Complete Horse Health Guide

Understanding Ulcers in Horses: Causes, Diagnosis, Treatment, and Prevention

Table of Contents
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What are Ulcers in Horses?

Ulcers in horses refer to gastric ulcers, which are erosions or sores that develop in the lining of the horse’s stomach. These ulcers can occur in both the squamous and glandular regions of the stomach and are a common issue seen in horses, especially those involved in high-stress activities like racing, showing, or intense training.

Gastric ulcers in horses can be caused by various factors, with one of the primary causes being prolonged exposure of the stomach lining to stomach acid. This often happens when horses are fed infrequently or when they have to endure periods of time without access to forage, which is essential for maintaining a healthy stomach environment.

Additionally, high-grain diets, intensive exercise, and stressful situations can contribute to the development of ulcers. The physical stress and pressure placed on the abdomen during intense workouts can also contribute to ulcer formation.

Signs of Gastric Ulcers in Your Horse

Gastric ulcers in horses can manifest with a range of signs, and it’s essential for horse owners and caretakers to be observant for any changes in their horse’s behavior or health. Here are some detailed signs that may indicate the presence of gastric ulcers in your horse:
  • Poor Appetite: Horses with gastric ulcers often exhibit a reduced appetite or may become picky eaters. They may take longer to finish their meals or show disinterest in their usual feed. In some cases, they might even leave their feed partially uneaten.
  • Weight Loss and Poor Body Condition: Due to the discomfort associated with ulcers, horses may not consume enough nutrients to maintain their weight properly. Over time, this can lead to weight loss and a decrease in body condition, with the horse appearing thin and lacking muscle mass.
  • Change in Attitude and Behavior: Horses with gastric ulcers may display behavioral changes, such as increased irritability, moodiness, or sensitivity to touch. They may be less tolerant of grooming or saddling and may display signs of discomfort during these activities.
  • Reduced Performance: Performance horses, such as those involved in racing, show jumping, or dressage, may experience a decline in their usual performance levels. They may seem reluctant to work, lack enthusiasm, or exhibit a decreased willingness to cooperate during training sessions or competitions.
  • Grinding Teeth or Excessive Yawning: Horses in discomfort may grind their teeth, especially while eating or during stressful situations. Excessive yawning can also be a sign of pain or discomfort in the abdomen.
  • Girthiness and Abdominal Sensitivity: Horses with gastric ulcers may show signs of discomfort when the girth is tightened or when pressure is applied to their abdomen. They may become fidgety, pin their ears back, or even attempt to bite or kick.
  • Change in Manure Patterns: Some horses with gastric ulcers may have alterations in their manure patterns. They may produce loose, watery stools or have increased frequency in passing manure.
  • Excessive Salivation: Affected horses may salivate more than usual, leading to foamy saliva around the mouth.

It’s important to note that these signs can vary in severity and may not always be specific to gastric ulcers. Some of these symptoms can also be associated with other health issues, so a thorough veterinary evaluation is essential for an accurate diagnosis.

If you observe any of these signs in your horse, it’s crucial to consult with an equine veterinarian promptly. A veterinarian can perform a comprehensive examination, including an endoscopic evaluation, to confirm the presence of gastric ulcers and recommend appropriate treatment and management strategies to improve your horse’s well-being.

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Causes of Gastric Ulcers in Horses

