Horse Ulcer Treatment and Dietary Management

Treating equine gastric ulcer syndrome requires medication combined with dietary management changes that address the underlying nutritional drivers of acid damage.

Key Facts

Omeprazole is the gold standard treatment for EGUS, suppressing acid production for the 28-35 day treatment period.
Treatment without dietary change produces rapid relapse — management modification is essential to sustained remission.
Aloe vera and sucralfate are used as adjunctive treatments but do not replace omeprazole as primary therapy.
Squamous ulcers (upper stomach) respond well to omeprazole; glandular ulcers (lower stomach) are more resistant and may require sucralfate.
Treatment cost is a significant barrier for some owners — generic omeprazole options have reduced costs substantially.

Welfare Considerations

Treating equine gastric ulcers without addressing the dietary and management causes produces temporary relief followed by inevitable relapse. The horse continues to be exposed to the conditions that caused the ulcers. Effective EGUS management combines medication with dietary modification — reducing concentrate levels, increasing forage access, maximizing turnout, and minimizing stabling — to prevent re-ulceration after the treatment course ends. Both treatment and prevention are welfare responsibilities.

What You Can Do

Complete the full treatment course of omeprazole at the prescribed dose — under-dosing produces treatment failure.
Implement dietary and management changes during treatment rather than after — address causes simultaneously.
Perform endoscopy 28 days post-treatment to confirm healing before withdrawing medication.
Maintain the dietary and management changes that prevented recurrence — they are ongoing welfare requirements, not temporary adjustments.