Horse Gastric Ulcer Prevalence: The Welfare Crisis Hidden in Plain Sight

Equine gastric ulcer syndrome (EGUS) affects up to 90% of racehorses and over 50% of performance horses, representing one of the most widespread welfare problems in equestrian sport.

Key Facts

EGUS encompasses squamous ulcers (ESGD) in the upper stomach and glandular ulcers (EGGD) in the lower stomach - different conditions requiring different treatments
Prevalence in racehorses is 80-90%; in performance horses 40-60%; in leisure horses 11-50% depending on management
Causes include intermittent feeding (horses evolved for 16+ hours of grazing), high-grain diets, intense exercise, stress, NSAID use, and stabling
Clinical signs include poor appetite, weight loss, poor coat, behavioral changes (cinchiness, reluctance to work), and colic
Diagnosis requires gastroscopy - direct visualization of the stomach; diagnosis cannot be made from clinical signs alone
Omeprazole (GastroGard/Ulcergard) is the primary treatment for squamous ulcers; glandular ulcers require additional medications
Management changes - ad libitum hay or turnout, reduced grain, multiple small meals - are as important as medication
Prevention is cost-effective: a horse in chronic pain from untreated ulcers is a compromised athlete and welfare problem simultaneously

Welfare Considerations

The extraordinary prevalence of gastric ulcers in horses under human management represents a systemic welfare failure created by conditions radically different from those horses evolved in. Horses evolved to graze continuously, have constant gastric acid buffered by forage, and move freely. Modern management - stabling, meal feeding of grain, intense exercise, transportation, and competition stress - creates perfect conditions for gastric acid to damage unprotected stomach tissue. The welfare impact is significant: gastric ulcers cause chronic pain that affects behavior, attitude, and performance. Many horses showing behavioral problems attributed to 'attitude' or 'back pain' have undiagnosed gastric ulcers. The high cost of gastroscopy and treatment has normalized a situation where most performance horses live with treatable pain. Welfare-first management changes can prevent ulcers in many horses without medication.

What You Can Do

Ensure your horse has access to forage (hay or pasture) for at least 16-18 hours per day to buffer gastric acid
Reduce grain feeding and increase forage quality and quantity as the foundation of ulcer prevention
Maximize turnout time - stabling increases ulcer risk through stress and reduced foraging behavior
If your horse shows behavioral changes, reluctance to work, or poor appetite, consider EGUS as a cause and seek gastroscopy
Discuss preventive omeprazole with your vet during high-risk periods (transport, competition, medication with NSAIDs)
Consider splitting meals into multiple small feedings and providing hay before exercise to buffer stomach acid
Minimize NSAID use and use gut-protective agents when NSAIDs are necessary
Treat diagnosed ulcers appropriately and then address management root causes to prevent recurrence