Equine Gastric Ulcer Syndrome (EGUS)
by Dr Maddy Gehin
If your horse seems grouchy, picky about feed, resistant under saddle, or just “not quite right,” stomach ulcers may be part of the picture.
Equine Gastric Ulcer Syndrome (EGUS) is one of the most common conditions we see in horses. In fact, gastric ulcers can affect horses of any age, breed, or discipline—from backyard companions to high-level performance horses. Understanding the signs, risk factors, and treatment options can help keep your horse comfortable and performing at their best.
What Is EGUS?
Equine Gastric Ulcer Syndrome (EGUS) is a term used to describe ulceration of the stomach lining. We now know that there are two distinct types of gastric ulcer disease:
Equine Squamous Gastric Disease (ESGD)
Occurs in the upper portion of the stomach
Most commonly associated with acid exposure
Frequently seen in performance horses
Equine Glandular Gastric Disease (EGGD)
Occurs in the lower portion of the stomach
Thought to be related to disruption of the stomach's protective mechanisms
Can be more challenging to treat than squamous ulcers
Why Do Horses Get Ulcers?
Horses are designed to graze almost continuously. Their stomachs produce acid around the clock, whether they are eating or not. In a natural grazing environment, forage and saliva help buffer that acid. Modern management practices can increase ulcer risk, including:
Long periods without forage
High-grain diets
Intense exercise or training
Frequent travel
Competition schedules
Stall confinement
Changes in routine
Illness or chronic pain
What Are the Signs?
One of the challenges with EGUS is that the signs can be subtle and vary from horse to horse. Common signs can include:
Poor performance
Resistance during riding
Changes in attitude or behavior
Girthiness
Poor appetite or picky eating
Weight loss or difficulty maintaining condition
Mild recurrent colic
Dull hair coat
Teeth grinding
Sensitivity around the abdomen, particularly on the left side
Reduced willingness to work
It's important to remember that these signs are not specific to ulcers and can be associated with many other conditions. A veterinary examination is the best place to start.
How Are Ulcers Diagnosed?
The gold standard for diagnosing gastric ulcers is gastroscopy, often referred to as "scoping." During this procedure, a specialized camera is passed into the stomach, allowing your veterinarian to directly visualize the stomach lining and determine whether ulcers are present, how severe they are, and where they are located. Because treatment recommendations can vary depending on the type of ulcer present, obtaining an accurate diagnosis is extremely valuable.
How Are Ulcers Treated?
Treatment typically involves a combination of medication and management changes. The only medication that is proved to heal gastric ulcers is omeprazole (GastroGard), which reduces stomach acid production and allows ulcers to heal. Horses with glandular ulcers may require additional medications depending on the severity and location of lesions. Treatment plans are tailored to each horse, and follow-up gastroscopy is often used to assess healing.
Prevention: The Key to Long-Term Success
One of the most frustrating aspects of EGUS is that ulcers can return if the underlying risk factors aren't addressed. Ways to help reduce ulcer risk include:
Provide Consistent Access to Forage- Horses should spend as little time as possible with an empty stomach. Slow feeders and multiple hay feedings can help extend forage availability.
Increase Turnout- Whenever possible, turnout encourages natural grazing behavior and can reduce stress.
Feed Before Exercise- Providing a small amount of hay (especially alfalfa) before riding may help create a protective "mat" within the stomach and reduce acid splash.
Minimize Stress- Travel, competition, changes in herd dynamics, and prolonged stall confinement can all contribute to ulcer development.
Work With Your Veterinarian- Some horses—particularly those that travel frequently or compete regularly—may benefit from preventative strategies during high-stress periods.
The Bottom Line
Ulcers are common, but they are not something horses simply have to live with. Many horses show significant improvement in comfort, attitude, appetite, and performance once ulcers are properly diagnosed and treated.
If your horse is showing behavioral changes, recurrent mild colic, poor performance, or unexplained weight loss, gastric ulcers may be worth investigating. The best way to know if your horse has ulcers is to schedule a gastroscopy exam.
At Shoreline Equine, we're happy to discuss whether gastroscopy or further evaluation may be appropriate for your horse and help develop a treatment and management plan tailored to their needs.
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