at The University of Texas Health Science Center, in Houston, examined the administration of PC along with NSAIDs and found that not only does PC significantly reduce gastrointestinal injury, but in some cases, it even eliminated gastrointestinal ulcerations. Furthermore, it offers this protection without altering the efficacy of bute (or other NSAID).

Lecithin is easy to feed
You can buy lecithin granules in any health food store, or in bulk through online providers such as BulkFoods.com. I recommend offering ½ to ¾ cup of lecithin with each dose of bute (for a 1000 lb horse). It can be mixed with any feed and is quite palatable. Another option is SBS Equine Products’ lecithin-based supplement called “Starting Gate.” In addition to offering gastrointestinal protection, lecithin boosts the health of all cell membranes, including those of skin, hair, and hooves. And the choline component can be used to produce acetylcholine, a neurotransmitter necessary for proper neuromuscular function.

Summary

When pain relief is necessary and you rely on an NSAID such as bute, protect your horse’s digestive tract by replacing what bute diminishes -- phospholipids found in the epithelial layer of the digestive tract. Phospholipids act as a barrier to acid damage. Lecithin (phosphatidyl choline) is a naturally-occurring phospholipid that can be easily supplemented to protect your horse against ulcers.

* Source: Lichtenberger, L.M., Barron, M., and Marathi, U., 2009. Association of phosphatidylcholine and NSAIDs as a novel strategy to reduce gastrointestinal toxicity. Drugs of Today, vol.45, no 12, 877-890.

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The above article offers insight into ulcers. For more details, please refer to Feed Your Horse Like A Horse:
• Chapter 1 – Ground Rules for Feeding A Horse. Pages 8-14.
• Chapter 14 – Digestive Problems. Pages 231-243.
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http://feedyourhorselikeahorse.com/