Horse EGUS Monitoring and Prevention

Ongoing monitoring of equine gastric ulcer syndrome (EGUS) after initial treatment is essential to prevent relapse and maintain welfare, as the underlying risk factors persist in many horses.

Key Facts

Relapse rates for equine squamous gastric ulcer syndrome (ESGUS) reach 50-70% within 90 days of treatment without management change
Monitoring includes gastroscopy, which remains the gold standard but is invasive and requires specialist equipment
Salivary biomarkers for EGUS are under investigation as non-invasive monitoring alternatives
Horses in intensive training are at highest relapse risk due to intermittent feeding, exercise, and stress factors
Maintenance doses of omeprazole are used in high-risk horses but long-term use has microbiome implications

Welfare Considerations

EGUS management is an ongoing welfare commitment, not a one-time treatment. Horses successfully treated with omeprazole will relapse rapidly if the management practices that caused the initial ulceration are resumed. The welfare goal is to modify the environment and feeding practices sufficiently that pharmacological treatment is only needed acutely rather than chronically. This requires owner and trainer commitment to management changes that may conflict with training programs.

What You Can Do

After EGUS treatment, make the management changes needed to reduce relapse risk - continuous forage is most important
Re-scope horses in intensive training quarterly to catch subclinical relapse before it becomes severe
Discuss maintenance omeprazole protocols with your vet for horses at high relapse risk
Provide hay before exercise to buffer acid splash during work
Support development of non-invasive EGUS monitoring biomarkers that reduce the need for repeated gastroscopy