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Effective Ulcer Treatments for Horses: What to Know

a chart of gastric ulcers in horses

This article explores the various effective ulcer treatments for horses, providing information and guidance on how to best manage the condition. We will look at the causes of equine ulcerations and the symptoms they present, as well as available treatment options and how to monitor progress in order to maximize success.

We will look at preventive measures, early identification, and when referral to a vet is warranted. Finally, we will cover nutrition adjustments that are important during and after an equine ulcer treatment plan.


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What are Gastric Ulcers?

Gastric ulcers, also known as peptic ulcers, are open sores that develop on the inside lining of the stomach and the upper portion of the small intestine. These ulcers are caused by an excessive amount of stomach acid, which can break down the protective lining of the stomach and small intestine, allowing the corrosive stomach acid to damage the tissue and form sores.



A horse with gastric ulcers in its stomach



The majority of ulcers found in the horse's stomach are found in the squamous portion along the margo plicatus, while ulcers can also be found in the upper squamous mucosa region, particularly greater and lesser curvatures, as well as in the glandular fundic and pyloric regions.

The two types of stomach ulcers seen in horses are equine glandular gastric disease (EGGD) and equine squamous gastric disease (ESGD). The two sections of the stomach are divided by the margo plicatus, with the glandular portion responsible for acid production. Horses secrete stomach acid differently than humans, as they continuously secrete stomach acid throughout the day, with mature adult horses producing about 60 litres (16 gallons) of hydrochloric acid per day. The glandular portion of the stomach contains acid-secreting cells which are responsible for the majority of the acid production.

Risk factors for gastric ulcers include high grain diets, stress, and stall confinement. High grain diets can lead to increased acid production in the stomach, which can cause gastric juices to splash onto the squamous portion of the stomach, leading to ulceration. Stress can also lead to an increase in gastric acid production and can lead to a decrease in blood flow to the stomach lining, leading to ulceration. Stall confinement can also increase the risk of ulcers, as horses are unable to eat small amounts of food and hay throughout the day.

This information is important to understand in order to properly diagnose and treat gastric ulcers. Diagnosing ulcers can be done with a combination of physical examination, radiographs, gastroscopy, and laboratory testing.

Treatment of gastric ulcers can include dietary changes, medications, and management practices to reduce the risk of recurrence. Nutrition for gastric ulcer management should include high-fiber feeds, hay, and limited grain intake, while management practices to reduce the risk of gastric ulcers should include stress reduction, regular exercise, and hay or forage as the primary diet component.



A horse with risk factors for gastric ulcers

Causes of Gastric Ulcers in Horses


Gastric ulcers in horses can be caused by a variety of factors, including exercise, diet, stress, and medication. It is estimated that 60-100% of adult horses, especially performance horses, have ulcers. Equine Gastric Ulcer Syndrome (EGUS) is the most common gastrointestinal disorder in horses. The stomach of the horse contains two portions: the squamous portion and the glandular portion. The glandular portion produces acid, which normally helps with digestion, while the squamous portion produces mucous and bicarbonate to protect the stomach lining. When these factors are out of balance, ulcers can develop.

Exercise, diet, and stress are all risk factors for gastric ulcer development. Racehorses are more likely to develop ulcers than other horses, with an incidence of nearly 90%. High-grain diets and intermittent feeding can also contribute to ulcer development. The fermentation of carbohydrates by bacteria in the gastrointestinal tract can produce acid byproducts, making the stomach environment more acidic. Horses on pasture have a lower incidence of ulcers than those athletes that need "high-energy" concentrates. Additionally, NSAIDs can decrease the production of the protective mucus layer of the stomach, making it more susceptible to ulcers.

Stress can also be a contributing factor to ulcer development. The release of the stress hormone cortisol can cause lesions that can develop into ulcers. Physical and environmental stressors, such as confinement and poor body condition, can increase the risk of ulcer development. Exercise can predispose to the formation of splash ulcers. These sores are most likely to develop when the stomach is empty. Therefore, it is important for horses to have access to forage, even during intense exercise, to buffer the stomach acid.

By understanding the causes of gastric ulcers in horses, owners and veterinarians can work together to create an effective treatment plan and reduce the risk of ulcer development. Factors such as diet, exercise, stress, and medication should be carefully monitored and managed to ensure the health of the horse. Horses should be given access to forage, even during intense exercise, to help buffer stomach acid and prevent ulcer development. Additionally, long-term use of NSAIDs should be avoided or monitored closely to reduce the risk of ulcer development.


