Evidence-based treatment of equine gastric ulcer syndrome requires distinguishing between ulcer types, appropriate medication selection, and parallel management changes to prevent recurrence.
Effective ulcer treatment requires addressing both the lesions and the management factors that created them. Horses that receive medication but return to unchanged management face near-certain recurrence and continued welfare compromise. The welfare-conscious approach integrates medication with parallel management modifications: increased forage access, stress reduction, appropriate turnout, and removal of triggering factors like NSAID overuse. Regular re-scoping to confirm healing before withdrawing treatment prevents premature discontinuation that leaves active lesions untreated.