Horse Gastric Ulcer Treatment and Prevention

Equine gastric ulcer syndrome causes chronic pain affecting millions of horses. Treatment with omeprazole combined with management change provides effective welfare improvement.

Key Facts

EGUS encompasses both squamous and glandular disease with different pathophysiology and treatment responses
Squamous disease responds well to omeprazole while glandular disease is more resistant requiring additional therapies
Sucralfate provides coating protection of glandular ulcers as an adjunct to proton pump inhibitor therapy
Treatment duration of minimum 28 days is required for adequate healing of established squamous ulcers
Recurrence after omeprazole cessation is common without concurrent management change addressing underlying causes
Feed-based prevention using alfalfa hay buffers acid and has evidence for squamous ulcer prevention
Competitive horses show seasonal ulcer prevalence increases during high-intensity training and competition periods
Biomarkers including serum sucrose permeability test and breath tests provide non-invasive ulcer detection options

Welfare Considerations

Gastric ulcer treatment provides significant welfare improvement for horses living with chronic gastric pain. However, treatment without addressing the underlying management causes leads to rapid recurrence creating a cycle of treatment and relapse that is both costly and welfare-suboptimal. Effective welfare management combines pharmacological treatment of established disease with systematic management change addressing forage restriction, training intensity, transport stress, and NSAID exposure. The welfare goal is permanent resolution of the conditions that caused ulcers, not just temporary symptom suppression through continuous medication.

What You Can Do

Confirm gastric ulcers through gastroscopy before committing to treatment rather than empirical treatment alone
Follow minimum 28-day omeprazole treatment courses for established squamous ulcers and extend if healing is incomplete
Implement management changes concurrent with treatment to prevent recurrence
Provide alfalfa hay as a dietary buffer particularly during high-stress periods of competition and training
Recheck via gastroscopy at treatment end to confirm healing before drug withdrawal
Work with your veterinarian to distinguish squamous from glandular disease as treatment protocols differ significantly