Predisposing factors include chronic stress, insufficient fiber and finely ground feed. Perforating ulcers may lead to severe peritonitis and death. Ulcers can also cause severe anemia with due to hemorrhage and a fecal occult blood test should be performed. Less severe cases result in appetite loss and abdominal pain. Pyelonephritis should be excluded as a differential diagnosis.

• Preventing ulcers means any time a pig goes without eating for any reason, an ulcer can begin.  Any pain remedy or steroid will cause ulcers quickly.  If you are giving these drugs, then give an acid reducer at the same time. There are 2 classes of stomach acid reduction drugs. The ones like Nexium and Prilosec that are acid pump inhibitors will heal reflux damage, and the kind like famotidine that simply reduce the acid in the stomach to stop the pain and damage to the stomach itself. Here, we use famotidine as a preventative and Nexium to heal.
• Diet: dry pellets for their entire diet may cause health problems. It may be ulcers, it may be obstructions or cancer or other diseases. But dry grains are not the diet they are designed to eat.  It is absolutely imperative that all day grazing or hay be available, and if they do not do so, that fresh fruits and vegetables, especially leafy green ones, be in their diet. 
• Particle sizes of dry matter (grains) can cause ulcers. Vitamin supplements are suspected of causing ulcers. (Use only whole food supplements, never derivatives). Junk foods no doubt add to the probabilities. It’s suggested to use a manufactured diet for those new to pigs. Vitamin balance and essential nutrients are extremely important to ensure health. Once you've researched the organic or natural diet and know what the vital nutrients are, only then you should transition to the diet of your choice.

 

SIGNALS

(when these are new behaviors)

1. Pig acts reluctant to eat their meal with real enjoyment
2. Shy behavior around the other pigs at meal time
3. Leaving food
4. Eating one food one day, then not the next day but will eat something different; then different the next
5. Refusing all grains but eating grass

If these conditions  exist and they do not seem “sick” in any acute manner, it’s recommended to usually start by discussing the pig and their history with the vet and if they agree, to start treating the pig for ulcers immediately. Take it off all grains and substitute fruits and veggies only. Be sure to give lots of them as lack of food in the stomach causes ulcers by itself. It takes approximately 4 cups of fresh vegetables and fruits to replace 1 cup of pellets.  Drug therapy starts with a week or two of Nexium, and if results are forthcoming, then we may drop back to famitidine. The length of time the pig will stay on the drugs is up to the vet and will depend on how the pig responds, and if there are complicating factors. Treatment usually results in a positive change in health signals within a day or two. If not, there may be another problem that isn't being addressed and diagnostics are needed.  They usually return to grain in a few weeks.

 

Ulcers, untreated, can kill without a visibly sick pig, just a bit shy or not too hungry every day. Then, you find them dead.  Necropsy will show the ulcers. Treating a suspected ulcer is not harmful even if they don’t have one . But treating for ulcers if there are other symptoms that may indicate kidney failure, would be treating symptoms and not disease. The vet will determine when additional diagnostics may be needed.  Scoping is seldom required to determine if ulcers are the problem. They are so common in pigs they are assumed to be the problem in the absence of other indicators. 

• Pale gums can give you an indication of anemia.
• Looking for blood in the stool is useless. It isn’t there. Their digestive system works too slowly.  Black stools that you may think are occult blood are often caused by nut shells and certain dark green vegetation. Visible blood in the stool may or may not be due to ulcers.

**Note**

With an arthritic pig, often the first medication a vet will suggest is for pain relief. Given with acid reducers for a short time, they can spare your pig a lot of discomfort. Pain meds are to be used while you get the animal established on a routine treatment of other medications. 

Just as with humans, long term (over a couple of weeks) use of pain meds will destroy the stomach and intestines. Unlike humans, this will happen quickly and is often fatal. Use of medications with pigs should be limited to NEED only. Ulcers dont always have symptoms and when they do, often times its too late to treat. Ask your vet if you should be using any ulcer prevention in addition to any prescribed medications.

Ulcers can occur in other parts of the gastrointestinal tract, and when they perforate, a deadly stew of microbes quickly cause peritonitis and death. 

 

TREATMENT

Please follow your vet’s instructions! These doses are for reference only! 

Omeprazole / Prilosec – 20-40 mg once a day

Famotidine / Pepcid – 0.25-0.5 mg per pound of body weight every 12 hours