Gastric ulcers affect over 50% of performance horses and cause chronic pain. Management practices including restricted turnout and high-concentrate diets drive this welfare epidemic.
Gastric ulcer welfare impact is significant and chronic — horses with active ulcers experience constant discomfort from gastric acid pain that worsens with exercise, empty stomach, and stress. The behavioral changes associated with ulcers — girthiness, reluctance to work, sensitivity on the left flank — are welfare indicators that are sometimes misinterpreted as training problems and addressed punitively, compounding the welfare harm. Management-driven ulcers are preventable: continuous forage access, reduced concentrated feed, increased turnout, and reduced exercise intensity during stressful periods dramatically reduce prevalence. Treatment with omeprazole is effective but must be combined with management changes or recurrence is inevitable when medication stops.