Detecting and Managing Ulcers in Horses

            Imagine trying to run a race when you are having extremely bad heartburn. The pain alone would keep you from performing to the best of your ability. Now, consider the same condition for your horse, with a gastric ulcer. Around 60% of performance horses have been shown to have gastric ulcers. There are many compounding factors that can cause ulcers in horses, such as meal frequency, feeds, exercise, and medications.

            The majority of horses with gastric ulcers don’t show outward signs and can appear healthy. However, there is an array of subtle signs that could indicate that your horse has ulcers, such as poor appetite, attitude changes, decreased performance, reluctance to train, poor body condition, poor hair coat, weight loss, consistently stretching out, excessive laying down, low-grade colic, and loose feces. Any sign of combination of these signs could mean that your horse has ulcers. Horses with more severe cases can show abdominal pain and/or grinding of their teeth. If you suspect that your horse may have ulcers, the only definitive way to diagnose ulcers is having your veterinarian scope your horse. By scoping the horse, your veterinarian is able to examine the lining of the esophagus, stomach, and a little portion of the small intestine in order to determine if ulcers are present.


            One of the greatest factors causing ulcers in performance horses is meal feeding. Typically, horses are fed on a meal basis because of the convenience to fit into our busy schedules as horse owners. However, when horses are allowed the opportunity to graze freely or eat hay throughout the day, they rarely have problems with ulcers. The reasoning for this is that horses are naturally designed to consume feed continuously. Their stomachs are very small in comparison to the rest of the digestive tract. In addition, the horse’s stomach produces gastric acid at all times. Without consistent access to feed, the small stomach is emptied and exposes the lining of the stomach, which can then easily be eroded by the acid. When horses are grazing throughout the day, they also are stimulating saliva production, the best natural buffer for stomach acid. By letting a horse have continuous access to feed, you allow them to better regulate their body and better protect themselves against ulcers.

            Another factor contributing to ulcers is the types of feed your horse is eating. Concentrates not only stimulate gastric acid production, but also require minimal chewing and therefore less saliva is produced. Saliva production during concentrate consumption is decrease by half in comparison to saliva production when consuming hay. Therefore, horse owners are better off to feed free-choice hay and limit their horses to no more than a few pounds of concentrate per day, broken up into at least two feedings. Research has also shown that adding alfalfa hay can help to decrease the risk of ulcers. Alfalfa helps to act as an antacid because of the high levels of calcium, which help buffer the stomach acid.

horse eating

            Stresses such as high-intensity exercise also can contribute to ulcers. Ulcers most commonly occur in the top portion of the stomach because the lining doesn’t have as much protection from the stomach acids. As the horse is worked, acid splashes around in the stomach, and the upper portion of the stomach that is not typically exposed to acid comes in contact with the erosive juices, making the exercised horse more susceptible to ulcerations than a sedentary horse. In addition, exercise stimulates gastric acid production and decreases the amount of blood flow to the GI tract, further increasing the chance of ulcers. Therefore, we need to handle all other aspects of horse management and provide probiotics to maximize gut functions in order to minimize the risk of ulcers during much-needed conditioning and training.

            In using a performance horse, there are always the common soreness and ails that need to be treated. However, chronic use of NSAIDS, such as bute and banamine, can contribute to ulcers. These NSAIDS block the production of Prostaglandin E2 and decrease the stomach’s protective mucus layer. Low levels of Prostaglandin E2 increase acid production. The combination of increased acid and a decreased protective layer further increase the chances of ulceration. Therefore, only use NSAIDs when absolutely necessary. If you need to use an anti-inflammatory continuously, talk to your veterinarian about other NSAID options, such as Previcox.

            When managing horses with ulcers, these are all important factors that need to be considered and managed to the best of your ability. There are multiple options in treating ulcers, which will allow you to choose the best option for you and your horse. Acid pump inhibitors, such as omeprazole, inhibit the production of gastric acid completely. This is typically prescribed for 3-4 weeks after a veterinarian diagnoses ulcers. Another option is histamine blockers. Histamine blockers limit the production of stomach acid. Antacids help buffer the acid; however, they are very short-acting. Although typically impractical for the long term, the horse may benefit when given antacids before a stressful event such as a competition. Aloe vera juice or gel may help to soothe ulcers as well. It is important to provide horses with ulcers a vitamin-mineral supplement and to minimize grain. Add calories with oil if need be. Also, feed the horse a supplement that provides probiotics to aid in digestion.

            When managed correctly, ulcers in horses can be healed and very commonly prevented from occurring again. While ulcers are essentially “man-made,” they are very manageable. With proper nutrition, access to free-choice hay, feeding a vitamin-mineral supplement with little grain, digestive aids such as probiotics, minimal use of NSAIDS, and an array of treatment options, you will be able to regain a happy, healthy horse that is able to compete at its highest level.

About Dr. Kelsey J. Nonella Ph.D., P.A.S.

Kelsey J. Nonella, Ph.D. is an equine nutritionist who was riding horses before she could walk. Her love for horses drives her to help educate people on what their horses’ needs in order to have happy, healthy horses. Kelsey went to Cal Poly receiving a Bachelor’s of Science in Animal Science and then onto West Texas A&M, where she got her Masters and eventually her Doctorates in Equine Science. At A&M, Dr. Nonella did extensive research on Selenium within horses. Click here to view her research. Kelsey’s colleagues have mentioned her as one of the United States equine Selenium experts.
View all posts by Dr. Kelsey J. Nonella Ph.D., P.A.S.

4 Responses to “Detecting and Managing Ulcers in Horses”

  1. Martha Harrison says:

    I would like to know if you see your product localy? I m interested in the gut guard. Thank you.

    • mm Dr. Kelsey J. Nonella Ph.D., P.A.S. says:

      Most stores don’t carry Gut Guard. However, you can request it from your local feed store, or order it from our website.

      Thank you for your interest.

  2. Becki Holte says:

    Question on ulcers, 9 year old barrel horse ,came off track, long history to get where we are now, short story thinking hind gut ulcers, product info please and for a horse with heaves,2 separate horses!!

    • mm Dr. Kelsey J. Nonella Ph.D., P.A.S. says:


      Thank you for reaching out. I would recommend Gut Guard or Super Weight Gain. The probiotic package will help to stabilize her gut flora to help develop an ideal hind gut flora. In addition, I have had good luck with aloe vera juice. I would also recommend Flaxen Flow for both of your horses. The Flaxen Flow will help with inflammation for both horses, and for the horse with heaves help to provide anti-histamine properties. Thank you for the question.

      Sincerely, Dr. Kelsey Nonella

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