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Gastric Ulcer Treatment In Horses

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Our Final Thoughts On Treating Ulcers In Horses

Diagnostic and Treatment of Gastric Ulcers in Horses

If you own a performance horse, you need to be prepared to tackle some stomach ulcers. Unfortunately, the most alluring thing about performance horses is also the reason why they are so prone to ulcers their energy and agility. But, there are several remedies for tackling the condition.

The home remedy thats most effective is rest and hay. Resting your horse ensures that the stress does not cause excess secretion of gastric acids. The hay makes sure that the animals stomach lining has protection from the acids. You can also try any of the supplements in this guide because they are some of the best ulcer treatment for horses. If you need a product for preventing stomach ulcers, you should try Ulcerguard Oral paste. Guard Ulcer treatment, on the other hand, is a great supplement for curing ulcers.

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The Placement Of The Ulcer Indicates The Seriousness Of The Issue

To examine a horse for ulcers, a vet will use an endoscope. The endoscope, 3 meters in length, is inserted into the nostril and passes through the epiglottis and stomach. The camera on the end of the instrument allows the vet to see the digestive tract and locate any ulcers clearly.

Of course, finding the ulcers is just the first step to determining the cause. This is where the big picture has relevance. For example, if ulcers are discovered primarily in just the upper portion of the stomach, this would indicate that the issue is likely a feed management-related issue.

In other words, an adjustment to the diet or the feed schedule and exercise may need to be altered. We will discuss this in greater detail later.

If ulcers are discovered in the lower portion of the stomach, this indicates a more serious condition because the bottom portion of the stomach has a lining designed to protect the stomach wall from the acidic digestive enzymes .

When ulcers are found in the lower stomach, this points to the possible over-use of NSAIDs or non-steroidal anti-inflammatory drugs. The treatment for this condition may vary slightly regarding oral dosing amounts and the duration of treatment.

Because horses cannot speak to us about their health, we must be fully engaged to ensure optimal health.

Treating Gastric Ulcers in Horses

There are several steps you can take to treat your horses ulcers. Most of these should be taken while consulting your vet.

What Dose Of Omeprazole Should My Horse Have

is typically administered to horses in 37% GastroGard paste form at a dose of 4 mg per kilogram bodyweight per day.

For a standard adult horse of 500 kg , this is 2000 mg of Omeprazole per day which is roughly equivalent to one syringe of GastroGard paste per day.

Lower doses of 1.6 mg per kilogram bodyweight per day have been shown effective at reducing gastric acid production and ulceration severity. However, this dosage is not as consistent at promoting ulceration healing compared to the 4 mg dose.

For squamous ulcers, omeprazole is typically administered for 28 days to enable full healing. Research shows that 86% of horses ulcers are healed within 28 days.

For glandular ulcers, omeprazole is typically administered for longer periods. It may also be administered alongside antimicrobials and gastroprotective supplements, such as sucralfate.

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Feeding Plan For Ulcer Recovery

Grain should be avoided for horses with or . Carbohydrates are fermented to some extent within the stomach, and releasing lactic acid and VFAs.

Instead, horses with ulcers should be fed a that supports gut health and prolongs feeding time. Consider the following strategies:

  • Provide continuous access to forage and avoid intermittent feeding or long periods of time between meals. The prevalence of ulcers in horses fed twice daily is 75% compared to 58% for horses fed three times daily.
  • Feed alfalfa prior to exercising this legume hay has high calcium content and can help to buffer stomach acid.
  • Feed oil as an energy source instead of grain-based concentrates.
  • Feed to reduce the likelihood of ulcers recurring after treatment. Visceral+ is formulated with natural ingredients that support gastric barrier function.
  • Give your horse constant access to fresh water. Horses that do not have contact access to water are 2.5 times more likely to develop ulcers.

