Gastric Ulcers

Equine squamous gastric ulcers (EGUS) are a common condition, particularly in performance horses or those on restricted grazing routines. Studies show that up to 90% of horses in work are affected. Squamous ulcers specifically impact the upper, non-glandular part of the stomach and are often linked to modern management practices – extended fasting periods, high-grain diets, stress from transport or training, and limited forage access.

What Causes Squamous Ulcers?

The equine stomach produces gastric acid continuously. Without sufficient fibre to buffer this acid, especially during fasting or stressful periods, the acid splashes up and damages the squamous lining. Unlike glandular ulcers – which occur in the lower, acid-secreting region – squamous ulcers are more predictable, both in cause and treatment.

Diagnosis: Scoping is the Gold Standard

While some horse owners begin treatment based on observed symptoms (girthiness, poor appetite, behaviour changes, or reluctance under saddle), gastroscopy remains the only definitive diagnostic method. Scoping allows for precise identification of the ulcer location, grading of severity, and targeted treatment. This is especially important to distinguish squamous from glandular ulcers, as the latter requires different management.

Treatment: What Works

For confirmed squamous ulcers, the gold standard treatment is omeprazole, a proton pump inhibitor that significantly reduces gastric acid production. Veterinary-grade, prescription-only omeprazole (e.g., Gastropell Forte and Ulcershield) delivers high bioavailability and consistency, which is critical for effective healing. Over-the-counter omeprazole products (like Gastropell Daily, Cale Gastro, and Equestra) are also available, particularly for horses with mild symptoms or a history of ulcer recurrence.
Important note: These OTC products vary in dosage and formulation. For treatment-grade results, veterinary consultation is recommended.

What About Supplements?

Supportive supplements, such as gastric buffers, lecithin/pectin complexes, or pre/probiotic blends, can help protect the stomach lining and reduce recurrence. However, they are not a substitute for omeprazole during active ulceration. Products like KER Neigh-Lox, Digestive EQ and Maxia Digest can be helpful in a maintenance setting or as part of a preventive routine.

Management Changes Matter

• Even the best treatment protocol will fail without environmental and nutritional support:
• Free access to quality forage is critical.
• Limit grain-based or high-starch feeds.
• Avoid long periods without food, especially before exercise or transport.
• Minimise stress through consistent routines and thoughtful training schedules.