Equine squamous gastric ulcer disease (ESGD) affects up to 90% of racehorses and 60% of sport horses. Prevention through management changes is more effective and welfare-positive than repeated treatment.
Gastric ulcers cause chronic, ongoing pain with every stomach acid surge. Affected horses show behavioral changes including girthiness, reluctance to work, and altered ridden behavior that are frequently mistaken for training or behavioral problems rather than pain responses. The chronic pain of untreated ulcers affects appetite, causing weight loss, reduced body condition, and reduced vitality. Treatment with omeprazole without management change leads to rapid recurrence after stopping medication. Genuine welfare improvement requires addressing the root causes: ensuring forage is available almost continuously, reducing concentrate proportion relative to forage, and providing forage before exercise. These changes cost less than repeated treatment courses while delivering sustained welfare benefit.