Equine Ulcer Treatment Plan

Gastric Ulcers In Horses Behaviour

The treatment and prevention of ulcers in horses has recently evolved to include controlling gastric acid production, rather than simply neutralizing it with antacids. The result is faster healing, and less pain and colic.

from the FEI and learn more about the causes, types, and symptoms of equine gastric ulcers, including an expert guided gastroscopy, which is used to diagnose ulcers.

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Preventing Gastric Ulcers In Horses

As always with health and wellness, prevention is the best medicine. We stress horses digestive systems simply by owning them and removing them from their natural environment. Then we further compound the difficulties by riding, traveling, and competing. Thus its critical, especially for the performance horse, to take as many measures as possible to encourage better digestive health.

We stress horses digestive systems simply by owning them and removing them from their natural environment. Then we further compound the difficulties by riding, traveling, and competing

The most beneficial changes to your feed and management program may include:

  • Providing as much turnout as possible with other horses
  • Offering forage continuously around the clock
  • Feeding alfalfa, which is shown to help buffer stomach acids
  • Reducing grain-based feed intake
  • Providing fats as a source of energy/calories
  • Feeding multiple small meals throughout the day
  • Mixing chaff with grain meals to increase chewing and slow intake
  • Using hay nets or slow feeders to increase chewing and slow intake
  • Feeding beet pulp, a complex carbohydrate metabolized in the hindgut, for higher caloric needs

In addition to these, and especially when its not possible to implement them all, digestive supplements can also play a role in supporting your horses gut health. Certain digestive supplements can help:

What Causes Ulcers In Horses

Equine ulcers are the result of a repeating cycle of increased acidity, decreased appetite, and the formation of an ulcerfollowed by moderate to severe discomfort.

Ulcers in horses can develop within as little as five days.1

Often the result of stress, which causes an increase in stomach acid secretions that damage the stomach lining, ulcers are painful and lead to an aversion to eating. Eating less roughage causes the horses digestive tract to become more and more acidic, leading to more ulcerations, appetite suppression, and painand the cycle continues.

Factors that can contribute to ulcers include:

  • High-starch diets that increase acid production
  • Strenuous training plans
  • Feeding pattern
  • Certain medications
  • Lifestyle and stress

Although common in performance horses, gastric ulcers can be a problem for all types of horses. Depending on a horses age, breed, and activity, the rate of equine ulcers may rise to 93%.2

1. McClure SR, Carithers DS, Gross SJ, et al. Gastric ulcer development in horses in a simulated show or training environment. JAVMA. 2005 227:775777.

2. Murray MJ, et al. Factors associated with gastric lesions in Thoroughbred racehorses.Equine Vet J. 1996 28:368374.

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How Is Stomach Ulcer Diagnosed

Since ulcer is a gastric problem, the only way diagnose it is to perform an endoscopy. During an endoscopy, the veterinarian inserts a scope into the horses stomach to see if ulcers are on the stomach wall. In some cases, an endoscopy procedure might not be possible. In these scenarios, the veterinarian may simply treat the horse for ulcer and see if the symptoms grow better over time.

Treating Gastric Ulcers In Horse: Is It Squamous Or Glandular

Treatment of Gastric Ulcers in horses

Youll need to work with your vet to come up with a thorough treatment plan for a horse you suspect has ulcers of any type. But most vets will prescribe some combination of the following.


  • Omeprazole to suppress production of gastric acid and give the tissue time to heal and prompt the horse to eat .
  • Ranitidine or Cimetidine, to help suppress gastric acidity.
  • Antacids, for short-term control.
  • Removal of horse from heavy work or competition schedule.


  • Omeprazole, a treatment that suppresses gastric acid production to allow healing to take place, particularly in the squamous region. While it has been shown to be less effective for treating glandular ulcers, most vets still recommend it as an aid for some healing. However, it would likely be prescribed in higher doses for longer and used in tandem with additional treatments.
  • Mucosal protectants, such as sulcrafate or pectin-lecithin. These are recommended for use along with omeprazole to aid healing in glandular ulceration.
  • Antibiotics, because bacteria may be a cause of some EGGUS.
  • A nutritional digestive supplement to support healthy gut structure and function, especially of the hindgut while suppressing stomach acids.
  • A high-roughage, low-concentrate diet.