Clinical Signs of Gastric Ulcers


Gastric ulcers in horses, otherwise known as equine gastric ulcer syndrome (EGUS), is a common condition that affects the stomach lining of horses. Symptoms can range from mild to severe depending on the severity of the ulceration. Poor appetite, decreased performance, weight loss and reluctance to finish meals are some of the most frequent signs in adult horses. Sour disposition, tail swishing during feed consumption and general unwillingness to work may also be present. Severe cases can cause abdominal pain - commonly referred to as colic.

In foals or young horses, clinical signs may differ slightly. Intermittent nursing, poor appetite and intermittent colic are all potential indicators of abdominal pain in these animals; other symptoms include poor body condition, diarrhea, teeth grinding and salivation plus a pot belly or rough hair/coat might be observed too.

Diagnosing and treating gastric ulcers can prove tricky due to their vague nature which makes it hard to differentiate them from other gastric diseases; duodenal ulceration or equine squamous/glandular gastric disease could complicate matters further!

Being aware of possible symptoms is key for owners & trainers so they can take proactive steps if any arise - pH testing & endoscopy being two reliable methods for diagnosis once suspicion has been raised. Once identified, an appropriate treatment plan should be put into place with recurrence prevention at its core alongside ensuring horse's stomach health is maintained going forward.


Diagnosis and Treatment of Gastric Ulcers


When it comes to treating gastric ulcers in horses, it is important to understand the diagnosis and treatment options available. Gastric ulcers are caused by an imbalance between the stomach acid and the protective mucus lining of the stomach. This imbalance can be due to environmental factors, underlying illnesses, or stress.

Diagnosing gastric ulcers involves clinical signs, endoscopic examination, and assessing the severity of ulceration. Treatment of gastric ulcers typically includes medications such as proton-pump inhibitors, dietary changes, and management changes. Omeprazole is considered the drug of choice for treating gastric ulcers in horses.

By understanding the diagnosis and treatment of gastric ulcers in horses, owners can ensure their horses receive the best possible care.




Diagnosis of gastric ulcers in horses is an important step in managing the condition. Clinical signs, such as poor appetite, failure to thrive, weight loss, and colic, can help identify gastric ulcers. Gastroscopy, or esophagogastroscopy, is the only sure way to confirm ulcers in horses. For squamous ulcers, a scoring system is used in the United States and Europe, with grade 4 being the most severe.

In order to have an accurate diagnosis, horses should be fasted for 12-16 hours prior to the gastroscopy. The process involves placing an endoscope into the stomach and looking at its surface. Evaluation of the esophagus, stomach, and small intestine can be done. This is a minimally invasive procedure, and horses should be fasted for six to eight hours prior to ensure most surfaces within the stomach can be observed.

By understanding the various diagnostic procedures and tests available, as well as the fasting requirements and scoring systems used, you can work with your veterinarian to ensure your horse receives the best possible care.




Once the diagnosis of gastric ulcers has been made, the next step is to determine the best course of treatment. Proton-pump inhibitors (PPIs) are the gold standard when it comes to ulcer treatment in horses. Omeprazole, the active ingredient in PPIs, is the only FDA-licensed drug for treating gastric ulcers in horses.

Treatment of gastric ulcers should include not only medication, but also nutritional changes and management modifications. Other medications, such as histamine H2-receptor antagonists and antacids, can also be used to treat ulcers. Ulcers typically take 1-2 months to heal, and the treatment may vary depending on the grade of ulcer.

Horse owners should be cautious when purchasing products for treating gastric ulcers, as some compounding products are not regulated by the FDA and may have lower amounts of active omeprazole than labeled. Gastro Aid or Stance UlcaBuf, over-the-counter products containing a lower dose of omeprazole, can be used preventatively during stressful situations. Low-dose omeprazole is beneficial for horses working in strenuous circumstances. It can help reduce the likelihood of ulcer development or reoccurrence.

It is important to remember that the success of treatment depends on the severity of the ulcer and the compliance of the horse owner.


Nutrition for Gastric Ulcer Management


Nutrition plays an important role in the treatment of gastric ulcers in horses, and there are several dietary and nutritional management strategies that can be used to reduce the risk of ulcer formation. A forage-first diet that includes plenty of roughage, frequent small meals and ad lib access to hay and pasture is the foundation of gastric ulcer prevention, as this encourages chewing, which in turn stimulates saliva production. Saliva contains bicarbonate, which helps to buffer stomach acid. Additionally, providing alfalfa hay and increasing the amount of fiber in the diet can also help buffer stomach acid and protect the stomach lining.

