Endoscope picture of typical upper-wall ulcers – courtesy Dr Tim Brazil

Symptoms of Gastro-Intestinal Ulcers include:
- poor condition.
- general lack of appetite.
- windsucking & crib-biting, grinding teeth and excessive salivation.
- weaving and box-walking.
- lethargy, dull coat.
- acute or repetitive mild colic.
- loose droppings and fluid; scouring.
- Fractious behaviour, including bucking when ridden, objecting to girth tightening.
- Sensitive flanks, especially the right.
- Difficulty or resistance to bending and collection.

Causes of Equine Gastro-Intestinal Ulcers
- Frequent or excessive use of NSAID type drugs e.g.'Bute; these damage
- Can occur when feed bolted - lack of saliva to buffer stomach acid.
- Horse allowed to go hungry - no fibre in stomach to protect against damage by stomach acid -for example in the early hours before morning stables.
- Intensive exercise - can cause the stomach acid to splash onto the upper, unprotected stomach wall.
- Stress - causes contraction of abdominal muscles, in turn compressing the stomach and forcing acid up onto the upper wall.
- Feeding poor quality acidic haylage (mainly affects hind gut).

Horseheath Nutrition can provide advice on management & diets for horses experiencing the problems outlined above. You can telephone 07721 384508 or use the NUTRITION ENQUIRY form.

Diagnosis, Management & Treatment
Whilst the experienced horse owner/manager could well be able to identify gastric ulcers, the only sure way is gastroscopy which can only be performed by a vet.
Your horse's diet must first be assessed. Horses are naturally trickle feeders – in the wild they will graze until their stomachs are full. Once empty, they start feeding again. Strong hydrochloric acid is continuously produced; it kills harmful pathogens ingested with food; and initiate the digestion processes. Chewing forage generates saliva; this is alkaline and buffers the stomach acid. Long fibre produces a mat, or crust, on top of the stomach contents, which will reduce or prevent splashing onto the unprotected upper stomach wall which causes ulcers. It should always be mixed with hard feed; Chopped alfalfa is particularly suitable because of its high calcium content.
All horses should have a supply of forage 24/7. Restricted hay feeders, or nets either with a small mesh, or doubled should be used in stables to make overnight hay last well into the early hours, so that stomachs are never empty. A slice of 2 of straw can also be provided to maintain forage supply. A high calcium content will buffer the acid, reducing it's strength. Chopped alfalfa is particularly suitable. Grazing is beneficial.
Treatment; there is a wide range of supplements available, from the simple acid - suppressors such as aluminium & magnesium hydroxides & calcium carbonate to various herbal supplements with anti-inflammatory herbs such as slippery elm bark, chamomile etc & nutrients such as brewers & live yeast, arginine & glutamine. The efficacy of these is very variable. The author had some spectacular successes & abysmal failures with a product he formulated some years ago.
Vets will prescribe omeprazole for 28 days to suppress the acid & allow natural healing. Sucralfate will be added to treat glandular ulcers. This is the most effective & also expensive treatment but must be followed by changes to diet & management to prevent recurrence.
Some owners have been buying Abler omeprazole from North America; this is much cheaper but illegal without a vet's prescription. Substantial amounts were seized by the Border Force & Veterinary Medicines Directorate late in 2024

IF YOU NEED ADVICE ABOUT YOUR HORSE'S DIET & MANAGEMENT SUBMIT THE HORSEHEATH NUTRITION ENQUIRY FORM