Stomach Ulcer in Horses: Special Care and Treatment

gastric ulcer in horses

Gastric ulcers are a common digestive disease in horses and can affect any horse at any age. Caused by acidity in the stomach, gastric ulcers can lead to significant discomfort and decreased performance. Early diagnosis and treatment are critical to prevent further complications.

What is a Stomach Ulcer?

Stomach ulcers, also known as equine gastric ulcer syndrome (EGUS), are lesions in the lining of the stomach that develop due to exposure to acid. These lesions can range from mild to severe and cause significant discomfort for horses, including reduced appetite, pain when eating, and decreased performance.

What Causes gastric Ulcer?

Gastric ulcers can be caused by a variety of factors:

Diet and feeding management

Gastric ulcers can be caused by a sudden change in the horse’s diet, insufficient forage intake, and diets that are too high in concentration. Feeding small meals at regular intervals throughout the day and providing access to hay or pasture can reduce the risk of developing gastric ulcers.

High grain consumption

High levels of grain in the diet can lead to gastric acid production and pH imbalances, leading to

Intensive exercise

Horses in training can be at risk of developing gastric ulcers due to the high-intensity exercise they are undertaking.

Stressful environments

The stress caused by environmental factors such as travel and competing, or even just everyday living conditions (such as stabling) can increase acid production, leading to the development of gastric ulcers.

Intermittent access to water

Intermittent access to water, such as if a horse is on a long journey or experiencing heat, can cause dehydration and reduce saliva production—which helps neutralize stomach acid. Reduced saliva production can also lead to the development of gastric ulcers in horses.

Social environment

The social environment can also be a contributing factor to gastric ulcers in horses. Horses are herd animals, and the stress of being separated from their herd or isolated for long periods can increase cortisol levels, leading to increased acid production and stomach ulcers.

Anti-inflammatory drugs

The administration of non-steroidal anti-inflammatory drugs (NSAIDs) to horses can also increase their risk of developing gastric ulcers. NSAIDs are commonly used for pain relief and to reduce inflammation, but they can also irritate the lining of the stomach, contributing to the development of ulcers.

Signs and Symptoms

Symptoms of equine gastric ulcers vary based on the severity of the ulceration, but can generally be divided into two categories:

Mild/early clinical signs:  

  • Reduced appetite 
  • Poor performance 
  • Irritable attitude 

Moderate to severe/advanced clinical signs:

  • Colic episodes
  • Diarrhea
  • Dull coat/hair loss
  • Lethargy and reluctance to move
  • Prolonged recumbency on their back (dorsal recumbency) 
  • Grinding teeth or excessive salivation 
  • Weight loss

Types of Gastric Ulcers

Gastric ulcers in horses can generally be divided into two categories: squamous and glandular ulcers. Squamous ulcers are typically found in the non-glandular part of the stomach, while glandular ulcers are located in the glands that line the interior of the stomach wall. Both types of ulcers can be present in the same horse, though squamous ulcers are more common.

Ulcer Diagnosis 

To properly diagnose a horse with gastric ulcers, your veterinarian must perform an endoscopic examination of the stomach. This procedure involves inserting a flexible scope into the horse’s stomach through the esophagus while they are sedated. Through this procedure, it is possible to detect lesions in both types of ulcers and determine their severity.

Treatment of Equine Gastric Ulcers

When it comes to treating equine gastric ulcers, the goal is to reduce acidity in the stomach and promote healing. The most common treatment includes changes to dietary management and feeding schedule, as well as medications such as omeprazole or ranitidine which reduce acid production. Additionally, providing your horse with a high-fiber diet and access to plenty of water can help. In some more severe cases, surgery may be necessary. 

In addition to these treatments, there are also various supplements available that can help reduce the symptoms associated with gastric ulcers in horses and promote healing. These include probiotics, herbs such as aloe vera, and omega-3 fatty acids. 

Finally, it is important to create a stress-free environment for your horse in order to promote healing and reduce the likelihood of recurrent ulcer formation. This may include providing a consistent feeding schedule and access to plenty of pasture time. Be sure to check with your equine veterinarian.


What is the most common complication of gastric ulcers?

The most common complication of gastric ulcers is the development of perforations in the stomach wall, which can cause internal bleeding. Other complications include poor absorption of nutrients and electrolytes, anemia, and colic.

What happens if ulcers go untreated in horses?

If left untreated, gastric ulcers can cause serious problems for horses such as poor performance or digestive issues. In some cases, the ulcer may rupture and lead to internal bleeding. It is important to seek veterinary care if your horse shows signs of gastric ulcers.

Can horses fully recover from ulcers?

Yes, horses can fully recover from gastric ulcers with prompt and appropriate treatment. Treatment typically involves a combination of medications to reduce acid production in the stomach, as well as supportive care such as dietary changes and stress management. Horse owners should work closely with their veterinarians to find the best plan for their horse’s needs.

Can ulcers be cured without surgery?

Yes, gastric ulcers in horses can be managed and treated without surgery. The most common treatment for equine gastric ulcers is a combination of medications that reduce the acid production in the stomach and prevent further damage to the lining of the stomach. In addition, changes to the horse’s diet and environment may help reduce stress levels, which can also help in managing the symptoms of gastric ulcers.

What happens if the gastric ulcer is serious?

If the gastric ulcer is serious, surgery may be required to repair the damage and prevent further complications. Surgery can involve endoscopy or a procedure called gastropexy, which attaches the stomach to the abdominal wall. The horse must be monitored closely after surgery until any potential complications have been addressed.


Equine Gastric Ulcers: Special Care and Nutrition

European College of Equine Internal Medicine Consensus Statement—Equine Gastric Ulcer Syndrome in Adult Horses

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