Equine Gastric Ulcer Syndrome: Welfare and Management

Comprehensive welfare guide to equine gastric ulcer syndrome (EGUS) — highly prevalent and often undertreated.

Key Facts

EGUS (equine gastric ulcer syndrome) is present in 37-90% of horses depending on management type
Racehorses in training have the highest prevalence; leisure horses are also commonly affected
Gastric ulcers cause chronic pain, behavioural changes, poor performance, and weight loss
The horse evolved for continuous grazing; periods without forage cause acid pooling in the stomach
Omeprazole treatment is highly effective but prevention through management is more sustainable

Welfare Considerations

Equine gastric ulcer syndrome represents one of the most prevalent and often overlooked welfare problems in domestic horses. The chronic, burning pain of gastric ulceration causes subtle but significant welfare impairment. Affected horses may show unwillingness to work, resistance to girthing, stereotypic behaviours (crib-biting, box-walking), reduced appetite, and poor body condition. These signs are often attributed to behavioural problems rather than recognised as pain indicators.

The modern management of horses — intermittent feeding, high concentrate rations, transport stress, training demands, and restricted turnout — creates ideal conditions for ulcer development. The horse's stomach produces acid continuously, and without the buffering effect of constant forage intake, the squamous (non-glandular) mucosa is exposed to damaging acid for prolonged periods.

Effective welfare management requires both treatment (omeprazole to heal existing ulcers) and management change (maximising forage availability, reducing concentrate-to-forage ratio, providing turnout). Without addressing management factors, ulcers recur rapidly after treatment cessation.

What You Can Do

Maximise turnout time and forage access to reduce acid exposure in the equine stomach
Feed little and often — never leave horses without access to hay or haylage for more than 4-6 hours
Reduce concentrate feeds and use oil or sugar beet as alternative energy sources where possible
Have a gastroscopy performed if your horse shows signs of discomfort, poor performance, or behavioural change
Discuss omeprazole treatment and management changes with your vet — both are needed for lasting resolution