The development of gastric ulcers in horses is multifactorial, and several factors can contribute to their occurrence. Here are some of the primary causes of gastric ulcers in horses:
  • Prolonged Stomach Acid Exposure: One of the leading causes of gastric ulcers in horses is prolonged exposure of the stomach lining to hydrochloric acid. Unlike humans, horses continuously produce stomach acid, even when not actively eating. When horses go for long periods without access to forage or are fed infrequently, the stomach remains empty, and acid can accumulate, leading to damage to the stomach lining.
  • Feeding Management: Poor feeding practices, such as infrequent or inadequate feeding, can contribute to the development of ulcers. Horses should have access to forage regularly to maintain a healthy stomach environment. Feeding high-grain diets without sufficient forage can also disrupt the natural buffering capacity of the stomach, making it more susceptible to ulceration.
  • Intensive Exercise: Horses engaged in rigorous exercise, such as racehorses, eventers, or show jumpers, experience increased physical stress. The high-intensity movements and the pressure placed on the abdomen during such activities can lead to a higher incidence of ulcers in these horses.
  • Stress and Anxiety: Horses are sensitive animals, and stress and anxiety can have a significant impact on their gastrointestinal health. Transport, changes in environment, social interactions, and other stressors can disrupt the normal function of the digestive system and increase the risk of ulcers.
  • Medication and Management Practices: Certain medications, such as non-steroidal anti-inflammatory drugs (NSAIDs), are known to be a risk factor for gastric ulcers in horses. Overuse or prolonged administration of NSAIDs can lead to a decrease in the protective mucus lining of the stomach, making it more susceptible to ulceration. Similarly, other management practices like stall confinement and limited turnout can contribute to stress and increase the likelihood of ulcers.
  • Individual Susceptibility: Some horses may have a higher predisposition to develop ulcers due to individual factors. Certain breeds or individual horses with naturally higher acid production or sensitivity to stress may be more prone to ulcer formation.
To prevent gastric ulcers in horses, it’s crucial to implement good management practices. Providing access to forage at all times, feeding multiple small meals throughout the day, and reducing stress levels are essential steps in minimizing the risk of ulcers. If a horse is at high risk or shows signs of ulcers, working closely with an equine veterinarian can help in early diagnosis and appropriate treatment, which may include medication to reduce stomach acid production and promote ulcer healing.
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Diagnosis of Gastric Ulcers in Horses

Diagnosing gastric ulcers in horses typically involves a combination of clinical evaluation, history-taking, and definitive diagnostic procedures. Here’s an overview of the diagnostic process:
  • Clinical Examination: The first step in diagnosing gastric ulcers is a thorough clinical examination by an equine veterinarian. The vet will gather information about the horse’s medical history, diet, exercise routine, and any recent changes in behavior or performance.
  • Physical Examination: During the physical examination, the vet will assess the horse’s overall health, body condition, and look for any signs of discomfort, sensitivity, or abnormalities in the abdomen or gastrointestinal tract.
  • Gastric Ulcer Scoring: Veterinarians often use a scoring system to assess the likelihood of gastric ulcers in horses. The scoring system involves the use of an endoscope, a flexible tube with a camera on the end, which is passed through the horse’s nostril and down into the stomach. The vet will examine the lining of the stomach and assign a score based on the severity and number of ulcers present.
  • Endoscopy: Endoscopy is the most definitive diagnostic procedure for confirming the presence of gastric ulcers. As mentioned earlier, the endoscope allows direct visualization of the stomach lining, enabling the vet to identify ulcerations, assess their severity, and determine their location within the stomach.
  • Biopsy (Optional): In some cases, the veterinarian may take tissue samples (biopsy) from the affected areas of the stomach lining. This is not always necessary for diagnosis, but it can be performed to rule out other potential causes of stomach abnormalities and to gather more detailed information about the ulcers.
  • Response to Treatment: Sometimes, the veterinarian may recommend a therapeutic trial to confirm the presence of ulcers. If the horse shows improvement in behavior and performance after receiving ulcer treatment, it can provide further evidence of the ulcer diagnosis.
It’s important to note that diagnosing gastric ulcers in horses requires the expertise of a qualified veterinarian and access to specialized equipment, such as an endoscope. If you suspect that your horse may have gastric ulcers based on the signs and symptoms mentioned earlier, it’s essential to consult with an equine veterinarian promptly. Early diagnosis and appropriate treatment can help improve the horse’s well-being and prevent the condition from worsening.
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Treatment for Ulcers in Horses

The treatment of gastric ulcers in horses involves a combination of management changes and medication to promote healing and reduce the risk of recurrence. Here are the main components of the treatment plan:
  • Medication:
    • Proton Pump Inhibitors (PPIs): e.g., omeprazole and esomeprazole, to reduce stomach acid production and promote ulcer healing.
    • Histamine Receptor Antagonists (H2 Blockers): e.g., ranitidine, which also decreases stomach acid production.
  • Diet Management:
    • Frequent Forage Access: Providing continuous access to forage or feeding multiple small meals throughout the day to reduce stomach acid exposure.
    • Low-Starch Diet: Minimizing high-starch grains to lower the risk of increased acid production.
  • Stress Reduction:
    • Managing stress by ensuring a calm routine, reducing exposure to stressful situations, and providing adequate turnout and social interaction.
  • Supportive Care:
    • Antacids: May be used for temporary relief from ulcer-related discomfort.
    • Gastrointestinal Protectants: Supplements containing substances like sucralfate to provide a protective coating to ulcerated areas.
  • Follow-Up Endoscopy:
    • Periodic endoscopy to assess ulcer healing progress and adjust treatment if necessary.
Remember to work closely with an equine veterinarian to develop a customized treatment plan based on your horse’s specific condition and needs. Long-term management and preventive measures are vital to reduce the risk of ulcer recurrence and maintain your horse’s gastrointestinal health.
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Prevention of Ulcers in Horses

