Gastric ulcers are a common but often overlooked condition in horses, affecting both performance and overall well-being. Research suggests that up to 90% of racehorses, 60% of performance horses, and even leisure horses suffer from Equine Gastric Ulcer Syndrome (EGUS) at some point. Understanding the causes, symptoms, and management strategies can help prevent and treat this painful condition, ensuring your horse remains happy and healthy.
What Are Gastric Ulcers?
Gastric ulcers are erosions or sores in the lining of the horse’s stomach, caused by excessive stomach acid. Unlike humans, who produce stomach acid in response to meals, horses produce gastric acid continuously, even when they aren’t eating. In a natural grazing environment, this isn’t a problem, as constant forage intake helps buffer the acid. However, modern management practices, such as meal feeding and increased stabling, can disrupt this balance, leading to ulcer development.
Causes of Gastric Ulcers in Horses
Several factors contribute to gastric ulcers, including:
1. Diet & Feeding Practices
Limited forage intake leads to excessive stomach acid exposure. Horses should ideally graze for 16-18 hours a day.
High-grain diets increase stomach acidity, as grains produce more acid during digestion than fibre.
Long fasting periods between meals allow acid to build up, damaging the stomach lining.
2. Stress & Lifestyle
Performance horses, particularly those in intense training or competition, are at higher risk due to exercise-induced stress.
Frequent travel, stabling, and isolation from other horses can contribute to increased stress levels.
Sudden changes in environment or routine can exacerbate stress-related gastric issues.
3. Exercise & Physical Activity
Intense exercise increases pressure within the abdomen, forcing stomach acid to splash onto the sensitive upper portion of the stomach lining (non-glandular region).
Exercising on an empty stomach worsens the risk, as there is no fibrous material to absorb excess acid.
4. Medication & Health Conditions
Long-term use of non-steroidal anti-inflammatory drugs (NSAIDs), such as Bute, can weaken the stomach lining, increasing ulcer susceptibility.
Underlying illnesses, poor dental health, or parasite infestations may contribute to poor digestion and ulcer formation.
Signs & Symptoms of Gastric Ulcers
Horses with gastric ulcers may show subtle or severe symptoms. Some of the most common signs include:
Behavioural Changes – Increased irritability, girthiness, reluctance to work, or sensitivity around the flanks.
Poor Performance – Resistance under saddle, unwillingness to move forward, or a noticeable decline in stamina.
Appetite Changes – Fussy eating, reluctance to finish meals, or selective eating (avoiding grains or hay).
Weight Loss & Poor Coat Condition – Unexplained weight loss, dull coat, and muscle wastage despite a normal diet.
Colic-like Symptoms – Recurrent mild colic episodes, particularly after eating or when stressed.
Frequent Yawning or Teeth Grinding – Indicators of gastric discomfort and pain.
Horses don’t always display obvious signs, so regular monitoring and awareness of subtle changes in behaviour or condition are crucial.
Diagnosis of Gastric Ulcers
The only definitive way to diagnose gastric ulcers is through gastroscopy, a procedure where a small camera is passed into the stomach to examine the lining for signs of ulceration. If ulcers are found, they are graded from 1 (mild) to 4 (severe) based on the level of damage.
If a gastroscopy is not immediately available, vets may recommend trial treatment to see if symptoms improve.
Treatment & Management of Gastric Ulcers
1. Veterinary Treatment
Omeprazole (GastroGard® or UlcerGard®) – A proton pump inhibitor that reduces stomach acid production and allows ulcers to heal.
Sucralfate – Forms a protective coating over ulcers, aiding healing in the non-glandular region of the stomach.
Antacids & Supplements – Some horses benefit from gut supplements containing aloe vera, lecithin, pectin, and slippery elm, which help soothe and protect the stomach lining.
2. Feeding & Management Changes
Ad-Lib Forage: Provide constant access to hay or grass to keep acid levels stable. Soaking hay can be beneficial for horses on restricted diets.
Reduce Grain Intake: Replace high-starch feeds with fibre-based options like beet pulp, alfalfa chaff, or soaked hay cubes.
Small, Frequent Meals: Feeding multiple small meals per day prevents long fasting periods.
Add Alfalfa to the Diet: Alfalfa hay has natural buffering properties that help protect the stomach lining.
3. Stress Reduction
Turnout & Social Interaction: Allow as much turnout as possible and ensure the horse has companionship to reduce anxiety.
Pre-Exercise Forage: Feeding a handful of alfalfa or soaked hay before exercise helps absorb excess acid and reduces acid splash.
Minimise Sudden Routine Changes: Gradually introduce any alterations in diet, stabling, or exercise.
Preventing Gastric Ulcers
Preventative care is key to reducing the risk of ulcers in horses. Simple adjustments to feeding, management, and training routines can make a significant difference:
✔️ Maximise forage availability – Free-choice hay or grass grazing reduces acid exposure.✔️ Limit high-starch feeds – Opt for fibre-based feeds instead of grain-heavy diets.✔️ Reduce stress – Provide a predictable routine, ample turnout, and social interaction.✔️ Feed before exercise – A small amount of hay before work helps prevent acid splash.✔️ Monitor for early signs – Catching symptoms early can prevent severe ulcer development.
Final Thoughts
Gastric ulcers are a serious but manageable condition in horses. With the right feeding practices, stress management, and veterinary care, you can help prevent ulcers and keep your horse comfortable and performing at their best.
If you suspect your horse may have ulcers, consult your vet for an assessment and treatment plan. A proactive approach to gastric health can lead to a happier, healthier horse with a stronger, more comfortable future.
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