Gastric ulcers are a common and painful problem in horses
Gastric ulcers are unfortunately very common in horses. According to some studies, as many as 70–90% of competition horses suffer from gastric ulcers, but the condition is also frequently found in foals and leisure horses. In the past, gastric ulcers were considered a relatively unfamiliar disease; in reality, their increased prevalence largely reflects improvements in diagnostic techniques as veterinary technology has advanced.
The horse’s transition from a wild grazing animal that eats continuously to a domesticated horse fed at restricted intervals has not been entirely without problems. Gastric ulcers can often be suspected based on certain clinical signs, but a definitive diagnosis can only be made through gastroscopy performed by a veterinarian. Common symptoms of gastric ulcers include poor appetite, teeth grinding, irritability, loose manure, and reduced performance.
In nature, a horse would eat almost continuously
In the wild, horses would graze and consume forage almost constantly. A horse’s stomach secretes hydrochloric acid continuously, which means that when a horse is without feed, gastric pH drops rapidly. The natural acidity of the stomach varies between pH 1.5 and 7 depending on the measurement location, as different parts of the stomach have different acidity levels. Feed material present in the stomach protects the stomach lining from acid exposure (including during exercise). When a horse spends long periods with an empty stomach, acids can act unchecked without this protective buffer.
For horses suffering from or predisposed to gastric ulcers, it is therefore advisable to provide hay before exercise to reduce acid splashing in an empty stomach. Gastric ulcers are fundamentally associated with an imbalance between factors that protect the stomach lining and those that damage it.
Stress is often considered the primary cause of gastric ulcers. While stress has not been conclusively proven as a direct cause, stressed horses often eat and drink poorly, which increases their susceptibility to ulcers. Reduced feed intake also decreases saliva production, and saliva plays an important role in buffering gastric acids. A high proportion of concentrates relative to forage weakens the buffering effect of hay and may exacerbate existing ulcers. In foals, congenital factors may also contribute.
The severity of gastric ulcers is classified based on the number, depth, and extent of ulcerated areas, and treatment is always planned according to the extent of the disease.
Veterinarians most commonly prescribe medications such as GastroGard and ranitidine (acid suppressants). Sucralfate may also be used to form a protective coating over ulcerated areas. Fenugreek seed may also be beneficial in some cases. Some horses recover after a single treatment course, while in others the condition recurs depending on circumstances. Some horses require medication only temporarily, others for the rest of their lives, and unfortunately not all horses recover sufficiently to be usable riding horses.
For this reason, it is essential to minimize stressors and to support conditions under which the individual horse can function best. One of the most effective ways to prevent the onset or recurrence of gastric ulcers is free-choice hay feeding. Horses should receive hay at least every 5–6 hours to avoid excessively long fasting periods. Most horses do better on pasture, but year-round grazing is not possible in the Finnish climate.
Forage should ideally be offered about 30 minutes before concentrates, and concentrates should be divided into several small meals. Hay consumption time can be extended by using small-mesh hay nets. In cases of acute gastric ulcers, concentrates are often completely removed from the diet, with sugars and rapidly fermentable carbohydrates being the first to be eliminated. Additional energy needs are then met using oil-, protein-, and fiber-based feeds. Good options include chia, hemp, alfalfa, and flax. Horses with gastric ulcers should avoid heavy electrolyte supplementation immediately after exercise, and feeds that protect the stomach lining or promote mucus production can be added to the diet.
When nutritional management is followed consistently, results often begin to appear within a few weeks. Changes are usually first observed in the composition, color, and odor of manure and urine. Once gastric ulcers are under control, it is important to carefully reassess both the horse’s living conditions and its long-term feeding plan to prevent future problems.
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