Stomach Ulcers in Horses and How to Treat Them

A slight burning sensation in the stomach or a common case of heartburn can cause so much discomfort, and pain to us. Imagine a horse suffering a stomach ulcer and running in races and competitive events.

head of horse looking over the stable doors on the background of other horses

Ulcers can affect horses of any age and aren’t necessarily associated with older horses. In fact, the foals are more susceptible to stomach ulcers as they begin secreting equine gastric acid within 2 days of birth and the acidity of the gastric acid is higher than normal. The ulcer syndrome is a condition prevalent in 70-90% of the horses. Ulcers in horses are very common among horses and only four to ten percent of these heal without any formal treatment.

Why Do Horses Get Ulcers?

You might be wondering why ulcers are so common amidst horses. Well, horses have a tiny stomach as compared to their bodies. A horse’s stomach can hold up to 15 liters or 4 gallons of water and food and is divided into two sections. The glandular and the non-glandular portion. The glandular portion of the stomach produces hydrochloric acid which helps in food digestion. However, if the horse doesn’t eat enough food or the feed dissents with the horse, it builds up within the stomach. The accumulated acid causes the stomach lining to inflame and turn into ulcers. There are two types of gastric ulcers in horses.

-Equine Glandular Gastric Ulcer Syndrome-


The equine glandular gastric ulcer is a rare form of gastric ulcers in horses. This is because it is caused in the lower glandular of the stomach which can endure the harsh acids that are released in the stomach. This makes the stomach less prone to become sore. EGGUS occurs more in racehorses that endurance horses.

-Equine Squamous Gastric Ulcer Syndrome-


The equine squamous gastric ulcer is the most common ulcer found in horses. Squamous is believed to be an extension of the esophagus lining and is situated on the upper part of the stomach. Studies have shown that endurance horses are 48 percent more prone to ESGUS during the offseason, whereas the rate rises up to 66-93 percent during the competitive racing season.

What Causes Gastric Ulcers in Horses?

As mentioned above, gastric ulcers are caused due accumulation of acids that are produced inside the stomach. However, there’s more than just building up of acids inside the stomach. The horse’s stomach is divided into two parts, the granular part, and the non-granular part.

The former produces enzymes like pepsin and hydrochloric acid that help with digestion in horses. The granular part is also coated with mucus and bicarbonates that protect it from the adverse effects of HCl. Unfortunately, the non-granular part is not protected by any such membrane or lining, which is why it is more prone to ulcers.

Causes that lead to ulcers are:

  • Prolonged feeding of concentrates
  • Starvation and low frequency of feeding the horses, i.e., three times a day
  • Stress, exhaustion due to excessive training, long periods of confinement and less or no socialization with fellow horses.
  • Excessive use of Non-Steroidal Anti Inflammatory Drugs.

What are the Symptoms of Gastric Ulcers in Horses?

arab horse in sunset

The following symptoms are easily recognizable by experienced riders, horse keepers, stable managers, and owners. In case you are a newbie or dealing with a sick horse for the first time, here is a list of symptoms you should look for in your horse.

  • A poor appetite
  • Sporadic stomach ache
  • A sudden change in attitude
  • Decreased performance
  • Weight or muscle loss
  • Dull hair coat
  • Cribbing or weaving
  • Anemia
  • Unusual teeth grinding
  • Discomfort near flanks
  • Periodic limping in the hind end
  • Regularly attempting to lay on his back (in foals)
  • Reluctance to bend, extend or collect
  • Lack of energy or stamina
  • Diarrhea

If you suspect that your horse is experiencing any of the above symptoms, take him to the vet for diagnosis.

Diagnosis of Gastric Ulcers

The diagnosis of gastric ulcers should be made through a vet and not through a bunch of symptoms you notice in your horse. The majority of horses suffering from the condition don’t show outward symptoms. The symptoms are more subtle and might go unnoticed. A poor appetite, and poor hair coat or sudden change in your horse’s behavior is some of the initial symptoms.

However, the only way to ensure the condition is through gastric endoscopy or gastroscopy. The procedure involves placing an endoscope into the stomach through the nostril. The endoscope shows the inside of the stomach on a monitor.

