Horse Gastric Ulcer Prevention: Diet and Management

Equine gastric ulcer syndrome affects the majority of performance horses and many leisure horses, with prevention through appropriate diet and management significantly more welfare-positive than repeated treatment.

Key Facts

EGUS affects approximately 60-90% of racehorses and 30-60% of pleasure horses based on endoscopic studies
The equine stomach secretes acid continuously unlike humans making fasting periods particularly damaging
Squamous ulceration develops in the upper non-glandular region most commonly affected by acid splash
Glandular ulceration in the lower stomach region is less well understood and often less treatment-responsive
Continuous access to hay or forage significantly reduces ulcer risk by providing buffering material
NSAIDs including phenylbutazone increase ulcer risk particularly with prolonged use
Omeprazole is the gold-standard treatment but relapse is common if underlying management issues are not addressed

Welfare Considerations

Gastric ulceration causes chronic abdominal pain in horses that may manifest as reluctance to work, behavioral changes, and reduced performance as well as more obvious signs of colic. The high prevalence of EGUS in performance horses reflects management systems incompatible with equine digestive physiology - infrequent large meals, high concentrate diets, periods of fasting, and high stress from training and competition. Treatment with omeprazole relieves symptoms but relapse is virtually inevitable without addressing the underlying management factors. Prevention through forage-based feeding and minimizing fasting is both more welfare-positive and more sustainable than repeated treatment cycles.

What You Can Do

Provide horses with access to hay or forage at all times to minimize fasting periods
Feed a forage-first diet minimizing high-starch concentrate feeds particularly before work
Allow access to turn-out and social contact to reduce stress-related ulcer risk
Use NSAIDs at the lowest effective dose for the shortest necessary duration with gastric protection
Discuss endoscopy to confirm diagnosis before treating for EGUS as other conditions can mimic the signs
Address underlying management causes alongside omeprazole treatment to prevent relapse
Consider sucralfate or antacid supplementation for horses in high-risk situations or during intensive work periods