Gastric Ulcers in Horses: The Hidden Epidemic
Up to 90% of racehorses and 60% of performance horses have gastric ulcers. Understanding the causes helps prevent this painful condition.
Equine gastric ulcer syndrome (EGUS) is one of the most common health problems in horses. Ulcers develop in the stomach lining due to acid exposure, stress, diet, and management practices. They cause pain, poor performance, and behavioral changes.
Key Points
- Up to 90% of racehorses, 60% of performance horses, and 50% of pleasure horses have ulcers
- Two types exist: squamous ulceration (ESGD) and glandular ulceration (EGGD)
- High-concentrate diets, stall confinement, and stress are major risk factors
- Signs include poor appetite, weight loss, girthiness, and behavioral changes
- Diagnosis requires gastroscopy — a camera inserted into the stomach
- Treatment with omeprazole (GastroGard) for 28 days heals most ulcers
Understanding Equine Stomach Anatomy
The horse stomach has two distinct regions. The upper squamous mucosa lacks glands and has no natural protection against acid — this is where most ulcers form (ESGD). The lower glandular mucosa produces bicarbonate and mucus for protection. Ulcers here (EGGD) are less common but harder to treat. Horses continuously secrete gastric acid; the squamous mucosa is protected only when saliva (containing bicarbonate) and food buffer the acid.
Causes and Risk Factors
High-grain, low-forage diets reduce saliva production and buffering. Fasting or meal feeding leaves the stomach empty and exposed to acid. Intense exercise increases abdominal pressure, pushing acid onto the squamous mucosa. Stress — transport, competition, illness, and changes in routine — elevates cortisol and reduces protective mechanisms. NSAID use (phenylbutazone, flunixin) impairs glandular blood flow. Stall confinement and limited turnout increase stress and decrease forage intake.
Treatment and Prevention
Omeprazole (GastroGard, UlcerGard) is the gold standard — it suppresses acid production, allowing ulcers to heal. Treatment lasts 28 days for squamous ulcers; glandular ulcers may need 6-8 weeks. Sucralfate coats and protects glandular ulcers. Feed frequent, small meals rather than large grain meals. Provide free-choice forage. Alfalfa hay is particularly effective due to high calcium and protein content. Reduce grain and increase fat for energy. Allow turnout and social contact.
When to See a Vet Immediately
- Your horse shows girthiness or resentment of the saddle
- There's poor appetite, especially for grain
- Weight loss with no other explanation
- Behavioral changes or decreased performance
- Recurrent mild colic episodes
How RVC Can Help
This article is for educational purposes only and does not replace professional veterinary advice. If your pet is showing any symptoms, please contact Royal Veterinary Center immediately at +853 6677 6611.