Gastroscopy remains the gold standard for equine gastric ulcer diagnosis, but practical early detection approaches — including behavior-based scoring and saliva cortisol monitoring — are expanding access to timely welfare assessment.
EGUS monitoring is a welfare priority because the condition causes significant chronic discomfort that degrades quality of life and performance without causing overt acute distress. The diagnostic gap — most horses with EGUS are not gastroscoped because of cost and sedation requirements — means that millions of horses with significant ulcer scores remain undiagnosed and untreated. Expanding access to reliable non-invasive monitoring tools would dramatically improve welfare by enabling earlier identification and treatment. Until such tools are validated, empirical treatment trials and behavioral monitoring are reasonable practical approaches for horses showing clinical signs compatible with EGUS.