Horse Ulcer Prevention and Management

Equine gastric ulcer syndrome (EGUS) affects a high proportion of horses in training and competition; management and treatment significantly improve welfare.

Key Facts

Studies estimate that 60-90% of racehorses and 40-60% of sport horses have gastric ulcers.
EGUS includes squamous (upper) and glandular (lower) ulcer types with different risk factors and treatments.
Risk factors include stabling, intermittent feeding, high-concentrate diets, NSAIDs, and training stress.
Omeprazole is the primary treatment for squamous EGUS; glandular disease may require sucralfate or misoprostol.
Ad libitum forage access is the single most important preventive measure for squamous ulcers.

Welfare Considerations

Gastric ulcers cause significant pain that may manifest as girthiness, reluctance to work, poor performance, and intermittent colic. Many horses suffer silently without owners or trainers recognising ulcer-related pain. The welfare impact of unrecognised and untreated EGUS in performance horses is substantial. Gastroscopy provides definitive diagnosis; empirical treatment trials are sometimes used in practice. Prevention through management changes — maximising forage access, reducing stabling time, limiting NSAIDs, and managing training stress — is more sustainable than repeated treatment cycles. The prevalence of EGUS in competition horses reflects management systems that frequently conflict with equine physiological needs.

What You Can Do

Provide horses with continuous access to forage — hay or grazing — to buffer stomach acid.
Limit NSAID use to the shortest effective duration and avoid routine use as a performance aid.
Discuss gastroscopy with your vet if your horse shows girth sensitivity, poor performance, or intermittent colic.
Allow rest time from training and consider pasture turnout as integral to ulcer prevention.