Ulcer Management Guide for Performance Horses

by Caitlyn Andrews November 17, 2017

Ulcer Management Prevention Horses

Could your horse be suffering from painful ulcers?

Your horse could have ulcers right now and not show any signs. This guide will tell you the most important things you need to know about ulcers. You'll learn why ulcers are so common in performance horses and how to prevent, manage, and treat them.

Ulcers in Horses

What are ulcers in horses?

Equine gastric ulcer syndrome is a common condition in horses. It can affect horses of all ages but is particularly common in performance horses. Ulcers are essentially sores in the lining of the stomach.

Ulcers typically appear in the upper portion of the stomach. This part of the stomach lacks thick mucus and bicarbonate layers to protect it from acid. The top part of the stomach is responsible for mixing the stomach contents. It has a thin lining and is subject to erosion since the horse is constantly producing gastric acid, even when it isn't eating.

The bottom part of the stomach secretes gastric acid. This means it's constantly exposed to the acid, but ulcers are rarely formed here. Unlike the upper part of the stomach, the lower part produces bicarbonate and mucus for protection.

Feed and saliva act to naturally protect the stomach lining from gastric acid. Frequent feeding or grazing acts as consistent protection against the acid. When horses are fed large meals twice, or even once a day, the acid is still produced but there is nothing to protect the stomach lining from the gastric acid.

Why Do Performance Horses Get Ulcers?

Horses of all ages and disciplines can get ulcers. The nature of equine digestive systems make them prone to getting ulcers if they eat infrequent meals.

However, performance horses are well-known for having ulcers. Why? Gastric ulcers occur in performance horses for several reasons.


One reason is that exercise has a tendency to increase gastric acid production while decreasing blood flow to the GI tract. A horse's body will concentrate blood flow to the heart and muscles during exercise, reducing the flow to the stomach.

As the horse moves during exercise the stomach compresses. This can cause the acid that normally rests in the lower portion of the stomach to splash up into the upper portion. 


Aside from the direct effects of exercise that contribute to ulcer formations, the diet of a performance horse can also lead to ulcers. When horses are fed twice a day the stomach is exposed to long periods without feed or saliva to buffer the gastric acid. Horses that spend a significant amount of time training, competing, or stalled are often unable to eat frequent meals.

The frequency of feeding affects ulcers and so does the type of feed. Horses fed a diet high in carbohydrates or grain have an increased chance of developing ulcers.


Stress is a contributing factor in ulcer development. It comes as no surprise that performance horses can be under a significant amount of stress. Performance horses, particularly those competing at high levels or on a regular basis, are constantly hauled and subjected to new, stressful environments.


Many riders rely on the aid of certain drugs to keep their horses feeling their best. The long-term use of non-steroidal and anti-inflammatory drugs such as phenylbutazone (Bute) and flunixin meglumine (Banamine) can decrease the amount of mucus produced in the stomach.

Performance Horse Barrel Racing

Intense exercise and high-stress environments can lead to ulcers in performance horses.

Symptoms of Ulcers in Horses

The majority of horses with ulcers will not show serious signs. Some horses may appear to be completely healthy but suffer from ulcers. Severe symptoms include teeth grinding and severe colic. You are likely to notice more subtle signs such as:

  • Dull or poor coat quality
  • Attitude changes
  • Poor performance or reluctance
  • Weight loss
  • Abnormal amount of lying down
  • Loose stool
  • Decrease in appetite
  • Mild colic

Horses of any age can show signs of ulcers. Here are the symptoms to look for in foals:

  • Lying on their back
  • Colic after nursing or eating
  • Disrupted nursing
  • Decrease in appetite
  • Salivation
  • Teeth grinding
  • Loose stool or diarrhea

Horse Laying Down Ulcers

A horse lying down more than usual could be showing signs of ulcers.

Diagnosing Ulcers in Horses

If you notice signs of ulcers, particularly in foals, it's important that you have your vet examine the horse as soon as possible. When a foal exhibits the signs above it's likely that the ulcers are already severe. Clinical signs such as colic and teeth grinding can mean severe ulcers.

A vet will not be able to tell that your horse has ulcers simply by looking at them. There are other conditions with similar symptoms, so your vet will want to do a diagnostic procedure to determine if your horse has ulcers.

Gastroscopy, or a gastric endoscopy, is a procedure that allows vets to definitively diagnose ulcers. An endoscopy is a non-surgical, minimally invasive procedure that involves inserting a tube with a light and camera into the throat and the stomach. From the diagnosis, your vet will be able to recommend appropriate treatment.

Ulcer Treatment for Horses

Talk with your vet to determine the best method for treating ulcers for your horse. Your vet may recommend changes in management, medical treatments, or a combination of both.


You may need to reduce the amount of exercise or training. Taking time off of competing with your horse can help to get the ulcers under control. Any steps that you can take to reduce stress in your horse's life will be beneficial in treating the ulcers. Trailer less, turn out more and avoid overcrowding.

You can also change your horse's feeding routine. Supply smaller, frequent meals or switch your horse to pasture where possible. Cut back on high grain diets and provide more roughage instead.

Alfalfa is an excellent addition to the diet for horses that are able to have it. The protein and calcium found in alfalfa hay work as a buffer against gastric acid. It works similarly to an antacid.


Your vet may prescribe or recommend certain medications to treat the ulcers. Omeprazole (the active ingredient in UlcerGard) can be used to suppress gastric acid secretion. Omeprazole is FDA approved and a common treatment option. Your vet may want you to try a different acid pump inhibitor or other medication. Be sure to discuss the treatment options with your vet.

Often, a horse will not need to be treated for the rest of its life, but you should always take preventative measures.

How to Prevent Ulcers

The same management techniques used to treat ulcers can be used to prevent them.

  • Reduce the time between meals
  • Provide more roughage and alfalfa when possible
  • Try using a slow feed hay net to slow down feed intake (Hint: These work great to keep your horse occupied while tied to the trailer!)
  • Use supplements to replace the vitamins and minerals in grain
  • Try adding vegetable oils to the diet for calories instead of grain
  • Allow your horse to graze if possible
  • Limit stressful events
  • Reduce the amount of time your horse is stalled
  • Cut back on training or exercise when necessary
  • Watch for symptoms


There are a variety of supplements available to help manage and prevent ulcers. Some of these supplements, such as Soothing Pink Xtra Strength, are designed to improve total digestive tract health. Be sure to do your research. You might want to try different supplements at different times to find out which one works best for your horse.

Performance Horse Grazing for Health

Allowing performance horses to graze naturally can reduce the risk of ulcers.

Ulcers and Your Horse

If you suspect that your horse is suffering from gastric ulcers then the most important thing you can do is act quickly. Involve your vet and make any management changes necessary. It can also help to speak with an equine nutritionist about your horse's diet and specific needs.

Gastric ulcers are painful, but can often be prevented. Even if your horse isn't showing any symptoms or has never had ulcers in the past, taking preventative measures can improve their overall health and potentially stop ulcers from ever forming.

Caitlyn Andrews
Caitlyn Andrews


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