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Key Times To Use Omeprazole For Horses With Ulcers

Managing the ulcer-prone horse can be tricky due to the fact that once a horse has developed ulcers, they are now at higher risk of recurring incidences of ulceration.

Franklin explains that UlcerGard, which contains a lower dose of omeprazole than GastroGard, is commonly used to maintain ulcer-prone horses. However, it can be expensive to give on a long-term basis, so instead, Franklin often recommends that UlcerGard be given to performance horses, as needed.

For example, if someone is hauling their horse to a big show where they plan to be for a week or so, Franklin will often recommend that the horse be given UlcerGard before they leave and stay on it while at the show.

You can do the same thing whenever your horse is in intensive training, says Franklin. The idea is that youre going to treat them with GastroGard and then, because you havent been able to take the horse out of that high-risk environment, you need to maintain them on UlcerGard so that the ulcers dont come back.

But he also notes that the coming back is the main problem that he and other veterinarians tend to see.

We can treat this condition–it may take four to eight weeks–but we can treat it. The problem is that horse owners and managers often make no management changes to prevent ulcers from returning. Thats where the right supplements can be beneficial–they are a relatively easy tool for the horse owner to implement while also greatly impacting horse health.

Diagnosis Of Ulcers In Horses

If you suspect your horse has a gastric ulcer, make an appointment with your veterinarian. An ulcer can be serious, and sometimes fatal if medical attention is not given in time. Your medical professional will ask questions pertaining to his health history, look closely at his clinical signs, perform blood work, urinalysis, biochemistry profile, and other laboratory testing in order to rule out any other illnesses and come to a preliminary diagnosis.

Your doctor may perform specific diagnostic testing using enhanced diagnostic equipment. He may use a gastroscope, which is an approximately 2 meters-long endoscope into the stomach of your horse. This is currently the most accurate and definitive diagnostic test used to confirm the presence of a stomach ulcer or ulcers.

This test will confirm the specificities of the ulcers, such as size, severity, and precise location. Typically, ulcers are found in the upper portion of the organ however, ulcers can also be found in the lower section, including the duodenum. The ulcer will be classified between the areas of 0-4, with a 4 having severe lesions. He will communicate with you the extent of the ulcer and let you know the options for treatment.

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Causes Of Gastric Ulcers In Horses

In a natural environment the horse will graze for up to 16hr a day, so the acidity is reduced by the forage filling the stomach almost constantly, as well as by bicarbonate in the saliva that is produced as the horse chews.

If stabled horses have access to ad-lib hay, haylage or grass, this natural preventative process continues. But if they are fed high-concentrate diets with only limited access to forage, the acidity in the stomach increases.

Any prolonged period without forage intake, whether due to management practices or illness, leads to increased gastric acidity and a risk of ulcers.

Training which includes fast work, especially on an empty stomach, increases the risk of the acid splashing around, resulting in damage the upper part of the stomach.

Stress can also be a factor.

Research undertaken in the UK1 on the stomachs of slaughtered horses showed that even feral ponies living on the moors can develop gastric ulcers, although it was unclear whether they were living with them all the time or had developed them during the brief period between round-up and slaughter. The samples were all taken from animals slaughtered in mid-summer, when grazing was at its best and the predicted environmental stress at its lowest.

How Can Gastric Ulcers Be Prevented

A Closer Look: Gastric Ulcer Formation  The Horse

The following management techniques may assist in preventing ulcers:

  • Feed horses frequently or on a free choice basis . This helps to buffer the acid in the stomach and stimulate saliva production, natures best antacid.
  • Reduce the amount of grain and concentrates and/or add alfalfa hay to the diet. Discuss any feed changes with your veterinarian so that medical conditions may be considered.
  • Avoid or decrease the use of antiinflammatory drugs. If anti-inflammatory drugs must be given, use newer, safer ones such as firocoxib, if appropriate and under veterinary recommendations.
  • Limit stressful situations such as intense training and frequent transporting.
  • If horses must be stalled, allow them to see and socialize with other horses as well as have access to forage.

