Equine Gastric Ulcer Syndrome


In this feature, Kristen Brennan, RW customer and PhD in Animal Sciences, returns to discuss the prevalance of stomach ulcers in horses and how you can manage them. Read on to learn more!

Equine Gastric Ulcer Syndrome (EGUS)

If you don’t think you need to be concerned about equine gastric ulcer syndrome (EGUS), think again.

Ulcers are extremely common, with an
estimated 50 to 90% of horses being affected.​

Equine Gastric Ulcer Syndrome is a condition where ulcers form in the stomach and sometimes in the upper part of the small intestine. The stomach of a horse contains glandular and non-glandular regions, with ridge called the margo plicatus dividing the two sections. The larger glandular region is covered in a protective mucosal barrier, as it contains glands that continuously secrete acid to help breakdown feed. Ulcers are mostly found in the non-glandular region and are thought to form when the factors that help maintain the protective barrier, such as blood flow and mucus production, are decreased. The biggest problem? Most of what we do today with horses can increase the risk of ulcers - how we feed them, how we keep them, and how we use them.

This means ulcers are prevalent in all horses,
regardless of breed or age, though they
tend to be greatest in performance horses.​


The way horses are managed can greatly influence the risk of ulcers

As if that wasn’t bad enough, the clinical signs of ulcers are often vague making them an issue that can go undiagnosed for long periods of time. Symptoms of EGUS include poor performance, changes in behavior, mild colic, decreased feed intake, and weight loss, but up to half of horses with EGUS show no signs at all.

The only way to truly determine if a horse
has ulcers is through a gastroscopy
conducted by your veterinarian.​

With this procedure, an endoscope is passed down the esophagus into the stomach to view the stomach lining, check for abnormalities, and determine the location, number and severity of ulcers.


Your horse may suffer from ulcers but show no day-to-day symptoms

How can you treat and prevent ulcers?

After your horse has been scoped and your vet determines he has EGUS, what do you do? The first step is to treat with medication to heal them. Currently, the only approved medication for EGUS is a drug called Gastrogard. Gastrogard contains a compound called Omeprazole, which decreases the production of stomach acid. Given once a day for 28 days, Gastrogard should heal ulcers, but its best to check by re-scoping after the 28-day treatment.

What can make EGUS a real challenge is that there is a high rate of reoccurrence without changes in management involving nutritional and environmental considerations. The first step to prevent reoccurrence should be to identify risk factors and try to change them.

One of the simplest things to do is
feeding your horse more frequently.​

Meal feeding once or twice a day means that the stomach remains empty for long periods of time with no feed or saliva to neutralize the acid that is continuously produced. Ideally, a horse should have access to pasture 24/7, but many times this isn’t possible so providing free choice hay, especially alfalfa because of its high calcium (another buffering agent) content, can help. High concentrate diets can increase the occurrence of EGUS as some of the simple carbohydrates wind up being fermented in the stomach, leading to a drop in pH causing damage to the mucosal layer.

Stress can also increase EGUS occurrence.​

Though not always avoidable, things like introducing a new horse to a herd, stall confinement, or transport can be stressful and cause increase risk of ulcers. Performance horses are at a high risk for developing ulcers, not only because of many of the factors above, but because the decreased volume and contraction of the stomach during exercise exposes the non-glandular region to acid. To help decrease the chance of your horse developing ulcers, a dose of UlcerGard Equine Gastric Omeprazole can be given prior to transport, competing or any other event that might cause stress.

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UlcerGard can help neutralize stomach acid to prevent ulcers during times of stress

Nutrition can be a big factor in managing ulcers. Aside from the management aspects mentioned above, there has been a lot of interest in supplement strategies to help combat EGUS. Antacid supplements, such as Cox Veterinary Gastroade Pellets Equine Ulcer Relief, that contain ingredients like calcium carbonate can help prevent a drop in stomach pH after feeding and help maintain the protective mucosal layer when fed frequently during the day.

The biggest challenge when it comes
to supplements to prevent EGUS is
the limited research available.​

Lucky for us, the equine and veterinary science communities recognize gut health and EGUS as hot topics for research, so more studies are coming. For now, the limited research out there suggests that some nutritional strategies can help with EGUS prevention. For instance, a study of show jumpers found that feeding beet pulp decreased the odds of developing ulcers, though the mechanism needs to be studied further. Aloe vera, found in products such as Cox Veterinary Gastroade Liquid Equine Ulcer Relief, has been investigated in the fight against EGUS, and while research has shown that it's not as effective as Omeprazole for healing ulcers, it may help some horses.


Sponsored rider Andrea Baxter giving her horse a dose of UlcerGard before they head off to a show

I don’t know about all of you, but when I think about EGUS, I get a bit overwhelmed. My horses are show horses, and I expose them to stressors daily. I haul to lessons, I take them to new show venues, and I exercise them intensely almost every day. However, I remind myself that there are ways to reduce the chances of my horses developing ulcers by changing how they are fed and how they are managed. When that isn’t possible, its good to know there are pharmaceutical and nutritional options available to help prevent the chance of developing EGUS.


Kristen and one of her show horses, Frankie, a big bay OTTB
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