The endoscopic procedure allows you to see the esophagus, squamous and see the glandular regions of the stomach. To allow this, the stomach must be empty, so most horses are held off feed for 12 to 24 hours and not allowed to drink water for two to three hours. It is a safe procedure which takes around 10-20 minutes. Once the diagnosis is confirmed, the treatment will commence, and the practitioner will look for clinical changes in the horse. Once the horses start showing improvement, they should be scoped before discontinuing the treatment.

Treatment of Ulcers in Horses

Treatment of horse ulcers can be short term as well as, long term in nature. The prescription and nature of medicine also depend on what type of gastric ulcer your horse is suffering from. It can either be EGGUS or ESGUS. Some methods may include:

-Acid Inhibitors-

Acid inhibitors are also called Proton pump inhibitors that are prescribed to decrease the number of acids the body produces in the stomach. Omeprazole is such medicine that is advised for the EGGUS type of gastric ulcer by the doctor. As a result, it happens to be the only treatment produced by the FDA for horse ulcer symptoms.

-H2 Blockers-

Histamine is a compound produced by body tissues that encourage the stomach to produce more acid. Cimetidine, ranitidine, and famotidine are standard H2 blockers are the usual H2 blockers that doctors prescribe to block histamine in your horse.


Antacids work to balance or decrease the pH of gastric acids in horses. However, they can’t be used for the long-run as the stomach is constantly producing acids and to keep up with the acid production, large quantities of antacids are needed. Maalox and Mylanta are two popular antacids.

Nutritional Treatment:

Apart from the chemical treatment, it is necessary to provide nutritional treatment to horses. Having regular access to good quality pastures for grazing is considered important. 4 to 6 meals a day helps in utilizing and controlling the gastric acid in the stomach. Horses that are fed hay should also be given 1.5 kg (DM)/100 kg body weight per day. In the case of overweight horses and ponies, low-quality forage that is mature and low in energy should be given. To substitute low-quality forage due to lack of availability, straw can be used as a suitable alternative.

Vegetable oil-like corn oil and linseed oil also help in reducing the risk of EGGD. Ponies that are fed with gastric cannulas “45 mL corn oil” PO once a day by dose syringe have significantly lower gastric acid output as compared to the ones that aren’t.

Preventive Care for Horse Ulcers

Prevention is better than cure; therefore it’s always advised to take preventive measures from the beginning. Preventive care should be a part of every horse’s daily regime, both before and after the diagnosis. Here is a list of things and measures you take to improve your horse’s health.

  • Resting your horse for at least a week will ensure better recovery and no reflux of acids will reach the non-granular part of the stomach. Rigorous training and exercise put a lot of pressure on the stomach that causes a lot of acids to reflux. This reflux is best avoided by rest and care.
  • Feed your horse enough and don’t starve him. Provide high-quality hay, like alfalfa throughout the day. Make sure your horse’s stomach is always full as the floating hay will create a protective membrane in the horse’s stomach and reflux of acids.
  • Horses must eat the way they designed to, like lightly grazing through the fresh pastures of grass and natural herbs. Horses are often fed on the owner’s terms which sometimes aren’t sufficient enough. Since acid is produced in the stomach, limited feeding can cause ulcers in horses easily. Therefore, if circumstances allow you, let your horse graze in the open or feed him with fresh hay or grass throughout the day.

red dog

Horse Supplements

  • Give your horse probiotics in the form of yogurt products that include Lactobacillus spp. Probiotic supplements help with fighting against ulcer-forming bacteria and are great for preventing gastric ulcers.
  • Grains concentrates and sweet food should be fed as sparingly as possible.
  • Studies show that horses that have hardly competed and have been brought up in their homely environment have only 11 percent chances of ESGD.

Horses are strong and graceful animals that are naturally born to graze in the open. Restricting their diet and ways of eating will cause more harm than do good. Make sure that you act like a responsible horse owner and not limit their diet just because you are lazy to feed them throughout the day.

Author Bio:
Harsh Arora is a proud father of four rescued dogs and a leopard gecko. So, besides being a full-time dog father, he’s a freelance content writer/blogger and educationist, with more than 6 years experience in the field.

 Related Products

Finish Line U-7 Gastric Acid Liquid

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SuperMask II – Mask for Horses

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