Equine Gastric Ulcer Syndrome: Prevention and Management in Sport Horses

Understanding the high prevalence of gastric ulcers in performance horses and how management and medication reduce this welfare burden.

Key Facts

Gastric ulcer syndrome affects approximately 60-90% of sport and racehorses with prevalence correlating with performance intensity
Horses have continuously secreting gastric acid unlike humans making extended fasting particularly damaging to squamous gastric mucosa
Feed management including hay provision before exercise and frequent small meals significantly reduces ulcer development
Omeprazole (GastroGard/UlcerGard) remains the most effective treatment with 28-day courses achieving healing in most grade 2-4 ulcers
Sucralfate and antacids provide limited benefit for squamous ulcers but may help with glandular disease which responds poorly to omeprazole alone
Competition schedules involving travel, diet changes and reduced turnout significantly increase ulcer risk requiring preventive management
Behavioral signs including girth resentment, poor performance and altered temperament correlate with endoscopic ulcer findings in some studies

Welfare Considerations

Gastric ulcer syndrome represents a chronic welfare burden affecting the majority of horses in intensive training and competition. The pain associated with active ulcers affects horses through every meal, every training session and every period of fasting, yet this suffering is frequently normalized in equine sport as an expected cost of performance. Management changes including ad lib forage access, reduced transport stress and competition frequency, and appropriate treatment courses can substantially reduce ulcer prevalence and severity. The welfare case for proactive ulcer management is strong but requires willingness to adjust management practices that prioritize performance over welfare, including reducing competition schedules and ensuring continuous forage access even when this is logistically challenging.

What You Can Do

Ensure horses in training have access to hay or grazing for the majority of each 24-hour period
Provide hay before morning exercise to buffer gastric acid and reduce exercise-associated ulcer development
Discuss omeprazole treatment and prevention protocols with your equine vet for horses in intensive training
Consider scoping horses with behavior or performance changes rather than assuming behavioral explanations for symptom changes
Reduce competition frequency and travel stress where clinically indicated by recurrent ulcer history
Implement management changes as the foundation of treatment rather than relying on medication alone