Preventing gastric ulcers in horses involves implementing management practices that promote a healthy stomach environment and reduce stress. Here are some key preventive measures:
  • Regular Forage Access: Ensure that your horse has access to forage, such as pasture or hay, throughout the day. Continuous grazing or providing hay in frequent small meals helps to buffer stomach acid and prevent prolonged exposure of the stomach lining to acid.
  • Balanced Diet: Maintain a balanced diet for your horse, providing the appropriate amount of roughage and avoiding excessive high-starch grains. High-starch diets can increase acid production and make the stomach more susceptible to ulceration.
  • Stress Management: Minimize stress in your horse’s environment. Maintain a consistent routine, provide a safe and comfortable living space, and reduce exposure to stressful situations, such as sudden changes in training, transportation, or social interactions.
  • Turnout and Social Interaction: Regular turnout in a safe and natural environment allows horses to move, graze, and interact with other horses, which can help reduce stress and promote overall well-being.
  • Avoid Overuse of NSAIDs: Non-steroidal anti-inflammatory drugs (NSAIDs) can contribute to the development of ulcers. Use NSAIDs judiciously and under veterinary supervision to minimize the risk.
  • Regular Veterinary Check-ups: Schedule regular veterinary check-ups to monitor your horse’s health and address any potential issues early on. If there are concerns about ulcers or changes in behavior or performance, seek veterinary advice promptly.
  • Gastric Health Supplements: Some owners may opt to use gastric health supplements containing ingredients like antacids, probiotics, or soothing herbs. These supplements should be used in consultation with a veterinarian and should not replace proper management practices.
  • Observe Behavior and Performance: Be vigilant for any changes in your horse’s behavior, appetite, or performance. Early detection of signs associated with gastric ulcers can prompt timely intervention.
By proactively implementing these preventive measures, horse owners can significantly reduce the risk of gastric ulcers and promote the overall digestive health and well-being of their equine companions. Remember that each horse is unique, and working closely with an equine veterinarian will help tailor the best prevention plan for your horse’s specific needs.

Gastric ulcers in horses are a prevalent and concerning health issue that can have a significant impact on their well-being and performance. As we delve deeper into the understanding of equine health, it becomes clear that prevention, early detection, and appropriate treatment are vital in managing this condition effectively.

Being proactive in recognizing the signs of gastric ulcers and addressing potential risk factors is crucial for every horse owner and caretaker. A comprehensive approach to prevention, including providing continuous access to forage, maintaining a balanced diet, managing stress, and ensuring regular veterinary check-ups, can go a long way in reducing the incidence of ulcers and improving the overall gastrointestinal health of our equine companions.

For those horses already affected by gastric ulcers, timely diagnosis and treatment are paramount. Collaborating closely with experienced equine veterinarians and adhering to prescribed medications and dietary adjustments can facilitate a successful recovery and minimize the risk of recurrence.

As guardians of these magnificent creatures, it is our responsibility to promote their well-being by creating a nurturing and stress-free environment. By working together, embracing preventive measures, and staying vigilant to any changes in our horses, we can ensure they lead happy, healthy lives, allowing them to thrive and forge lasting bonds with their human partners. Gastric ulcer prevention and care are pivotal steps towards securing the health and happiness of our beloved equine companions, fostering a harmonious partnership built on trust and mutual understanding.


Bethany Hall

Bethany's journey began in a small farming community in Missouri, where she developed a deep connection with animals, especially horses. Over the years, Bethany has honed her expertise in horse care through hands-on experience and dedication to understanding the intricacies of equine health. She has spent countless hours studying equine nutrition, exercise, and behavior, all in pursuit of providing the best care possible for these beloved animals.
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