In some cases, a horse may benefit from supplementation with natural antiacids such as red seaweed extract, digestive enzymes, glutamine and threonine, slippery elm, curcumin, prebiotics, probiotics, and mycotoxin binders. These ingredients can help protect the stomach lining from gastric acids and reduce the risk of ulcer formation. Furthermore, nutritional management can help reduce the risk of recurrence of ulcers after treatment.

In addition to dietary management, there are other steps owners can take to reduce the risk of gastric ulcers in horses. These include controlling the environment, adjusting the diet, providing frequent small meals, using hay nets, reducing stress, and increasing access to forage during travel and competitions. It is also important to look out for any nutritional deficiencies, as they can increase the risk of ulcer formation.

Overall, nutrition is an important part of managing gastric ulcers in horses. Appropriate dietary and nutritional management can help reduce the risk of ulcer formation and recurrence, as well as provide essential nutrients for ulcer healing. It is important to consult with a qualified veterinarian to determine the best dietary and nutritional management plan for your horse.


Management Practices to Reduce Risk of Gastric Ulcers


Management practices are an essential part of minimizing the risk of gastric ulcers in horses. By understanding the associated risk factors, horse owners can modify their management and feeding practices to reduce the likelihood of ulcer development. To protect horses from gastric ulcers, horse owners should focus on reducing stress, providing adequate forage, and changing feeding habits.

Stress is a major factor when it comes to preventing gastric ulcers in horses. Horses are delicate animals and can be easily distressed by travelling, competitive events, or stall confinement. To decrease stress levels in horses, horse owners should increase pasture time and avoid stressful situations.

Accessible forage is critical in decreasing the risk of gastric ulcers in horses. For horses, forage digestion produces saliva which buffers stomach acid - protecting the stomach lining from corrosive effects of gastric acidity. To guarantee sufficient forage intake, horse owners should offer ad-lib hay or pasture access.

Feeding practices also play an important role when managing the risk of gastric ulcers in horses. Horses are designed to digest small amounts of food over long periods - large amounts of grain or feed at one time increases chances that they will develop stomach issues. To reduce this danger, horse owners should feed several small meals throughout the day with access to forage between them. This helps buffer stomach acidity and reduces the chance that their steeds will suffer from gastro problems.

By implementing proper management practices, horses can help lower the risks associated with developing gastric ulcers among their mounts. Reducing stress, providing ample fodder, and adjusting feeding routines all contribute towards keeping horses healthy so they perform at peak levels.




This article highlighted the importance of recognizing gastric ulcers in horses and providing an effective treatment plan to reduce the risk of their occurrence. Recognizing clinical signs is essential for early diagnosis, as this can have a tremendous impact on the ability to control and prevent these ulcers from occurring in the future.

Appropriate medications should be used in conjunction with dietary and management changes to reduce stress, provide forage, and adjust feeding patterns for optimal results. As shown, implementing such prescriptions can have profound effects in controlling and managing horse's health conditions and reduce or eliminate adverse symptoms associated with gastric ulcers.

With early recognition, timely diagnosis, and appropriate treatments, owners and veterinarians will be better equipped to prevent and manage the formation of equine stomach ulcers in the future.


Popular Questions

What is the best treatment for ulcers in horses?

The best treatment for ulcers in horses are any approved medications such as Stance UlcaBuf that helps to reduce stomach acid production and protect the stomach lining. By inhibiting a pump responsible for the secretion of stomach acid, omeprazole is effective in both preventing and treating gastric ulcers in all types of horses.

How do you treat a horse's ulcer at home?

Home treatment of a horse's ulcer can include administering various herbs and supplements to provide mucous layer coverage over the stomach lining. Herbs such as Comfrey leaf, Marshmallow root, Liquorice, Meadowsweet and Slippery elm are recommended due to their mucilaginous properties.

These herbs can be administered in the form of tea, tincture, or powder. The tea is made by boiling the herbs in water and then straining the liquid. The tincture is made by the tincture.

How do you treat a horse for ulcers without a vet?

To treat a horse with ulcers without a vet, feed small amounts of lucerne chaff or hay before any exercise. It provides both a physical barrier and helps to buffer the acid that causes discomfort.

Additionally, avoiding both physical and behavioural stress can aid in healing. Make sure not to give the horse long treatments of certain drugs.

Can ulcers heal on their own horses?

Research shows that while equine ulcers can sometimes heal on their own, they are likely to recur without proper treatment. It is important to consult with a veterinarian and devise a medical plan for the horse in order to ensure the best chance of successful ulcer healing.

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