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  • Abi Kroupa

Gastric Ulcers In Horses - Diagnosis and Top Treatments

Updated: Jan 16, 2021

Gastric ulcers are shockingly common in horses. Up to 90% of racehorses and an estimated 60% of show horses are affected by equine gastric ulcers. However, ulcers can affect any horse at any age. Foals are also particularly susceptible because they sleep lying down for long periods and start secreting gastric acid as young as two days old.

Ulcers result from erosion of the stomach lining due to prolonged exposure to ordinary acid in the stomach. In a natural grazing situation, the horse's stomach creates a steady flow of acid for digestion. Because of this, the horse's stomach produces up to 9 gallons of acid per day, which is buffered naturally by grass/hay and saliva in a high forage diet.


The stomach, divided into two parts, has a lower (or glandular) section that secrets the stomach acid. This portion of the stomach has a protective coating to prevent it from being damaged by acid. Ulcers sometimes occur in the glandular portion of the stomach, but it's much less common. The upper part of the stomach (non-glandular region) is where 80% of ulcers occur in horses. This area does not have protection from acid like the glandular part of the stomach.


Ulcers are frequently seen in athletic horses because exercise increases gastric acid production. Other external risk factors for developing ulcers include:

· transport stress

· stall confinement

· limited feeding schedule (only feeding two times a day)

· lack of exposure to other horses

· chronic administration of non-steroidal anti-inflammatory drugs such as phenylbutazone and flunixin, decreasing the stomach's protective mucus layer.


The majority of horses with gastric ulcers show no or very subtle clinical signs. However, indicators of gastric ulcers include decreased performance, attitude changes, dull coat quality, weight loss with poor body condition, girthiness, grinding teeth, idle chewing or excessive licking, excessive tail swishing, not wanting to go forward, loose feces, and low-grade colic.


The only way to definitively diagnose ulcers is through gastroscopy (scoping). This veterinary procedure involves placing an endoscope camera into the horse's stomach. This procedure is easy to perform and is minimally invasive. It allows your vet to evaluate the esophagus, stomach (non-glandular and glandular regions), and a part of the small intestine. For safety, a short-acting tranquilizer lightly sedates the horse. The procedure is considered very safe, and a complete evaluation only takes about 20 minutes.

In horses showing possible signs of ulcers, some veterinarians and horse owners will opt to treat for gastric ulcers before doing the gastroscopy, looking for improvement in those symptoms. This can be helpful but doesn't answer whether the horse has ulcers or when to discontinue treatment.


Prevention of ulcers is vital. However, medication is necessary for horses showing more severe clinical symptoms or when cause factors such as horses in race or show training cannot be removed. Omeprazole (Gastrogard) is currently the only FDA approved drug in horses for the treatment of gastric ulcers. However, there are a few treatment models that also prescribe the use Gastrogard in conjunction with other medications. In 2000, the FEI approved omeprazole and ranitidine for gastric ulcers in competition horses.

After treating your horse for ulcers, it's essential to have a prevention plan to limit reoccurrence. Horses with a history of gastric ulcers may benefit from proactive treatment to decrease the recurrence of ulcers. Ulcergard is an example of a gastric preventative. Feeding your horse more frequently and offering free-choice forage (either via pasture or hay) helps buffer acid in the stomach and stimulates saliva production. Avoid the use of anti-inflammatory drugs and limit stressful situations such as frequent transport and intense training. Because of the high percentage of ulcer cases in the equine industry, there are many preventative treatments and supplements on the market to help keep your equine's gut more comfortable, especially in stressful situations. Below is a list of products that I have personally used and had favorable results:

· Ulcergard - helps prevent the formation of gastric ulcers in horses.

· SmartGut Ultra Pellets – In a university-led research study, SmartGut Ultra helped maintain stomach health, specifically in horses under stress. It is a patented formula designed to support horses under pressure from training and traveling.

· Purina Outlast Gastric Support Supplement – formulated to support health and proper pH.

· Purina Ultium Gastric Care Horse Feed – formulated to help equine athletes during the stress of competition by providing optimal gastric and immune support

· Triple Crown Stress Free Forage Supplement – is an alfalfa-based supplement that utilizes a nutrient-based approach to support normal digestive health.

· Succeed Digestive Conditioning Program – delivers specialized nutrients to support the entire digestive tract's healthy structure and function, including the stomach and hindgut.

· Vitamin E, Nano-EMany studies have shown that Vitamin E can improve gastric ulcers or lesions induced by non-steroidal anti-inflammatory drugs.


American Association of Equine Practitioners, "Equine Gastric Ulcers: Special Care and Nutrition", "Diagnosing and Treating Gastric Ulcers in Horses," posted by UC Davis Center for Equine Health


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