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Causes Of Ulcers In Horses

There are several different causes of the development of gastric ulcers in horses. Ulcers can be very mild or quite severe. Causes can include:

  • Fasting
  • Feed that does not allow the horse to produce saliva
  • Too much exercise
  • Stress increases the amount of blood flow to stomach
  • Overuse of anti-inflammatory medications

How Do Gastric Ulcers Develop

Horses differ from humans because they secrete stomach acid continuously, even when not eating. Adult horses secrete 30 litres of gastric acid daily. When horses are unable to access food on a continual basis, such as when grazing, the pH balance of the stomach changes drastically and gastric juices begin to attack the stomach mucosa. Acid produced in the stomach is generally buffered by saliva which contains a high concentration of bicarbonate and mucus.

If access to feed is reduced then consequently the saliva production is greatly reduced. As a result the squamous portion of the horse’s stomach, the most common part to be affected, lacks the buffer bicarbonate and protective mucous coating to protect the stomach lining from acid.

Various feed stuffs produce different amounts of saliva, for example 1 kg of hay takes 3000 chewing movements and produces 4 litres of saliva versus 1 kg of grain takes only 1000 chewing movements and produces 2 litres of saliva.

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Alternative Remedies And Natural Ulcer Treatments For Horses

Many equine owners turn to herbal or alternative remedies such as aloe vera juice, marshmallow root, slippery elm, etc., in order to treat ulcers in their horses, and while some of these remedies do have gut-soothing properties, most of them are better suited for prevention, rather than treatment purposes.

Ive been in barns where the trainers have done everything they can to try to keep horses off medication, and theyre really making all the right moves in the way that they feed, supplement, and manage the horses, says Franklin. Even so, after scoping, we have found that unfortunately, those horses still have a very high incidence of developing gastric ulcers.

Because of this, Franklin recommends that horse owners focus on healing the condition first and foremost, and then trying to prevent them from coming back by using certain supplements–those that are backed by science.

Gastric Ulcers In Horses: The Important Facts Every Owner Needs To Know

Gastric Ulcers in Horses
  • This article has been edited and approved by Karen Coumbe MRCVS, H& Hs veterinary advisor since 1991.
  • Gastric ulcers in horses are a common problem, particular among racehorses and elite competition horses, although horses of all ages and types can have them, particularly if they have limited access to forage. Foals are also susceptible, not least because they have relatively thin gastric mucosa.

    Squamous gastric ulcers occur when the digestive stomach acids come in to contact with the upper part of the stomach lining, which does not have the same protective layer as the lower part of the stomach. Glandular ulcers affect the bottom two-thirds of the stomach, which is submerged below the acidic gastric juices.

    It can be hard to interpret the significance of gastric ulcers in the horse, as some positive cases will have no definitive clinical signs and it is important to review the whole horse health picture and not just the ulcers themselves.

    Equine gastric ulcers : Causes | Diagnosis | Treatment | Prevention

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    Causes For Ulcer Treatment For Horses

    • A high-concentrate diet with low-roughage intake
    • Withholding feed during competitions and intensive exercise on an empty stomach. Exercise Exercise is shown to reduce blood flow to the stomach lining as well as increasing abdominal pressure which may cause gastric compression, in turn forcing acid contents into the proximal stomach
    • Other factors which induce a stressful environment including physical stress such as illness and behavioural stress such as stall confinement, long-distance transportation, unfamiliar environments
    • Use of Non-Steroidal Anti-Inflammatory Drugs (e.g. Phenylbutazone or Flunixin meglumine

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